Telmisartan blocks the vasoconstriction and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor in many tissues, such as vascular smooth muscle and the adrenal gland. It's action is therefore, independent of the pathways for angiotensin II synthesis. Telmisartan has much greater affinity (>3,000 fold) for the AT1 receptor than for the AT2 receptor. As Telmisartan does not inhibit ACE (kininase II), it does not affect the response to bradykinin. Telmisartan does not bind to or block other hormone receptors or ion channels known to be important in cardiovascular regulation.

Hypertension- Treatment of essential hypertension in adults; Cardiovascular prevention- Reduction of cardiovascular morbidity in adults with: Atherothrombotic cardiovascular disease (history of coronary heart disease, stroke, or peripheral arterial disease) or • Type 2 diabetes mellitus with documented target organ damage.

Dosage must be individualized. The usual starting dose of Teltab is 40 mg once a day. Blood pressure response is dose-related over the range of 20 to 80 mg. Most of the antihypertensive effect is apparent within 2 weeks and maximal reduction is generally attained after 4 weeks. When additional blood pressure reduction beyond that achieved with 80 mg is required, may switch to combination. No initial dosage adjustment is necessary for elderly patients or patients with renal impairment, including those on hemodialysis. Patients on dialysis may develop orthostatic hypotension; their blood pressure should be closely monitored. Teltab tablet may be administered with other antihypertensive agents. Teltab tablet may be administered with or without food. Initial therapy with Teltab is not recommended in patients 75 years old or with hepatic impairment.

Known hypersensitivity to this product or any of its components

• Avoid fetal or neonatal exposure • Hypotension • Monitor carefully in patients with impaired hepatic or renal function • Avoid concomitant use of an ACE inhibitor and angiotensin receptor blocker. Drug interaction:

• In hypertensive patients: The most common side effects of Telmisartan includes sinus pain and congestion (sinusitis), back pain, diarrhea etc. • For patients of cardiovascular risk reduction: The most common side effects of Telmisartan in cardiovascular risk reduction include intermittent claudication and skin ulcer.

• Pregnancy: Pregnancy Category D. • Lactation: It is not known whether Telmisartan is excreted in human milk.

Valsartan, Rifampin, Mefenamic acid either increase or decrease plasma concentration of Dapagliflozin. Dapagliflozin either increase or decrease plasma concentration of Bumetanide, Pioglitazone and Valsartan.

Very limited information is available on Trimetazidine overdose. Treatment should be symptomatic.

Store in a cool (below 30°C) and dry place, protect from light and moisture. Keep out of the reach of children.

Teltab 40 Tablet: Each box contains 3 x 10 tablets in Alu-Alu blister pack.