3850 Grand View Blvd. - Los Angeles, CA 90066 - Phone:(310) 391-6741 - Fax:(310) 391-6744 - Email: MarVistaAMC@gmail.com
(310)391-6741
www.marvistavet.com
TELMISARTAN (for veterinary information only)
BRAND NAMES: SEMINTRA, MICARDIS
AVAILABLE AS BACKGROUND Telmisartan is a member of a class of medications known as the ARBs (Angiotensin II Receptor Blockers), a class that has been around in human medicine since the mid-1990's. Recently, telmisartan received FDA approval for the treatment of high blood pressure in cats but more commonly it is used in the treatment of inappropriate urinary protein loss (glomerular disease). So how does that work and how are those two conditions even related? The answer is Angiotensin II, a biochemical designed to maintain your blood pressure in times of blood loss. The problem is that your body thinks that any drop in blood pressure ought to generate angiotensin II. This would be great if you were in hand to hand combat against a predator where blood loss is likely but not great if you are having heart failure (i.e. no blood loss at all, just a drop in blood pressure because of a weak heart). Angiotensin II constricts blood vessels which raises blood pressure and reduces wound bleeding but makes higher pressure for your heart to pump against. We want angiotensin II in certain circumstances only. If high blood pressure is already your problem, the last thing you need is any angiotensin II. The ARB's will help out by blocking the activity of angiotensin II and this is how they help in the treatment of high blood pressure. As for inappropriate urinary protein loss, blocking angiotensin turns out to be helpful as well. Angiotensin II brings up blood pressure in many ways: narrowing blood vessels, generating other hormones, causing sodium to be retained and more. Part of its actions include altering the circulation through the kidneys. More specifically, angiotensin II alters the way blood flows through the nephrons in the kidneys, the nephrons being the function units of the kidneys that are busily filtering out toxins, balancing electrolytes etc. In diseases where the nephron's filtration mechanisms are damaged and proteins are lost inappropriately in urine, angiotensin II makes things worse and inhibiting the actions of angiotensin II is helpful. This is often done with angiotensin converting enzyme inhibitors (like benazepril, or enalapril). Sometimes these are not enough or the patient does not tolerate them so in these cases ARB's like telmisartan come in handy.
HOW THIS MEDICATION IS USED This medication is typically given once a day with or without food. Monitoring blood pressure, kidney function and urinary protein loss should be expected to assess how well the medication is working. Monitoring tests will be on-going so be sure you understand the schedule your veterinarian has recommended. Because red blood cell loss can be a side effect, red blood cell counts should be monitored every 3- 6 months as well.
SIDE EFFECTS The full side effects profile is still being worked out for pets. Low blood pressure (manifesting as weakness or even fainting) is possible with any medication that reduces blood pressure. Upset stomach (vomiting, diarrhea, appetite loss) should be reported to your veterinarian if persistent. Telmisartan is not considered to be safe in pregnancy and should not be handled by pregnant women (wear gloves and wash hands after administration).
INTERACTIONS WITH OTHER DRUGS Concurrent use of telmisartan with any of the following medications can further drop blood pressure:
If telmisartan is used with Non-Steroidal Anti-Inflammatory medications, monitoring of kidney function becomes especially important and the monitoring test interval may become more frequent.
CONCERNS AND CAUTIONS The biggest concerns stems from the newness of this medicine in veterinary practice. The side effects potential is still being described.
Short version (to help us comply with "Lizzie's Law") Page posted: 3/4/2021 |