Arbitel-40 Dosage/Direction for Use

Dosage must be individualized. The usual starting dose of telmisartan is 40 mg once a day. Some patients may derive benefit at a daily dose of 20 mg. Blood pressure response is dose related over the range of 20-80 mg. Most of the antihypertensive effect is apparent within two weeks and maximal reduction is generally attained after four weeks. When additional blood pressure reduction beyond that achieved with 80 mg telmisartan is required, a diuretic may be added.
Patients with depletion of intravascular volume should have the condition corrected or telmisartan should be initiated under close medical supervision. Patients with biliary obstructive disorders or hepatic insufficiency should have treatment started under close medical supervision. Patients on dialysis may develop orthostatic hypotension; their blood pressure should be closely monitored. As limited experience is available in patients with severe renal impairment or haemodialysis, a lower starting dose of 20 mg is recommended in these patients. In patients with mild to moderate hepatic impairment, the dosage should not exceed 40 mg once daily.