Posology: Treatment of essential hypertension: The usually effective dose is 40 mg once daily. Some patients may already benefit at a dally dose of 20 mg. In cases where the target blood pressure is not achieved, the dose of telmisartan can be increased to a maximum of 80 mg once daily. Alternatively, telmisartan may be used in combination with thiazide-type diuretics such as hydrochlorothiazide, which has been shown to have an additive blood pressure lowering effect with telmisartan. When considering raising the dose, it must be borne in mind that the maximum antihypertensive effect is generally attained four to eight weeks after the start of treatment (see Pharmacology: Pharmacodynamics under Actions).
In patients with severe hypertension treatment with telmisartan at doses up to 160 mg alone and in combination with hydrochlorothiazide 12.5-25 mg daily was well tolerated and effective.
Reduction of cardiovascular morbidity: The recommended dose is 80 mg once daily. It is not known whether doses lower than 80 mg of telmisartan are effective in reducing cardiovascular morbidity.
When initiating telmisartan therapy for the reduction of cardiovascular morbidity, close monitoring of blood pressure is recommended, and if appropriate adjustment of medications that lower blood pressure may be necessary.
Special populations: Patients with renal impairment: No posology adjustment is required for patients with renal impairment, including those on haemodialysis. Telmisartan is not removed from blood by hemofiltration.
Patients with hepatic impairment: Tolura is contraindicated in patients with severe hepatic impairment (see Contraindications).
In patients with mild to moderate hepatic impairment the posology should not exceed 40 mg once daily (see Precautions).
Elderly patients: No dose adjustment is necessary for elderly patients.
Paediatric population: The safety and efficacy of Tolura in children and adolescents aged below 18 years have not been established.
Method of administration: Telmisartan tablets are for once-daily oral administration and should be taken with liquid, with or without food.
Precautions to be taken before handling or administering the medicinal product: Telmisartan should be kept in the sealed blister due to the hygroscopic property of the tablets. Tablets should be taken out of the blister shortly before administration (see Cautions for Usage).