Micardis/Micardis Plus Dosage/Direction for Use

Micardis: Adults: Treatment of Essential Hypertension: Recommended Dose: 40 mg once daily.
In cases where the target blood pressure is not achieved, telmisartan dose can be increased to a maximum of 80 mg once daily. Alternatively, telmisartan may be used in combination with thiazide-type diuretics eg, hydrochlorothiazide which has been shown to have an additive blood pressure-lowering effect with Micardis. When considering raising the dose, it must be borne in mind that the maximum antihypertensive effect is generally attained 4-8 weeks after the start of treatment. In patients with severe hypertension treatment with telmisartan at doses up to 160 mg alone and in combination with hydrochlorothiazide 12.5-25 mg daily was well tolerated and effective.
Prevention of Cardiovascular Morbidity and Mortality: The recommended dose is 80 mg once daily. It is not known whether doses lower than telmisartan 80 mg are effective in preventing cardiovascular morbidity and mortality. When initiating telmisartan therapy for the prevention of cardiovascular morbidity and mortality, monitoring of blood pressure is recommended, and if appropriate adjustment of medications that lower blood pressure may be necessary.
Elderly: No dosing adjustment is necessary.
Renal Impairment: No dosage adjustment is required for patients with renal impairment, including patients on hemodialysis. Telmisartan is not removed from blood by hemofiltration.
Hepatic Impairment: In patients with mild to moderate hepatic impairment, the dosage should not exceed 40 mg once daily.
Micardis Plus: Adults: Micardis Plus should be taken once daily. The dose of telmisartan could be up-titrated before switching to Micardis Plus. Direct change from monotherapy to the fixed combinations may be considered.
Micardis Plus 40/12.5 mg may be administered in patients whose blood pressure is not adequately controlled by telmisartan 40 mg or hydrochlorothiazide.
Micardis Plus 80/12.5 mg may be administered in patients whose blood pressure is not adequately controlled by Micardis 80 mg or by Micardis Plus 40/12.5 mg.
The maximum antihypertensive effect is generally attained with Micardis Plus 4-8 weeks after the start of treatment.
When necessary, Micardis Plus may be administered with another antihypertensive drug.
In patients with severe hypertension, treatment with telmisartan at doses up to 160 mg alone and in combination with hydrochlorothiazide 12.5-25 mg daily was well tolerated and effective.
Elderly: No dosage adjustment is necessary.
Renal Impairment: Due to the hydrochlorothiazide component, Micardis Plus should not be used in patients with severe renal dysfunction (CrCl <30 mL/min). Loop diuretics are preferred to thiazides in this population. Experience in patients with mild to moderate renal impairment is modest but has not suggested adverse renal effects and dose adjustment is not considered necessary. Periodic monitoring of renal function is advised.
Hepatic Impairment: In patients with mild to moderate hepatic impairment, the dosage should not exceed Micardis Plus 40/12.5 mg once daily. Micardis Plus is not indicated in patients with severe hepatic impairment. Thiazides should be used with caution in patients with impaired hepatic function.
Administration: Micardis/Micardis Plus may be taken with or without food.