Micardis (Telmisartan) - Oral

Warning:

The United States Food and Drug Administration (FDA) has issued a black box warning for Micardis. Boxed warnings are the agency’s strongest warnings for serious and potentially life-threatening risks. Review these warnings and discuss any concerns you have with your healthcare provider before starting treatment.

The boxed warning for Micardis:

The use of drugs that act on the renin-angiotensin system (a critical regulator of blood pressure) during the second and third trimesters of pregnancy reduces fetal renal (kidney) function and increases fetal (unborn offspring) and neonatal (babies four weeks of age or younger) morbidity. The resulting excess amount of amniotic fluid can be associated with abnormally small lungs (pulmonary hypoplasia) and skeletal deformations.

Potential neonatal adverse effects include abnormally small skull/head (skull hypoplasia), the lack of urine production (anuria), kidney failure, and death. When pregnancy is detected, discontinue Micardis as soon as possible.

What Is Micardis?

Micardis (telmisartan) is a prescription medication categorized in the angiotensin II receptor blocker (ARBs) drugs class. This medication is approved by the United States Food and Drug Administration (FDA) to treat high blood pressure (hypertension) and reduce the risk of cardiovascular disease, including heart attack and stroke, in people 55 or older who are unable to take angiotensin-converting enzyme (ACE) inhibitors.

Micardis is available in an oral tablet form.

Drug Facts

Generic Name: Telmisartan

Brand Name(s): Micardis

Drug Availability: Prescription 

Administration Route: Oral

Therapeutic Classification: Angiotensin II Receptor Antagonist

Available Generically: Yes

Controlled Substance: N/A

Active Ingredient: Telmisartan

Dosage Form(s): Tablet

What Is Micardis Used For?

Micardis has been approved for use by the FDA to treat:

  • High blood pressure
  • Cardiovascular diseases (stroke, heart attack, death) for people 55 or older unable to take ACE inhibitors

How to Take Micardis

This drug should only be taken with guidance from your prescriber. Micardis comes as a tablet taken orally once a day with or without food. Take Micardis exactly as directed and do not stop taking it without talking to your healthcare provider. This medication, and other medications for controlling high blood pressure, should be taken even if you are feeling well.

Storage

Micardis should be stored in a cool, dry place. Generally, medications should be kept away from areas of heat, such as your kitchen, or places with high amounts of humidity, such as your bathroom. These environments can impact how well medications work. It is also important to make sure that this medication is kept away from children, and pets, to avoid accidental consumption.

There are no specific travel requirements set by the Transport Security Administration for Micardis.

When refilling medications such as Micardis, it is always important to contact your pharmacy before you run out to clarify any details.

Off-Label Uses

Healthcare providers may prescribe medications for uses other than those approved by the FDA. This is called off-label use.

Micardis is sometimes used off-label to treat:

How Long Does Micardis Take to Work?

The antihypertensive activity of Micardis (the process of lowering high blood pressure) initiates within three hours after consuming a single oral dose.

However, it’s important to remember that Micardis controls high blood pressure but does not cure it. Your blood pressure may decrease during the first two weeks of your treatment, but it may take four weeks for you to notice the full benefit of Micardis.

What Are the Side Effects of Micardis?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

All medications, including Micardis, can cause side effects. Let your healthcare provider know if you experience any side effects that don’t go away or bother you. 

Some common side effects include:

Severe Side Effects

The FDA has issued a black box warning for Micardis. Boxed warnings are the agency’s strongest warnings for serious and potentially life-threatening risks. Review these warnings and discuss any concerns you have with your healthcare provider before starting treatment.

The boxed warning for Micardis states that the use of drugs that act on the renin-angiotensin system (a critical regulator of blood pressure) during the second and third trimesters of pregnancy reduces fetal renal (kidney) function and increases fetal (unborn offspring) and neonatal (babies four weeks of age or younger) morbidity. The resulting excess amount of amniotic fluid can be associated with abnormally small lungs (pulmonary hypoplasia) and skeletal deformations.

Potential neonatal adverse effects include abnormally small skull/head (skull hypoplasia), the lack of urine production (anuria), kidney failure, and death. When pregnancy is detected, discontinue Micardis as soon as possible.

Serious side effects and their symptoms include:

  • Abnormal heart rhythm (cardiac arrhythmias)
  • Severe allergic reaction symptoms include rash, hives, itching, red, swollen, blistered, or peeling skin (anaphylaxis)
  • Kidney (renal) failure
  • Muscular atrophy and harmful alterations in fluid levels (rhabdomyolysis)

If you have any signs of these side effects, you should seek urgent medical attention, as they can progress rapidly and may be life-threatening.

Long-Term Side Effects

One of the most common long-term side effects reported with ARBs and other blood pressure medications is low blood pressure (hypotension).

The signs and symptoms of low blood pressure include:

Talk with your prescriber if you experience frequent symptoms of low blood pressure, as your dose may need to be reduced. 

Report Side Effects

Micardis may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Micardis Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. 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.

  • For oral dosage form (tablets):
    • For high blood pressure:
      • Adults—At first, 40 milligrams (mg) once a day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 80 mg per day.
      • Children—Use and dose must be determined by your doctor.
    • To lower the risk of heart attacks or stroke:
      • Adults—80 milligrams (mg) once a day.
      • Children—Use and dose must be determined by your doctor.

Modifications

Due to the possible effects of this medication, there may be changes to how it is used. Therefore, it is important for users to be aware of the following when taking Micardis:

Severe allergic reaction: Avoid using Micardis if you have a known allergy to it or any of its ingredients. Ask your pharmacist or healthcare provider for a complete list of the ingredients if you're unsure.

Pregnancy: Micardis can cause fetal harm if administered to a pregnant person. Once pregnancy is detected, discontinue Micardis immediately. People of childbearing age should be aware of the potential risk, and Micardis should only be given after careful counseling of individual risks and benefits.

Breastfeeding: Talk with your healthcare provider if you plan to breastfeed, weigh the benefits and risks of taking Micardis while nursing, and the different ways to feed your baby.

Adults over 65: No overall differences in efficacy and safety were observed in older adults compared to younger people, but the greater sensitivity of some older individuals cannot be ruled out.

Administration modifications: The dosing does not change for age, whether you are in the advanced age population or the pediatric population. Therefore, no initial dosage adjustment is necessary for older people, or those with renal impairment, including those on hemodialysis. Doses will still generally be started on a standard dose and then increased or decreased depending on the response to the medication.

Missed Dose

If you miss a dose of Micardis, you should take it as soon as you remember. When you remember and are close to the next scheduled dose, you should take just that dose and not the one missed. It is important NOT to take more than one dose at a time.

Missed doses may make it more difficult to control your blood pressure.

Overdose: What Happens If I Take Too Much Micardis?

There is not a specific dose that indicates you have taken too much Micardis. Generally, an overdose with Micardis will look similar to its side effects.

To treat an overdose, you will primarily get treated for the symptoms that you are experiencing. For example, if you’re experiencing excessively low blood pressure, symptoms will be treated accordingly.

What Happens If I Overdose on Micardis?

Examples of what may be seen during an overdose include:

  • Low blood pressure
  • Dizziness
  • Increased heart rate (tachycardias)

If you think you or someone else may have overdosed on Micardis (telmisartan), call your healthcare provider or the Poison Control Center.

If someone collapses or isn’t breathing after taking Micardis (telmisartan), call 911.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using this medicine, tell your doctor right away.

Dizziness, lightheadedness, or fainting may occur with this medicine, especially when you get up suddenly from a lying or sitting position. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or not alert. If you feel dizzy, lie down so you do not faint. Then sit for a few moments before standing to prevent the dizziness from returning.

Check with your doctor right away if you become sick while taking this medicine, especially with severe or continuing nausea, vomiting, or diarrhea. These conditions may cause you to lose too much water and may lead to low blood pressure. You can also lose water by sweating, so drink plenty of water during exercise or in hot weather.

Ask your doctor before you use medicines, supplements, or salt substitutes that contain potassium.

Do not take other medicines unless they have been discussed with your doctor. This especially includes nonprescription medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may increase your blood pressure.

What Are Reasons I Shouldn't Take Micardis?

If you are pregnant or think you are pregnant, you should not take or be prescribed Micardis or any other ARB. Micardis belongs to the ARBs drug class, which has teratogenic effects and carries a high chance of leading to birth defects in a fetus.

Micardis should also be prescribed and consumed cautiously for people with:

  • Hypovolemia shock
  • Hepatic (liver) disease 
  • African American ethnicity (generally a smaller antihypertensive response versus other ethnic populations)

What Other Medications Interact With Micardis?

Micardis and other ARBs should not be taken with drugs in the nonsteroidal anti-inflammatory drug (NSAID) class. NSAIDs are commonly used in cases of mild pain and soreness but are also used for more specific diagnoses, including osteoarthritis.

Additional drugs that may interact negatively with Micardis include:

This is not a complete list of all the drugs that may interact with Micardis. Always keep an up-to-date list of all the medicines you take and share this information with your healthcare provider and pharmacist any time there are changes.

What Medications Are Similar?

Micardis is a commonly prescribed medication for high blood pressure and other heart conditions.

Examples of other medications that are in the ARB class, or contain an ARB, include:

Other medications, such as angiotensin-converting enzyme (ACE) inhibitors, are also used to treat high blood pressure, similar to Micardis and ARB drugs. 

Examples of ACE inhibitors include:

This is a list of drugs that are also prescribed for certain heart conditions. It is NOT a list of drugs recommended to take with Micardis. In fact, you should not take these drugs together. Ask your pharmacist or healthcare provider if you have any questions.

Frequently Asked Questions

  • What else should I do to manage my high blood pressure?

    Lifestyle plays an integral role in the management of high blood pressure. Some lifestyle changes include limiting alcohol, weight reduction, exercise, and eating a nutritious diet.

  • What is Micardis used for?

    Micardis is used to treat high blood pressure and reduce the risk of cardiovascular disease in people 55 or older who cannot take ACE inhibitors.

  • What medications shouldn’t be taken with Micardis?

    While many medicines interact with Micardis, avoid taking NSAIDs (nonsteroidal anti-inflammatory drugs), Lithobid (lithium), Altace (ramipril), or Diovan (valsartan).

How Can I Stay Healthy While Taking Micardis?

To stay healthy while taking Micardis, it is important to take it as directed by your prescriber.

Consistent adherence to your medication schedule is crucial in managing high blood pressure. Along with taking this medication regularly, it is important to live a healthy lifestyle by maintaining a nutritious diet, staying well hydrated, and achieving seven to eight hours of sleep a night.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. DailyMed. Micardis- telmisartan tablet.

  2. MedlinePlus. Telmisartan.

  3. Rothlin RP, Vetulli HM, Duarte M, Pelorosso FG. Telmisartan as tentative angiotensin receptor blocker therapeutic for COVID-19. Drug Dev Res. 2020;81(7):768-770. doi:10.1002/ddr.21679

  4. Prescribers’ Digital Reference. Telmisartan - drug summary.

  5. American Heart Association. Low blood pressure - when blood pressure is too low.

  6. Moretti ME, Caprara D, Drehuta I, et al. The fetal safety of angiotensin converting enzyme inhibitors and angiotensin II receptor blockers. Obstet Gynecol Int. 2012;2012:658310. doi:10.1155/2012/658310

  7. Cooper C, Chapurlat R, Al-Daghri N, et al. Safety of oral non-selective non-steroidal anti-inflammatory drugs in osteoarthritis: what does the literature say? Drugs Aging. 2019;36(suppl 1):15-24. doi:10.1007/s40266-019-00660-1

  8. FDA. Diovan (valsartan).

  9. FDA. Cozaar (losartan).

  10. FDA. Entresto (sacubitri and valsartan).

  11. FDA. Angiotensin-converting enzyme inhibitor (ACE inhibitor) drugs.

  12. Mahmood S, Shah KU, Khan TM, et al. Non-pharmacological management of hypertension: in the light of current research. Ir J Med Sci. 2019;188(2):437-452. doi:10.1007/s11845-018-1889-8