Micardis Side Effects

Generic Name: telmisartan

Please note - some side effects for Micardis may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA at http://www.fda.gov/medwatch/ or 1-800-FDA-1088 (1-800-332-1088).

Side Effects of Micardis - for the Consumer

Micardis

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Micardis:

Back pain; dizziness; upper respiratory tract infection.

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; hoarseness); change in the amount of urine produced; chest pain; difficulty swallowing; fast, slow, or irregular heartbeat; muscle pain or cramps; symptoms of low blood pressure (eg, fainting, lightheadedness, severe dizziness).

Micardis HCT

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Micardis HCT:

Diarrhea; dizziness; nausea; tiredness.

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; confusion; decrease in sexual ability; decreased urination; depression; drowsiness; fainting; fast or irregular heartbeat; fever, chills, or persistent sore throat; hoarseness; muscle pain, tenderness, or cramps; red, swollen, blistered, or peeling skin; restlessness; seizures; severe or persistent dry mouth; shortness of breath; swelling of the arms or legs; unusual bruising or bleeding; unusual thirst, tiredness, or weakness; vomiting; yellowing of the skin or eyes.

Micardis Side Effects - for the Professional

Micardis

Micardis tablets have been evaluated for safety in more than 3700 patients, including 1900 treated for over six months and more than 1300 for over one year. Adverse experiences have generally been mild and transient in nature and have only infrequently required discontinuation of therapy.

In placebo-controlled trials involving 1041 patients treated with various doses of telmisartan (20-160 mg) monotherapy for up to 12 weeks, an overall incidence of adverse events similar to that of placebo was observed.

Adverse events occurring at an incidence of 1% or more in patients treated with telmisartan and at a greater rate than in patients treated with placebo, irrespective of their causal association, are presented in the following table.

In addition to the adverse events in the table, the following events occurred at a rate of 1% but were at least as frequent in the placebo group: influenza-like symptoms, dyspepsia, myalgia, urinary tract infection, abdominal pain, headache, dizziness, pain, fatigue, coughing, hypertension, chest pain, nausea and peripheral edema. Discontinuation of therapy due to adverse events was required in 2.8% of 1455 patients treated with Micardis® (telmisartan) tablets and 6.1% of 380 placebo patients in placebo-controlled clinical trials.

The incidence of adverse events was not dose-related and did not correlate with gender, age, or race of patients.

The incidence of cough occurring with telmisartan in six placebo-controlled trials was identical to that noted for placebo-treated patients (1.6%).

In addition to those listed above, adverse events that occurred in more than 0.3% of 3500 patients treated with Micardis tablets monotherapy in controlled or open trials are listed below. It cannot be determined whether these events were causally related to Micardis tablets:

Autonomic Nervous System: impotence, increased sweating, flushing; Body as a Whole: allergy, fever, leg pain, malaise; Cardiovascular: palpitation, dependent edema, angina pectoris, tachycardia, leg edema, abnormal ECG; CNS: insomnia, somnolence, migraine, vertigo, paresthesia, involuntary muscle contractions, hypoaesthesia; Gastrointestinal: flatulence, constipation, gastritis, vomiting, dry mouth, hemorrhoids, gastroenteritis, enteritis, gastroesophageal reflux, toothache, non-specific gastrointestinal disorders; Metabolic: gout, hypercholesterolemia, diabetes mellitus; Musculoskeletal: arthritis, arthralgia, leg cramps; Psychiatric: anxiety, depression, nervousness; Resistance Mechanism: infection, fungal infection, abscess, otitis media; Respiratory: asthma, bronchitis, rhinitis, dyspnea, epistaxis; Skin: dermatitis, rash, eczema, pruritus; Urinary: micturition frequency, cystitis; Vascular: cerebrovascular disorder; and Special Senses: abnormal vision, conjunctivitis, tinnitus, earache.

During initial clinical studies, a single case of angioedema was reported (among a total of 3781 patients treated).

Clinical Laboratory Findings

In placebo-controlled clinical trials, clinically relevant changes in standard laboratory test parameters were rarely associated with administration of Micardis tablets.

Hemoglobin: A greater than 2 g/dL decrease in hemoglobin was observed in 0.8% telmisartan patients compared with 0.3% placebo patients. No patients discontinued therapy due to anemia.

Creatinine: A 0.5 mg/dL rise or greater in creatinine was observed in 0.4% telmisartan patients compared with 0.3% placebo patients. One telmisartan-treated patient discontinued therapy due to increases in creatinine and blood urea nitrogen.

Liver Enzymes: Occasional elevations of liver chemistries occurred in patients treated with telmisartan; all marked elevations occurred at a higher frequency with placebo. No telmisartan-treated patients discontinued therapy due to abnormal hepatic function.

Cardiovascular Risk Reduction Trials

In clinical studies with patients at high risk of developing major cardiovascular events, cases of sepsis, including some with fatal outcomes, have been reported.

Post-Marketing Experience

The following adverse reactions have been identified during post-approval use of Micardis® (telmisartan) tablets. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to estimate reliably their frequency or establish a causal relationship to drug exposure. Decisions to include these reactions in labeling are typically based on one or more of the following factors: (1) seriousness of the reaction, (2) frequency of reporting, or (3) strength of causal connection to Micardis tablets. The most frequently spontaneously reported events include: headache, dizziness, asthenia, coughing, nausea, fatigue, weakness, edema, face edema, lower limb edema, angioneurotic edema, urticaria, hypersensitivity, sweating increased, erythema, chest pain, atrial fibrillation, congestive heart failure, myocardial infarction, blood pressure increased, hypertension aggravated, hypotension (including postural hypotension), hyperkalemia, syncope, dyspepsia, diarrhea, pain, urinary tract infection, erectile dysfunction, back pain, abdominal pain, muscle cramps (including leg cramps), myalgia, bradycardia, eosinophilia, thrombocytopenia, uric acid increased, abnormal hepatic function/liver disorder, renal impairment including acute renal failure, anemia, increased CPK, anaphylactic reaction, and tendon pain (including tendonitis, tenosynivitis).

Rare cases of rhabdomyolysis have been reported in patients receiving angiotensin II receptor blockers, including Micardis tablets.

Side Effects by Body System

Cardiovascular

Cardiovascular side effects associated with the use of angiotensin II receptor inhibitors have included dizziness (related to orthostatic hypotension). Palpitations, chest pain, and angioedema have been reported rarely. A single case of angioedema has been reported during initial clinical studies; however, additional cases of angioedema and urticaria have been reported in postmarketing experience. Hypertension, chest pain, peripheral edema, palpitations, tachycardia, and abnormal ECG findings have been reported in 1% or less in patients and at rates similar to placebo. Stroke has been reported rarely. A case of myocardial infarction has been reported. Dependent edema, angina, abnormal ECG findings, hypertension, cerebrovascular disorder, and peripheral edema have been reported. Atrial fibrillation, bradycardia, congestive heart failure, myocardial infarction, increased blood pressure, aggravated hypertension, and hypotension (including postural hypotension) have been reported during postmarketing experience.

One patient in a clinical trial died of a presumed myocardial infarction, however, causality was not established.

The risk of orthostatic hypotension has been greater among patients with intravascular salt or volume depletion.

Respiratory

Respiratory side effects including upper respiratory infections, sinusitis, and pharyngitis have been reported in 1% to 7% of patients and at rates similar to placebo. Asthma, rhinitis, dyspnea, and epistaxis have also been reported. Cough has been reported during postmarketing experience. Acute sinusitis and bronchitis have been reported.

Musculoskeletal

Musculoskeletal side effects including back pain has been reported in 3% of patients and at rates similar to placebo. Leg pain, arthritis, arthralgias, myalgias, leg pain, and leg cramps have been reported in less than 1% of patients and at rates similar to placebo. Rhabdomyolysis has been reported during postmarketing experience in patients receiving angiotensin II receptor blockers including telmisartan. Muscle cramps (including leg cramps), myalgia, and elevated CPK have also been reported during postmarketing experience. Peripheral ischemia has been reported.

Gastrointestinal

Gastrointestinal side effects including diarrhea has been reported in 3% of patients. Flatulence, abdominal pain, nausea, constipation, gastritis, vomiting, dry mouth, dyspepsia, hemorrhoids, gastroenteritis, enteritis, and gastroesophageal reflux has been reported in less than 1% of patients and at rates similar to placebo. A case of pancreatitis has been reported. Cholecystitis and cholelithiasis have been reported.

Nervous system

Nervous system side effects have included headache in 1% of patients and at a rate similar to placebo. Dizziness, pain, fatigue, insomnia, somnolence, migraine, vertigo, tinnitus, earaches, paresthesias, involuntary muscle contractions, and hypoesthesia have been reported in less than 1% of patients and at rates similar to placebo. Asthenia, weakness, and syncope have been reported during postmarketing experience.

Genitourinary

Genitourinary side effects have been reported rarely. Impotence, urinary frequency, and cystitis have been reported at rates similar to placebo. Endometriosis has been reported. Urinary tract infection and erectile dysfunction have been reported during postmarketing experience.

Metabolic

Metabolic side effects including gout, hypercholesterolemia, and hyperglycemia have been reported in less than 1% of patients. Causal relationships have not been shown, and these side effects were also noted among placebo patients. Hyperkalemia and increased uric acid have been reported during postmarketing experience.

Psychiatric

Psychiatric side effects have rarely included anxiety, depression, and nervousness.

Dermatologic

Dermatologic side effects have been reported rarely. Pruritus, rash, eczema, and general dermatitis have been reported at rates similar to placebo.

Ocular

Ocular side effects have rarely included abnormal vision and conjunctivitis.

Hematologic

Hematologic side effects have included anemia and granuloma. Eosinophilia and thrombocytopenia have been reported in postmarketing studies.

Renal

Renal side effects have rarely included oliguria, azotemia, and acute renal failure.

Hepatic

Hepatic side effects have rarely included elevations of serum hepatic enzymes at rates slightly greater than placebo. Abnormal hepatic function and liver disorder have been reported in postmarketing studies.

Hypersensitivity

Hypersensitivity side effects have been reported rarely. A case of angioedema has also been reported. Edema (including face, lower limb, and angioneurotic edema), hypersensitivity, erythema, angioedema, and urticaria have been reported during postmarketing experience.

Other

Other side effects including increased sweating, flushing, fever, malaise, infection, abscess, otitis media, tinnitus, earache, and toothache have been reported. Influenza-like symptoms have been reported.

General

In general, telmisartan has been well tolerated in premarketing clinical trials. This drug has been evaluated for safety in more than 3,700 patients, including 1,900 treated for more than 6 months and more than 1,300 for more than 1 year. Adverse drug events associated with the use of telmisartan have generally been mild and transient and have only infrequently required discontinuation of therapy. In placebo-controlled trials involving 1,041 patients treated with daily doses ranging from 20 to 160 mg (monotherapy) for up to 12 weeks, the overall incidence of adverse events was similar to placebo.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date, and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This information does not endorse drugs, diagnose patients, or recommend therapy. This drug information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug of drug combination is safe, effective, or appropriate for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of information provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.