Micardis is a drug used primarily in the treatment of hypertension or high blood pressure. It works by blocking the effects of angiotensin II, a hormone in the body that causes blood vessels to narrow and tension to increase. By blocking this hormone, Micardis helps relax blood vessels and lower blood pressure.
Micardis was first approved for medical use in 1998 and is sold under the brand name Micardis among others. It belongs to a class of medications known as angiotensin receptor blockers (ARBs) which work via the renin-angiotensin-aldosterone system (RAAS) in the body. Other ARBs include losartan, valsartan, irbesartan and candesartan.
How Does it Work to Treat Heart Failure?
While initially approved for high blood pressure, further research showed Micardis could provide benefits for heart failure as well. Heart failure occurs when the heart muscle is weak and unable to pump enough blood to meet the body's needs. Over time, high blood pressure and other conditions can damage and weaken the heart.
In heart failure, angiotensin II not only causes blood vessels to constrict but also leads to fibrosis or scarring of heart muscle tissues. This scarring further reduces the heart's ability to function properly. Micardis works by blocking the effects of angiotensin II, thereby reducing fibrosis and allowing the heart to pump more effectively.
Studies have shown Micardis can reduce markers of fibrosis like procollagen types I and III in patients with heart failure. It may also help control sympathetic nerve activity which places added strain on the heart. Overall, Micardis treatment lowers clinical symptoms and hospitalization rates in individuals with heart failure.
Dosage and Administration
Telmisartan is available in both oral tablet and suspension formulations. The typical starting dose for heart failure is 20–40 mg taken once daily, preferably at the same time each day with or without food. The dose may then be increased up to 80 mg daily based on patient tolerance and response.
Micardis should be taken whole and not crushed or chewed. Missed doses can be made up by taking them as soon as remembered unless it is close to the time of the next scheduled dose. Tablets should be stored at room temperature away from excess heat, moisture and direct light.
Contraindications and Side Effects
Micardis is generally well-tolerated but some individuals may experience side effects like dizziness, fatigue, upper respiratory infection and diarrhea. As an ARB, it should not be used during pregnancy due to the risk of fetal harm. Nursing mothers and individuals with a history of angioedema or who are hypersensitive to Micardis should also avoid use.
Like other heart failure medications, Micardis may cause elevated potassium levels so monitoring is needed. It can also potentially interact with potassium supplements, salt substitutes containing potassium, NSAIDs and diuretics. As with any prescription medication, patients should discuss risks/benefits with their doctor and report any severe side effects.
Role in Guidelines and Ongoing Research
Current heart failure guidelines from the American College of Cardiology/American Heart Association list ARBs like Telmisartan as a recommended addition to standard heart failure therapy with ACE inhibitors. They provide additive benefits for mortality reduction and cardiovascular outcomes when used together.
Ongoing research continues to explore Micardis's potential benefits. One study found it helped control arrhythmias and reduced the recurrence of atrial fibrillation in heart failure patients. Other investigations have looked at whether Micardis might also benefit those with diabetes or kidney disease often related to heart failure. Tolerability also appears favorable compared to some other ARBs.
Telmisartan remains an important option for clinicians managing hypertension as well as heart failure. Future research may provide additional insights into maximizing its effects via dosing, administration schedule and combination therapy approaches. Meanwhile, guidelines emphasize using ARBs along with ACE inhibitors, beta-blockers and mineralocorticoid receptor antagonists to best support heart pump function and improve quality of life.
