telmisartan, fosinopril. cornsilk increases effects of telmisartan by pharmacodynamic synergism. After the first dose of telmisartan, the antihypertensive activity gradually becomes evident within 3 hours. Monitor Closely (1)enoxaparin increases toxicity of telmisartan by Other (see comment). xipamide increases effects of telmisartan by pharmacodynamic synergism. Use Caution/Monitor. Use Caution/Monitor. Concomitant use of insulin and ARBs may require insulin dosage adjustment and increased glucose monitoring. Monitor Closely (1)telmisartan and salicylates (non-asa) both increase serum potassium. telmisartan and potassium chloride both increase serum potassium. telmisartan increases and hydrochlorothiazide decreases serum potassium. This is not a complete list of side effects and others may occur. Minor/Significance Unknown. Use Caution/Monitor. Following an oral dose of 1 mg/kg telmisartan once daily for five days, the time to reach mean peak plasma concentration (T max) was 21 minutes and 32 minutes for fasted and fed cats, respectively. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. Monitor patients for changes in glycemic control. The average initial daytime systolic blood pressure (SBP) was 149 +/- 19.7 mm Hg, average night-time SBP 145 +/- 23.0 mm Hg, average initial daytime diastolic BP (DBP) 90.6 +/- 2.5 mm Hg, night-time DBP 88.9 +/- 13.5 mm Hg. Modify Therapy/Monitor Closely. telmisartan and propranolol both increase serum potassium. Serious - Use Alternative (1)telmisartan, benazepril. Use Caution/Monitor. However, the dose is usually not more than 80 mg per day. Use Caution/Monitor. Use Caution/Monitor. Dual blockade of renin-angiotensin system increases risks of hypotension, hyperkalemia, and renal impairment. Either increases toxicity of the other by Other (see comment). include protected health information. Monitor Closely (1)telmisartan and amiloride both increase serum potassium. Contraindicated. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. Tell your doctor right away if you have any signs of kidney problems such as a change in the amount of urine.A very serious allergic reaction to this drug is rare. Modify Therapy/Monitor Closely. Avoid or Use Alternate Drug. Monitor Closely (1)telmisartan increases and furosemide decreases serum potassium. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: fainting, symptoms of a high potassium blood level (such as muscle weakness, slow/irregular heartbeat).Although telmisartan may be used to prevent kidney problems or treat people who have kidney problems, it may also rarely cause serious kidney problems or make them worse. Monitor Closely (1)telmisartan increases toxicity of atorvastatin by Other (see comment). 40 mg/day PO initially; titrated to 20-80 mg/day PO, depending on response; patients with volume depletion should receive the lower dosage initially, under close supervision, Most of the antihypertensive effect is apparent within 2 weeks and maximal reduction is generally attained after 4 weeks, When additional blood pressure reduction is required after the 80-mg dose, a diuretic may be added, Indicated for cardiovascular (CV) risk reduction in patients unable to take ACE inhibitors, Unknown whether doses lower than 80 mg are effective in reducing the risk of cardiovascular morbidity and mortality, Renal impairment: No dosage adjustment necessary; hemodialysis (HD) patients at risk for orthostatic hypotension, Use of telmisartan with an ACE inhibitor is not recommended, <18 years old: Safety and efficacy not established. Comment: Angiotensin II receptor antagonists may enhance hypoglycemic effects of antidiabetic agents by improving insulin sensitivity. Use Caution/Monitor. Use Caution/Monitor. Modify Therapy/Monitor Closely. Concomitant use of insulin and ARBs may require insulin dosage adjustment and increased glucose monitoring. telmisartan and digoxin both increase serum potassium. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. Mechanism: pharmacodynamic synergism. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Monitor Closely (1)telmisartan increases effects of insulin isophane human/insulin regular human by unspecified interaction mechanism. Monitor Closely (3)telmisartan, diflunisal. Use Caution/Monitor. Modify Therapy/Monitor Closely. Administered directly into the mouth, or next to or on top of a small amount of food. MISSED DOSE: If you miss a dose, take it as soon as you remember. Missed Dose . Monitor Closely (1)telmisartan decreases effects of synthetic human angiotensin II by pharmacodynamic antagonism. meclofenamate decreases effects of telmisartan by pharmacodynamic antagonism. telmisartan will increase the level or effect of baricitinib by decreasing elimination. The amount of medicine that you take depends on the strength of the medicine. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect. Modify Therapy/Monitor Closely. Monitor Closely (3)telmisartan, etodolac. telmisartan and nebivolol both increase serum potassium. Both drugs decrease blood glucose. Maintenance dose: 40 to 80 mg orally once a day Comments: Most of the antihypertensive effect is present within 2 weeks; maximum blood pressure reduction at a given dose is generally observed within 4 weeks of starting that dose. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. diclofenac decreases effects of telmisartan by pharmacodynamic antagonism. Either increases toxicity of the other by Other (see comment). Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Dual blockade of renin-angiotensin system increases risks of hypotension, hyperkalemia, and renal impairment. telmisartan increases toxicity of fluvastatin by Other (see comment). Monitor Closely (3)telmisartan, ketoprofen. Minor (1)octacosanol increases effects of telmisartan by pharmacodynamic synergism. Dual blockade of renin-angiotensin system increases risks of hypotension, hyperkalemia, and renal impairment. Use Caution/Monitor.sotalol, telmisartan. telmisartan and naproxen both increase serum potassium. Avoid or Use Alternate Drug. . food decreases levels of telmisartan by inhibition of GI absorption. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Use Caution/Monitor.tolmetin decreases effects of telmisartan by pharmacodynamic antagonism. Monitor Closely (2)acebutolol, telmisartan. Use Caution/Monitor. Monitor renal function periodically. ChildrenUse and dose must be determined by your doctor. Monitor Closely (2)metoprolol, telmisartan. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. Monitor Closely (1)apalutamide will decrease the level or effect of telmisartan by increasing elimination. View the formulary and any restrictions for each plan. Use Caution/Monitor. telmisartan and timolol both increase serum potassium. Use Caution/Monitor. Monitor Closely (3)telmisartan, sulindac. Consider decreasing dosage of antihypertensive agent. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect. Use Caution/Monitor. Use Caution/Monitor. Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. Most people with high blood pressure do not feel sick. health information, we will treat all of that information as protected health Storage Keep out of the reach of children. Mayo Clinic does not endorse companies or products. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Risk of fetal compromise if given during pregnancy. Use Caution/Monitor.nadolol, telmisartan. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.telmisartan and meclofenamate both increase serum potassium. Concomitant use of insulin and ARBs may require insulin dosage adjustment and increased glucose monitoring. Monitor Closely (2)nadolol, telmisartan. This drug is available at a middle level co-pay. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.telmisartan, oxaprozin. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.telmisartan, flurbiprofen. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Monitor Closely (1)telmisartan increases and gentamicin decreases serum potassium. Comment: Low molecular weight heparins may suppress adrenal aldosterone secretion, which can potentially cause hyperkalemia. Effect of interaction is not clear, use caution. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.telmisartan, sulindac. Minor (1)agrimony increases effects of telmisartan by pharmacodynamic synergism. Monitor Closely (1)encorafenib will increase the level or effect of telmisartan by Other (see comment). commonly, these are "preferred" (on formulary) brand drugs. Risk of fetal compromise if given during pregnancy. It can be taken with or without food. Monitor Closely (1)telmisartan increases and indapamide decreases serum potassium. There was a higher systemic exposure to telmisartan in the fasted cats based on the maximum concentration (C max ) and area under the concentration vs time curve (AUC). Monitor Closely (2)telmisartan increases effects of insulin inhaled by unspecified interaction mechanism. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect. Use Caution/Monitor.sulfasalazine decreases effects of telmisartan by pharmacodynamic antagonism. Monitor Closely (1)sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of telmisartan by Other (see comment). Your list will be saved and can be edited at any time. high potassium level -- nausea, weakness, tingly feeling, chest pain, irregular heartbeats, loss of movement. Use Caution/Monitor.penbutolol, telmisartan. Use Caution/Monitor. Comment: Low molecular weight heparins may suppress adrenal aldosterone secretion, which can potentially cause hyperkalemia. Increased incidence of clinically important renal dysfunction (death, doubling of serum creatinine, dialysis) compared with groups receiving either drug alone. Monitor Closely (1)telmisartan and tolfenamic acid both increase serum potassium. Mechanism: pharmacodynamic synergism. Concommitant administration with telmisartan may result in significant decrease in mycophenolic acid (MPA) concentrations; telmisartan changes MPA?s elimination by enhancing PPAR gamma (peroxisome proliferator-activated receptor gamma) expression, which in turn results in an enhanced UGT1A9 expression and activity. Effect of interaction is not clear, use caution. ketoprofen decreases effects of telmisartan by pharmacodynamic antagonism. Consult your doctor for more details.Lifestyle changes that may help this medication work better include stress reduction programs, exercise, and dietary changes. Either increases toxicity of the other by Other (see comment). Modify Therapy/Monitor Closely. High blood pressure adds to the workload of the heart and arteries. Comment: Low molecular weight heparins may suppress adrenal aldosterone secretion, which can potentially cause hyperkalemia. Minor/Significance Unknown. Monitor Closely (1)telmisartan will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Consider decreasing dosage of antihypertensive agent. 4.7 Effects on ability to drive and use machines. Use Caution/Monitor.pindolol, telmisartan. Monitor Closely (1)telmisartan increases effects of insulin regular human by unspecified interaction mechanism. Monitor Closely (3)telmisartan, indomethacin. Serious - Use Alternative (1)telmisartan, quinapril. Comment: Angiotensin II receptor antagonists may enhance hypoglycemic effects of antidiabetic agents by improving insulin sensitivity. Avoid or Use Alternate Drug. Use Caution/Monitor. Monitor Closely (3)telmisartan, nabumetone. Use Caution/Monitor. Use Caution/Monitor. telmisartan and nadolol both increase serum potassium. Telmisartan belongs to a class of drugs called angiotensin receptor blockers (ARBs). amifostine, telmisartan. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect. Dual blockade of renin-angiotensin system increases risks of hypotension, hyperkalemia, and renal impairment. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.telmisartan, etodolac. Concomitant use of insulin and ARBs may require insulin dosage adjustment and increased glucose monitoring. Use Caution/Monitor.ketoprofen decreases effects of telmisartan by pharmacodynamic antagonism. Adding plans allows you to compare formulary status to other drugs in the same class. telmisartan and naproxen both increase serum potassium. telmisartan and oxaprozin both increase serum potassium. Use Caution/Monitor. telmisartan and penbutolol both increase serum potassium. 20, 21 In addition, White et al 7 showed that after a missed dose, telmisartan had a large effect on systolic BP at the end of the dosing period as compared with valsartan. If it continues for a long time, the heart and arteries may not function properly. Concomitant use of elagolix and strong OATP1B1 inhibitors is contraindicated. Modify Therapy/Monitor Closely. 5, 17 Thus, the most optimal telmisartan dose for both targets seems to differ. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect. Use Caution/Monitor.nebivolol, telmisartan. telmisartan and carvedilol both increase serum potassium. Coadministration of baricitinib with strong organic anion transporter 3 (OAT3) inhibitors is not recommended. Telmisartan administered at bedtime, as opposed to morning dosing, improved the sleep time-relative blood pressure decline toward a more dipper pattern without loss in 24-hour efficacy. Use Caution/Monitor.nabumetone decreases effects of telmisartan by pharmacodynamic antagonism. It will take about 2 weeks for reductions in blood pressure to become noticeable and another 2 weeks until the full effects of the medication are realized. Modify Therapy/Monitor Closely. restrictions. Effect of interaction is not clear, use caution. Read and follow these instructions carefully. Risk of hypotension. telmisartan and sotalol both increase serum potassium. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.telmisartan, choline magnesium trisalicylate. telmisartan and tolvaptan both increase serum potassium. Use Caution/Monitor. telmisartan and tolfenamic acid both increase serum potassium. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. Use Caution/Monitor. Either increases toxicity of the other by Other (see comment). Observe for possible additive hypotensive effects during concomitant use. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Effect of interaction is not clear, use caution. Coadministration with blood pressure lowering agents may increase the risk and severity of hypotension associated with amifostine. Effect of interaction is not clear, use caution. Mechanism: pharmacodynamic synergism. ibuprofen IV decreases effects of telmisartan by pharmacodynamic antagonism. Batch CBD Full-Spectrum Gummies. Avoid or Use Alternate Drug. Modify Therapy/Monitor Closely. Results: A total of 77 patients were randomized and received at least 1 dose of study medication (placebo, n = 16; low-dose telmisartan, n = 30; high-dose telmisartan, n = 31). You might have to take high blood pressure medicine for the rest of your life. Avoid or Use Alternate Drug. telmisartan and esmolol both increase serum potassium. Either increases toxicity of the other by Other (see comment). Contraindicated. Use Caution/Monitor. . Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. Dual blockade of renin-angiotensin system increases risks of hypotension, hyperkalemia, and renal impairment. Monitor Closely (1)telmisartan increases and chlorthalidone decreases serum potassium. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. Either increases toxicity of the other by Other (see comment). Risk of fetal compromise if given during pregnancy. Comment: Angiotensin II receptor antagonists may enhance hypoglycemic effects of antidiabetic agents by improving insulin sensitivity. Mechanism: pharmacodynamic synergism. Concomitant use of insulin and ARBs may require insulin dosage adjustment and increased glucose monitoring. To lower the risk of heart attacks or stroke. Either increases toxicity of the other by Other (see comment). Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. Avoid or Use Alternate Drug. Contraindicated. Monitor Closely (3)telmisartan, mefenamic acid. Modify Therapy/Monitor Closely. Use Caution/Monitor. Use Caution/Monitor. This content does not have an English version. Risk of fetal compromise if given during pregnancy. Monitor Closely (1)telmisartan and spironolactone both increase serum potassium. This content does not have an Arabic version. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. Modify Therapy/Monitor Closely. All material on this website is protected by copyright, Copyright 1994-2023 by WebMD LLC. Monitor BP. Use Caution/Monitor. Contact the applicable plan Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment. Use Caution/Monitor. Use Caution/Monitor. Comment: Low molecular weight heparins may suppress adrenal aldosterone secretion, which can potentially cause hyperkalemia. telmisartan and diflunisal both increase serum potassium. Modify Therapy/Monitor Closely. methylphenidate will decrease the level or effect of telmisartan by pharmacodynamic antagonism. Concomitant use of insulin and ARBs may require insulin dosage adjustment and increased glucose monitoring. 1 Tel increases the phosphorylation of eNOS at Thr 497 but not Ser 116 in a time- and dose-dependent manner in hyperglycemic BAECs. Reduce dosage in 0.5 mg/kg dose increments to a minimum of 0.5 mg/kg. Mechanism: pharmacodynamic synergism. maitake increases effects of telmisartan by pharmacodynamic synergism. Dual blockade of renin-angiotensin system increases risks of hypotension, hyperkalemia, and renal impairment. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Mayo Clinic on Incontinence - Mayo Clinic Press, Mayo Clinic on Hearing and Balance - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press. telmisartan and noni juice both increase serum potassium. Use Caution/Monitor. Use Caution/Monitor. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.telmisartan, salsalate. If possible, avoid coadministration or modify dose of OATP1B1/3 substrates coadministered with fostemsavir. Use Caution/Monitor. Telmisartan is also used to lower the risk of heart attacks or stroke in patients 55 years of age and older who have diabetes or heart problems. Minor (1)food decreases levels of telmisartan by inhibition of GI absorption. Serious - Use Alternative (1)lofexidine, telmisartan. Use Caution/Monitor. Minor/Significance Unknown. Effect of interaction is not clear, use caution. Either increases toxicity of the other by Other (see comment). Make your tax-deductible gift and be a part of the cutting-edge research and care that's changing medicine. Use Caution/Monitor. STORAGE: Store at room temperature away from light and moisture. Autonomic nervous system: Impotence, increased sweating, flushing, Body as a whole: Allergy, fever, leg pain, malaise, Cardiovascular: Palpitations, dependent edema, angina pectoris, tachycardia, leg edema, abnormal ECG, Central nervous system: Insomnia, somnolence, migraine, vertigo, paresthesia, involuntary muscle contractions, hypoesthesia, Gastrointestinal: Flatulence, constipation, gastritis, vomiting, dry mouth, hemorrhoids, gastroenteritis, enteritis, gastroesophageal reflux, toothache, nonspecific gastrointestinal disorders, Metabolic: Gout, hypercholesterolemia, diabetes mellitus, Musculoskeletal: Arthritis, arthralgia, leg cramps, Psychiatric: Anxiety, depression, nervousness, Resistance mechanism: Infection, fungal infection, abscess, otitis media, Respiratory: Asthma, bronchitis, rhinitis, dyspnea, epistaxis. Either increases toxicity of the other by Other (see comment). Either increases toxicity of the other by pharmacodynamic synergism. leniolisib will increase the level or effect of telmisartan by Other (see comment). Minor/Significance Unknown. Monitor Closely (1)tadalafil increases effects of telmisartan by pharmacodynamic synergism. This document does not contain all possible drug interactions. Serious - Use Alternative (1)trofinetide will increase the level or effect of telmisartan by Other (see comment). Use Caution/Monitor. Use Caution/Monitor. ibuprofen decreases effects of telmisartan by pharmacodynamic antagonism. Comment: Low molecular weight heparins may suppress adrenal aldosterone secretion, which can potentially cause hyperkalemia. telmisartan, moexipril. telmisartan, insulin inhaled. Use Caution/Monitor. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.telmisartan, fenoprofen. Modify Therapy/Monitor Closely. Use Caution/Monitor.choline magnesium trisalicylate decreases effects of telmisartan by pharmacodynamic antagonism. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. Minor/Significance Unknown. Closely monitor for signs and symptoms of increased exposure and consider adjusting the dose of these substrates. Use Caution/Monitor. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect. telmisartan, trandolapril. indomethacin decreases effects of telmisartan by pharmacodynamic antagonism. St. John's Wort The metabolism of St. John's Wort can be decreased when combined with Telmisartan. Use Caution/Monitor. Mechanism: pharmacodynamic synergism. Risk of fetal compromise if given during pregnancy. Mechanism: pharmacodynamic synergism. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment. apalutamide will decrease the level or effect of telmisartan by increasing elimination. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. Avoid coadministration with sensitive substrates. Use Caution/Monitor.ibuprofen decreases effects of telmisartan by pharmacodynamic antagonism. Effect of interaction is not clear, use caution. What are the possible side effects of Micardis? Use Caution/Monitor. Risk of hypotension. Either increases toxicity of the other by Other (see comment). Modify Therapy/Monitor Closely. Serious - Use Alternative (1)telmisartan, trandolapril. Use Caution/Monitor. Use Caution/Monitor. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, bile duct blockage, high level of potassium in the blood, dehydration.This drug may make you dizzy. You must continue to take it as directed if you expect to lower your blood pressure and keep it down. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.telmisartan, mefenamic acid. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.telmisartan, tolmetin. Risk of fetal compromise if given during pregnancy. Skin: Dermatitis, rash, eczema, pruritus; Urinary: micturition frequency, cystitis; Special senses: Abnormal vision, conjunctivitis, tinnitus, earache, Most frequent spontaneously reported events include: Headache, dizziness, asthenia, coughing, nausea, fatigue, weakness, edema, face edema, lower limb edema, angioneurotic edema, urticaria, hypersensitivity, sweating increased, erythema, chest pain, atrial fibrillation, congestive heart failure, myocardial infarction, blood pressure increased, hypertension aggravated, hypotension (including postural hypotension), hyperkalemia, syncope, dyspepsia, diarrhea, pain, urinary tract infection, erectile dysfunction, back pain, abdominal pain, muscle cramps (including leg cramps), myalgia, bradycardia, eosinophilia, thrombocytopenia, uric acid increased, abnormal hepatic function/liver disorder, renal impairment including acute renal failure, anemia, increased CPK, anaphylactic reaction, tendon pain (including tendonitis, tenosynovitis), drug eruption (toxic skin eruption mostly reported as toxicoderma, rash, and urticaria), hypoglycemia (in diabetic patients), and angioedema (with fatal outcome), Rare cases of rhabdomyolysis have been reported, Hypersensitivity to telmisartan or any other component of this product, Coadministration with aliskiren in patients with diabetes, Use of drugs that act on the renin-angiotensin system during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death, Hyperkalemia may occur in patients on ARBs, particularly in patients with advanced renal impairment, heart failure, on renal replacement therapy, or on potassium supplements, potassium-sparing diuretics, potassium-containing salt substitutes or other drugs that increase potassium level, As the majority of telmisartan is eliminated by biliary excretion, patients with biliary obstructive disorders or hepatic insufficiency can be expected to have reduce clearance, Pregnancy (2nd and 3rd trimesters); significant risk of fetal or neonatal morbidity and mortality (see Black Box Warnings), Dual blockade of the renin-angiotensin system with angiotensin-receptor blockers (ARBs), angiotensin-converting enzyme (ACE) inhibitors, or aliskiren is associated with increased risk of hypotension, hyperkalemia, and altered renal function (including acute renal failure) in comparison with monotherapy, Most patients receiving the combination of two RAS inhibitors do not obtain any additional benefit compared to monotherapy; avoid combined use of RAS inhibitors; closely monitor blood pressure, renal function and electrolytes in patients on benazepril and other agents that affect the RAS, May cause fetal harm when administered to a pregnant woman, Most epidemiologic studies examining fetal abnormalities after exposure to antihypertensive use in the first trimester have not distinguished drugs affecting the renin-angiotensin system from other antihypertensive agents, When pregnancy is detected, discontinue as soon as possible, There is no information regarding the presence of telmisartan in human milk, the effects on the breastfed infant, or the effects on milk production, Advise a nursing woman not to breastfeed during treatment. 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