Telma (Telmisartan)
Also sold as: Telma, Telsartan, Tazloc, Cresar, Telpres
Pregnancy
Cat D
Lactation
Avoid
Schedule
H
Forms
Tablet 20/40/80mg +1
Indications
- Hypertension
- Cardiovascular risk reduction (high-risk patients)
- Diabetic nephropathy
- Heart failure (alternative to ACEi)
Adult Dosing
HTN
40 mg PO once daily; titrate to 80 mg
Max 80 mg/day
CV risk reduction
80 mg PO once daily
Pediatric Dosing
Insufficient pediatric data
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| No specific dose adjustment by CrCl | Use cautiously in renal artery stenosis. Monitor K+ and creatinine within 1-2 weeks of starting. |
| eGFR < 30 | Use with caution; monitor K+ closely |
Hepatic Adjustment
Start at 20 mg in mild-moderate hepatic impairment. Avoid in severe.
Pregnancy & Lactation
Pregnancy: Category D
CONTRAINDICATED — fetal renal damage, oligohydramnios, skull hypoplasia. Switch to alternative (labetalol, methyldopa) immediately if pregnancy confirmed.
Lactation: Avoid
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| NSAIDs | AKI, reduced antihypertensive effect ("triple whammy" with diuretic) | Major |
| ACE inhibitors | AVOID combination (per ONTARGET trial — increased AKI, hyperkalemia) | Major |
| Potassium-sparing diuretics, K+ supplements | Hyperkalemia | Major |
| Lithium | Increased lithium toxicity | Moderate |
| Digoxin | Increased digoxin levels | Moderate |
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Side Effects
Common
- Dizziness
- Headache
- Hyperkalemia
- Back pain
Serious / Discontinue If
- Angioedema (rare, less than ACEi)
- Hyperkalemia
- AKI in renal artery stenosis
- Severe hypotension
Contraindications
- Pregnancy
- Bilateral renal artery stenosis
- Severe hepatic impairment
- Hypersensitivity
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Telma 40 | Glenmark | 15 tab ₹110 |
| Telsartan 40 | Sun Pharma | 15 tab ₹95 |
| Tazloc 40 | IPCA | 15 tab ₹85 |
| Cresar 40 | Cipla | 15 tab ₹105 |
Monitoring Required
- BP, K+, creatinine within 1-2 weeks of initiation/dose change
- Then every 3-6 months
Patient Counseling Points
- Take at the same time daily
- Avoid potassium supplements unless directed
- Stop immediately if pregnant
- Avoid OTC NSAIDs without doctor approval
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EasyClinic auto-flags Telma interactions, renal cutoffs, and pregnancy warnings the moment you write the prescription. Built-in safety net for every Indian doctor.
References
- BNF
- Lexicomp Drug Information
- Indian National Formulary
- IAP/RSSDI/CSI Guidelines