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Telmisartan - an angiotensin receptor blocker

Micardis, Tolura

The usual dose is one tablet daily. You can take telmisartan before or after meals.

Side-effects are usually mild. They include feeling dizzy and stomach upset.

Keep your regular appointments with your doctor to have your blood pressure measured.

Some painkillers interfere with telmisartan, so ask your pharmacist for advice before you buy any medicines.

Clinical author's note: Michael Stewart 15/11/2018: Following an MHRA update, new advice has been added to this leaflet for people also taking the blood pressure medicine hydrochlorothiazide. Hydrochlorothiazide is only available in the UK in combination with other blood pressure medicines such as telmisartan. It may be available on its own in other countries. For more information see 'Getting the most from your treatment' below or view the MHRA Alert.

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About telmisartan

Type of medicine

Angiotensin-II receptor antagonist (A2RA)

Used for

High blood pressure
To reduce the risk of heart attack or stroke

Also called

Micardis®, Tolura®
Combination brands: Micardis Plus®, , Tolucombi® (telmisartan with hydrochlorothiazide)

Available as


Telmisartan is an angiotensin receptor blocker (also called an angiotensin-II receptor antagonist (A2RA)). It is used to treat high blood pressure (hypertension). People with high blood pressure often do not feel unwell but, if left untreated, high blood pressure can harm the heart and damage blood vessels.

Telmisartan works by blocking the effect of a natural chemical made in your bloodstream, called angiotensin II. Angiotensin II causes your blood vessels to narrow, so by blocking this effect, telmisartan allows your blood vessels to relax and widen. As this happens, the pressure within your blood vessels is reduced. This also makes it easier for your heart to pump blood around your body.

Telmisartan is also used to help prevent heart attacks and strokes in people who may be at risk of these because of other medical conditions, such as diabetes.

Telmisartan is also available in a combination tablet with another medicine used to reduce high blood pressure, called hydrochlorothiazide. Taking combination tablets like this can help reduce the number of tablets you need to take each day.

Before taking telmisartan

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking telmisartan it is important that your doctor or pharmacist knows:

  • If you are pregnant, trying for a baby or breastfeeding.

  • If you have kidney problems or if you have a blockage of the artery which supplies blood to your kidneys.

  • If you have liver problems.

  • If you have any problems with your heart valves or heart muscle.

  • If you have high blood sugar levels (diabetes).

  • If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.

  • If you have ever had an allergic reaction to a medicine.

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How to take telmisartan

  • Before you start this treatment, read the manufacturer's printed information leaflet from inside the pack. The leaflet will give you more information about telmisartan and a full list of possible side-effects from taking it.

  • Take telmisartan exactly as your doctor has told you to. It is usual to take one tablet a day, although there are several strengths of tablet available. The usual starting dose for high blood pressure is 20-40 mg each day, although your doctor may decide to increase your dose after a few weeks. If you are taking telmisartan to reduce your risk of a heart attack or stroke, the usual dose is 80 mg each day

  • Each time you collect a prescription, check to make sure it is the strength of tablet that you are expecting.

  • Try to take telmisartan at the same time of day each day. This will help you to remember to take it regularly.

  • You can take telmisartan before or after meals.

  • If you forget to take a dose, take it as soon as you remember. If you do not remember until the following day, skip the missed dose. Do not take two doses together to make up for a forgotten dose.

Getting the most from your treatment

  • Try to keep your regular appointments with your doctor. This is so your progress can be monitored. Your doctor will want you to have some blood tests from time to time to check on your kidneys, and also how much potassium is in your blood.

  • If you buy any medicines, check with a pharmacist that they are suitable to take with telmisartan. This is because some anti-inflammatory painkillers (such as aspirin and ibuprofen) may interfere with the way telmisartan works, and also may increase the risk of side-effects.

  • It is very important that you follow any dietary and lifestyle advice that you may have been given by your doctor, such as eating a healthy diet, not smoking, and taking regular exercise.

  • If you drink alcohol, ask your doctor for advice about drinking while you are on telmisartan. Alcohol will increase the risk of you feeling dizzy or faint and may not be recommended for you.

  • Do not use salt substitutes which contain potassium while you are taking these tablets. This is because they increase the amount of potassium in your blood and this can cause problems.

  • If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking telmisartan. This is because telmisartan taken with an anaesthetic may make your blood pressure drop too low.

  • Treatment with telmisartan is usually long-term unless you experience an adverse effect. Continue to take it unless you are advised otherwise by your doctor.

If you are also taking hydrochlorothiazide in combination with this medicine

  • Studies have suggested that taking higher doses of hydrochlorothiazide for long periods of time may increase the risk of certain skin cancers.

  • Tell your doctor if you have ever been treated for skin cancer before.

  • Tell your doctor about any new or changed moles or worrying marks on your skin.

  • Use a sunscreen in strong sunlight. Do not use sunbeds.

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Can telmisartan cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. Side-effects from telmisartan are uncommon and usually improve as your body adjusts to the new medicine, but you should speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

Telmisartan side-effects - these affect fewer than 1 in 10 people who take this medicine

What can I do if I experience this?

Feeling faint, tired, or light-headed

Moving more slowly may help. If you begin to feel dizzy, sit down for a while. Do not drive and do not use tools or machines until you feel better

Feeling sick (nausea), tummy (abdominal) pain, indigestion, wind

Stick to simple foods - avoid rich or spicy meals

Loose, watery stools (diarrhoea)

Drink plenty of water to replace lost fluids

Infections and flu-like symptoms, cough, feeling breathless, sleeping problems, feeling low, aches and pains, itchy rash

If any of these become troublesome, discuss them with your doctor

Changes to some blood tests

Your doctor will check for these

Important: if you develop any swelling of your mouth or face, speak with your doctor or go to your local accident and emergency department straightaway. These are signs of an allergic reaction.

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

How to store telmisartan

  • Keep all medicines out of the reach and sight of children.

  • Store in a cool, dry place, away from direct heat and light.

Important information about all medicines

Important information about all medicines

Never take more than the prescribed dose. If you suspect that someone has taken an overdose of this medicine, go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.

This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.

Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.

If you have any questions about this medicine ask your pharmacist.

Report side effects to a medicine or vaccine

If you experience side effects, you can report them online through the Yellow Card website.

Further reading and references

Article history

The information on this page is written and peer reviewed by qualified clinicians.

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