Telmisartan
Telmisartan reduces angiotensin-II-mediated vascular and renal effects. Feline hypertension and proteinuria protocols differ.
Group
Angiotensin II AT1-receptor blocker
Mechanism of Action
Selectively blocks AT1 receptors and reduces vasoconstriction, aldosterone-related effects and glomerular protein loss.
Dose Rates
Dogs
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Hypertension or proteinuria — Initial | 1 mg/kg | PO | Every 24 h | Starting regimen; source describes escalation to 3 mg/kg daily and, in selected refractory cases, twice daily with monitoring. |
| Hypertension or proteinuria — Maintenance | 3 mg/kg | PO | Every 24 h | Escalation only when justified by monitored response; not the initial dose. |
Cats
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Systemic hypertension — Initial | 1.5 mg/kg | PO | Every 12 h | Up to 14 days; Initial 14-day regimen, followed by the once-daily maintenance regimen. |
| Systemic hypertension — Maintenance | 2 mg/kg | PO | Every 24 h | After the initial course. Reduce to 1 mg/kg daily if hypotensive; titration follows measured blood pressure. |
Indications
- Feline systemic hypertension
- Proteinuria associated with chronic kidney disease
- Selected canine hypertension or proteinuria
Contraindications
- Do not initiate in a dehydrated, hypovolaemic or hypotensive patient without stabilisation.
- Pregnancy and breeding safety are not established.
Interactions
- Dual RAAS blockade with an ACE inhibitor may increase renal injury, hypotension and hyperkalaemia.
- Other antihypertensives may increase hypotension; NSAIDs can increase renal risk in volume depletion.
Adverse effects
- Vomiting, diarrhoea, hypersalivation, lethargy, hypotension, anaemia and altered renal indices.
Toxicity
Support blood pressure and hydration after overdose; monitor renal function, potassium and red-cell indices.
Preparations
| Preparation | Form | Strength | Route |
|---|---|---|---|
| Semintra oral solution 10 mg/mL | Oral Liquid | 10 mg / mL | PO |
| Telmisartan 20 mg tablet | Tablet | 20 mg / tablet | PO |
| Telmisartan 40 mg tablet | Tablet | 40 mg / tablet | PO |
| Telmisartan 80 mg tablet | Tablet | 80 mg / tablet | PO |
Monitoring and Administration
Check blood pressure within 7-10 days of starting or adjusting treatment; also assess creatinine, potassium, hydration and urinary protein response.
Do not interchange the 4 and 10 mg/mL oral solutions by syringe volume. Give directly or with a small amount of food according to the specific product directions.
For symptomatic hypotension reduce or withhold treatment and reassess; avoid combining starting and maintenance regimens.