[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Angiotensin II receptor blockers (ARBs)](https://durgical.com/en/pharmacology/classes/angiotensin-ii-receptor-blockers/) › Telmisartan

[Pharmacology](https://durgical.com/en/pharmacology/) · [Angiotensin II receptor blockers (ARBs)](https://durgical.com/en/pharmacology/classes/angiotensin-ii-receptor-blockers/)

# Telmisartan

A long-acting ARB cleared in bile. Used for high blood pressure and to lower cardiovascular risk in people who cannot take an ACE inhibitor.

Updated 2026-11-01

- Class: [Angiotensin II receptor blockers (ARBs)](https://durgical.com/en/pharmacology/classes/angiotensin-ii-receptor-blockers/)
- Receptor: Angiotensin II type 1 (AT1) receptor
- ATC code: C09CA07

◎**Angiotensin II type 1 (AT1) receptor**Telmisartan

ⓘ The figure shows olmesartan, another ARB, in the same binding pocket of the human AT1 receptor; no structure with telmisartan bound is available.

**Target in 3D:** Angiotensin II type 1 (AT1) receptor. PDB structure 4ZUD (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/4ZUD) · Drag to rotate · pinch to zoom

## Mechanism of action

Telmisartan blocks the AT1 receptor, so angiotensin II cannot constrict arterioles or release aldosterone. Blood pressure falls and sodium retention lessens, without bradykinin build-up. Its long half-life keeps the effect through the whole day.

- Telmisartan blocks the AT1 receptor
- Arterioles dilate and aldosterone falls
- Blood pressure stays lower through the day

## Pharmacokinetics

**Absorption**
Bioavailability depends on the dose; food lowers it slightly

**Elimination**
Mostly by biliary excretion, so biliary obstruction or liver failure raise its levels

**Half-life**
Terminal half-life about 24 hours

## Indications

- High blood pressure [Arterial hypertension →](https://durgical.com/en/conditions/arterial-hypertension/)
- Cardiovascular risk reduction in high-risk patients who cannot take ACE inhibitors [Myocardial Infarction (Heart Attack) →](https://durgical.com/en/conditions/myocardial-infarction/)

## Adverse effects

### Common

- Dizziness
- Back pain
- Sinusitis
- Diarrhoea
- Hyperkalaemia

### Serious (rare, important)

- Acute kidney injury
- Hypotension in volume depletion
- Fetal toxicity

## Contraindications

- Pregnancy
- Hypersensitivity to the drug
- Use with aliskiren in people with diabetes

## Key interactions

**Potassium-sparing diuretics, potassium supplements or salt substitutes**
Hyperkalaemia

**NSAIDs, including COX-2 inhibitors**
Weaker effect and risk of kidney injury

**Lithium**
Higher lithium levels and toxicity

**Digoxin**
Higher digoxin levels; digoxin is monitored

**Ramipril or another ACE inhibitor**
Dual blockade: more kidney injury and hyperkalaemia without more benefit

## What is monitored

- Blood pressure
- Potassium and creatinine
- Digoxin level if combined

## Administration and safety

- Given by mouth once a day
- Several «-sartan» names look alike: the name is checked on every order

## Nursing care

- Check blood pressure, potassium and creatinine when starting and after changes
- Watch for dizziness, especially in patients on diuretics
- Ask women of childbearing age about pregnancy plans
- Teach the patient that face, lip or tongue swelling is an emergency

## Pregnancy and breastfeeding

Contraindicated: drugs acting on the renin-angiotensin system can injure and kill the developing fetus; it is stopped as soon as pregnancy is detected.

## Memory aid

TELmisartan TELls time all day (long half-life) and leaves by the bile.

## Test yourself

Think of the answer, then tap the question to see it.

## How is telmisartan mainly eliminated?

By biliary excretion, so biliary obstruction or liver failure raise its levels.

## For which patients is telmisartan used to lower cardiovascular risk?

High-risk patients who cannot take an ACE inhibitor.

## Which cardiac drug's level rises with telmisartan?

Digoxin, so its level is monitored.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/telmisartan/)

## Related drugs

- [Ramipril](https://durgical.com/en/pharmacology/ramipril/)
- [Valsartan](https://durgical.com/en/pharmacology/valsartan/)
- [Candesartan](https://durgical.com/en/pharmacology/candesartan/)

## Related conditions

- [Arterial hypertension](https://durgical.com/en/conditions/arterial-hypertension/)
- [Myocardial Infarction (Heart Attack)](https://durgical.com/en/conditions/myocardial-infarction/)

[← Back to the class: Angiotensin II receptor blockers (ARBs)](https://durgical.com/en/pharmacology/classes/angiotensin-ii-receptor-blockers/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [DailyMed - TELMISARTAN tablet](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=dd2b0604-f887-40d9-9109-dafcc9987e4e) (DailyMed (U.S. National Library of Medicine), 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=C09CA07) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/telmisartan/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/telmisartan/