Meta Information
ID:telmisartan
Name:
Schema Version:AIM-2.0
Interactions
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Telmisartan can cause significant injury or death to a developing fetus, particularly when taken during the second and third trimesters.
Actionable advice:
Do not take if you are pregnant. Stop taking immediately if you become pregnant and consult your doctor.
Target id:
/class/ace-inhibitors
Target name:
ACE Inhibitors
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Combining telmisartan with an ACE inhibitor (e.g., lisinopril, ramipril) constitutes dual RAAS blockade, which significantly increases the risk of hyperkalemia (high potassium), hypotension (low blood pressure), and acute kidney injury without providing additional benefit.
Actionable advice:
Avoid using telmisartan in combination with any ACE inhibitor.
Target id:
/intervention/aliskiren
Target name:
Aliskiren
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
The combination of telmisartan and aliskiren (a direct renin inhibitor) is contraindicated, especially in patients with diabetes or renal impairment, due to a high risk of severe adverse events including kidney failure, hyperkalemia, and hypotension.
Actionable advice:
Do not take telmisartan and aliskiren together, especially if you have diabetes or kidney disease.
Target id:
/class/potassium-sparing-diuretics
Target name:
Potassium-Sparing Diuretics
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Telmisartan decreases aldosterone, reducing potassium excretion. Co-administration with potassium-sparing diuretics (e.g., spironolactone, eplerenone, amiloride) can lead to dangerously high potassium levels (hyperkalemia), which can cause cardiac arrhythmias.
Actionable advice:
Avoid this combination unless under strict medical supervision with frequent potassium monitoring.
Target id:
/intervention/potassium
Target name:
Potassium Supplements
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Taking potassium supplements while on telmisartan can easily lead to hyperkalemia (high potassium levels) because the drug already reduces your body's ability to excrete potassium.
Actionable advice:
Do not take potassium supplements unless specifically prescribed and monitored by your doctor.
Target id:
/biomarker/serum-potassium
Target name:
Serum Potassium Levels
Severity:
major
Interaction type:
requirement
Nature:
absolute
Temporal spacing:
null
Description:
Because telmisartan can increase potassium levels, regular monitoring is essential to prevent hyperkalemia, a condition that can affect heart rhythm.
Actionable advice:
Ensure you have your serum potassium levels checked periodically as recommended by your healthcare provider.
Target id:
/biomarker/egfr
Target name:
Kidney Function (eGFR, Creatinine)
Severity:
major
Interaction type:
requirement
Nature:
absolute
Temporal spacing:
null
Description:
Telmisartan can affect renal blood flow and function, particularly at the start of therapy or in susceptible individuals. Monitoring is crucial to ensure renal safety.
Actionable advice:
Ensure you have your kidney function (creatinine and eGFR) checked before starting and periodically during treatment.
Target id:
/intervention/lithium
Target name:
Lithium (Medication)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Telmisartan can decrease the kidneys' ability to clear lithium from the body, leading to elevated lithium levels and a high risk of toxicity.
Actionable advice:
Avoid this combination. If unavoidable, serum lithium levels must be monitored very closely.
Target id:
/class/nsaids
Target name:
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
NSAIDs (e.g., ibuprofen, naproxen) can reduce the blood pressure-lowering effect of telmisartan and, especially in dehydrated or elderly individuals, increase the risk of acute kidney damage.
Actionable advice:
Avoid long-term use of NSAIDs. For occasional use, ensure you are well-hydrated and monitor blood pressure.
Target id:
/class/antihypertensives
Target name:
Other Antihypertensive Medications
Severity:
moderate
Interaction type:
synergistic
Nature:
absolute
Temporal spacing:
null
Description:
Using telmisartan with other blood pressure-lowering drugs has an additive effect, which can increase the risk of hypotension (dizziness, fainting). This is often a therapeutic goal but requires careful monitoring.
Actionable advice:
Monitor your blood pressure regularly, especially when starting or adjusting the dose of another antihypertensive.
Target id:
/condition/renal-impairment
Target name:
Renal Impairment
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Patients with pre-existing kidney disease are at higher risk for further decline in renal function, hypotension, and hyperkalemia when taking telmisartan.
Actionable advice:
Use with caution under medical supervision; dose adjustments and frequent monitoring of kidney function and potassium are necessary.
Target id:
/condition/hepatic-impairment
Target name:
Hepatic Impairment
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Telmisartan is cleared from the body primarily via the liver and bile. Impaired liver function can significantly increase drug levels, raising the risk of side effects.
Actionable advice:
Use with caution at a lower dose in mild-to-moderate liver impairment; avoid in severe cases.
Target id:
/condition/dehydration
Target name:
Dehydration or Volume Depletion
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
In a dehydrated state (e.g., from diuretics, diarrhea, or vomiting), starting telmisartan can cause a sharp drop in blood pressure and increase the risk of kidney dysfunction.
Actionable advice:
Ensure you are adequately hydrated before starting telmisartan and correct any volume depletion.
Target id:
/condition/lactation
Target name:
Breastfeeding (Lactation)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
It is unknown if telmisartan passes into human breast milk, but due to the potential for serious harm to the nursing infant, it is generally not recommended.
Actionable advice:
Discuss the risks and benefits with your doctor; an alternative medication may be preferred while breastfeeding.
Target id:
/intervention/digoxin
Target name:
Digoxin
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Telmisartan can slightly increase the concentration of digoxin in the blood, which may enhance its effects and potential for toxicity.
Actionable advice:
If taking both medications, your doctor may need to monitor your digoxin levels, especially when starting or stopping telmisartan.
Target id:
/dietary/potassium-salt-substitutes
Target name:
Potassium-Containing Salt Substitutes
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Salt substitutes often contain potassium chloride instead of sodium chloride. Using these products while taking telmisartan can significantly increase potassium intake and risk of hyperkalemia.
Actionable advice:
Avoid using salt substitutes that contain potassium.
Target id:
/dietary/potassium-rich-foods
Target name:
High-Potassium Foods
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
While normal dietary intake is generally safe, excessive consumption of foods very high in potassium (e.g., potatoes, spinach, avocados, bananas) can contribute to elevated potassium levels.
Actionable advice:
Maintain a normal, balanced diet but avoid consuming excessive amounts of high-potassium foods.
Target id:
/class/ampk-activators
Target name:
AMPK Activators (e.g., Metformin, Berberine)
Severity:
minor
Interaction type:
synergistic
Nature:
absolute
Temporal spacing:
null
Description:
Telmisartan acts as a partial PPAR-gamma agonist, which can improve insulin sensitivity. This action may complement the metabolic benefits of AMPK activators, potentially enhancing metabolic health.
Actionable advice:
This combination may offer synergistic metabolic benefits, but monitor blood glucose and blood pressure for additive effects.
Target id:
/dietary/meal
Target name:
Any Caloric Meal
Severity:
minor
Interaction type:
synergistic
Nature:
absolute
Temporal spacing:
null
Description:
The absorption and effectiveness of telmisartan are not significantly affected by food, which provides flexibility in administration.
Actionable advice:
Take telmisartan at the same time each day, either with or without food, to maintain consistent levels.
Target id:
/circadian/sleep
Target name:
Going to Sleep
Severity:
minor
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
1
Hours after target:
null
Description:
Some evidence suggests that bedtime dosing of antihypertensives may improve control of nighttime blood pressure and potentially reduce cardiovascular risk, though this is not definitive for all individuals.
Actionable advice:
Consider taking your daily dose about an hour before bedtime, but confirm this timing strategy with your doctor.