• High blood pressure with no known cause (essential hypertension).
• Reducing the risk of heart attack or stroke in people with a history of coronary heart disease, previous stroke or type 2 diabetes that has caused damage to any organs.

• Take your medications exactly as prescribed by your doctor, including at the right times and for the full length of your prescribed treatment.

• Blood pressure medicines such as this one may occasionally cause drowsiness and dizziness. You should take care when performing potentially hazardous activites, such as driving or operating machinery, until you know how this medicine affects you and are sure you can perform such activities safely.
• You should take extra care if you drink alcohol while taking this medicine, as it may enhance the blood pressure lowering effect and could make you feel dizzy or faint.
• People with decreased kidney function should have regular blood tests to monitor the levels of potassium and creatinine in their blood while taking this medicine.
• This medicine may be less effective at lowering blood pressure in people of Afro-Caribbean descent.

• Elderly people.
• People with a low volume of fluid or salt in their body, eg due to diuretic therapy, low salt diet, kidney dialysis, diarrhoea, vomiting, dehydration.
• Mild to moderately decreased liver function.
• Decreased kidney function or kidney disease.
• People with narrowing in the one or both of the arteries that supply blood to the kidneys (renal artery stenosis).
• People with narrowing of the main artery that leaves the heart to supply blood to the body (aortic stenosis).
• Heart valve disease (mitral valve stenosis).
• Heart disease characterised by thickening of the internal heart muscle and a blockage inside the heart (hypertrophic obstructive cardiomyopathy).
• Severe heart failure.
• Heart disease caused by inadequate blood flow to the heart (ischaemic heart disease, eg angina).
• People with high levels of potassium in their blood (hyperkalaemia).
• Diabetes.

• Severely decreased liver function.
• Blockage of the bile duct (biliary obstruction).
• Pregnancy.
• Breastfeeding.
• Telmisartan tablets contain sorbitol and are not suitable for people with an inherited intolerance to fructose in the diet.
• The safety of this medicine has not been established in children and adolescents under the age of 18. It is not recommended for this age group.
• People with high blood pressure due to high levels of the hormone aldosterone (primary hyperaldosteronism) do not generally respond to this type of blood pressure lowering medicine, and it is not recommended for these people. This medicine should not be used if you are allergic to any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

•Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
• This medicine should not be used during pregnancy, particularly the second and third trimesters, as it may be harmful to the developing baby. If you get pregnant during treatment or want to try for a baby, you should stop taking this medicine and consult your doctor. If appropriate, your doctor may prescribe you a different blood pressure medicine that is safe to take during pregnancy. Seek further medical advice from your doctor.
• It is not known if this medicine passes into breast milk. For this reason, the manufacturer states that it should not be used during breastfeeding. Seek medical advice from your doctor.

•Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.
• Abdominal pain.
• Diarrhoea.
• Indigestion (dyspepsia).
• Wind (flatulence).
• Dry mouth.
• Low blood pressure (hypotension).
• Sensation of spinning (vertigo).
• Fainting.
• Difficulty sleeping (insomnia).
• Shortness of breath.
• Increased sweating.
• Itching.
• Pain in the muscles (myalgia).
• Chest pain.
• Increased level of potassium in the blood (hyperkalaemia).
• Decreased kidney function, including kidney failure.
• Upper airway infections, eg pharyngitis, sinusitis.
• Flu-like symptoms.
• Decreased levels of red blood cells (anaemia) or platelets (thrombocytopenia) in the blood.
• Joint or back pain.
• Muscle cramps.
• Weakness.
• Upset stomach or vomiting.
• Skin reactions such as redness or hives (urticaria).
• Severe swelling of lips, face, tongue or throat (angioedema). Stop taking this medicine and consult your doctor immediately if you experience difficulty breathing or swallowing, or swelling of your face, lips, tongue or throat while taking this medicine.
• Anxiety.
• Depression.
• Abnormal vision.
• Increased heart rate (tachycardia).
• Drop in blood pressure that causes dizziness when moving from a lying down or sitting position to sitting or standing.
• Liver problems.

•It is important to tell your doctor or pharmacist what medicines you are taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Likewise, always check with your doctor or pharmacist before taking any other medicines during treatment with this one so that they can make sure that the combination is safe. Telmisartan has an additive effect with other medicines that decrease blood pressure, particularly other medicines used to treat high blood pressure (antihypertensives). This may cause dizziness, particularly when standing up. This can usually be relieved by lying down until the symptoms pass. If you are taking a diuretic medicine, your doctor may reduce your dose or ask you to stop taking it for a few days before starting telmisartan. This is to prevent your blood pressure from dropping too low. If you frequently feel dizzy while taking this medicine in combination with other medicines that can lower blood pressure you should let your doctor know, as your doses may need adjusting. Other medicines that decrease blood pressure include the following:
• ACE inhibitors, eg captopril
• aldesleukin
• alpha-blockers such as prazosin
• alprostadil
• other angiotensin II receptor antagonists such as losartan
• antipsychotics
• benzodiazepines, eg temazepam, diazepam
• baclofen
• beta-blockers such as propranolol
• calcium-channel blockers such as verapamil, nifedipine
• clonidine
• diazoxide
• diuretics, eg furosemide, bendroflumethiazide
• dopamine agonists, eg bromocriptine, apomorphine
• hydralazine
• levodopa
• MAOI antidepressants, eg phenelzine
• methyldopa
• minoxidil
• moxonidine
• moxisylyte
• nicorandil
• nitrates, eg glyceryl trinitrate
• tizanidine.
• Non-steroidal anti-inflammatory drugs (NSAIDs, eg indometacin, aspirin, diclofenac, ibuprofen) may reduce the blood pressure lowering effect of telmisartan, and may increase the risk of a decline in kidney function. You should avoid taking this type of painkiller unless recommended by your doctor. There may be a risk of raised potassium levels in the blood (hyperkalaemia) if any of the following medicines are taken in combination with telmisartan. If you are taking any of these with this medicine you should have regular blood tests to monitor the amount of potassium in your blood:
• ACE inhibitors, eg enalapril, captopril
• other angiotensin II receptor antagonists, eg losartan
• ciclosporin
• drospirenone
• epoetin (this may also oppose the blood pressure lowering effect of telmisartan)
• heparin
• NSAIDs, eg indometacin, aspirin, diclofenac, ibuprofen
• potassium-containing salt substitutes (eg Lo-Salt)
• potassium salts, eg potassium citrate for cystitis
• potassium-sparing diuretics, eg spironolactone, triamterene, amiloride
• potassium supplements
• tacrolimus. Telmisartan may increase the blood levels of the following medicines. If you are taking either of these medicines in combination with telmisartan your doctor may need to monitor their blood levels to make sure they do not rise too high:
• digoxin
• lithium

•Read the package insert and/or patient product information sheet that comes with your prescription.
• Most medications should be stored in a dry place away from heat and humidity.
• Some medications also have special instructions for storage. Check for special instructions on your prescription label.
• If your medication needs to be protected from light, it should be stored in a container that filters out light, such as a clean film canister.
• If your medication needs to be refrigerated, and you do not have a fridge available (for example, if you are working outside or on the road all day), try using a cooler with an ice pack. An ordinary cooler found at hardware or sporting goods stores will do.

•Consult your doctor for further instructions and also read the package insert and/or patient product information sheet that comes with your prescription.