Vetdrugs 2.0Telmisartan is an angiotensin-II receptor blocker used in veterinary renal and cardiovascular medicine. Established feline applications include systemic hypertension and reduction of proteinuria associated with chronic kidney disease, with product indications differing by region. It is also used extra-label in selected dogs with proteinuric kidney disease or hypertension.
Group
Angiotensin II AT1-receptor blocker
Mechanism of Action
Telmisartan selectively antagonizes angiotensin-II AT1 receptors, reducing receptor-mediated vasoconstriction and aldosterone-associated effects. In the kidney, reduced angiotensin-dependent glomerular pressure can decrease protein leakage into urine. Vascular relaxation lowers systemic blood pressure. Direct receptor blockade acts on angiotensin II regardless of the enzyme pathway responsible for its formation.
Dose Rates
Dogs
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Hypertension or proteinuria — Initial | 1 mg/kg | PO | Every 24 h | Starting regimen; source describes escalation to 3 mg/kg daily and, in selected refractory cases, twice daily with monitoring. |
| Hypertension or proteinuria — Maintenance | 3 mg/kg | PO | Every 24 h | Escalation only when justified by monitored response; not the initial dose. |
Cats
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Systemic hypertension — Initial | 1.5 mg/kg | PO | Every 12 h | Up to 14 days; Initial 14-day regimen, followed by the once-daily maintenance regimen. |
| Systemic hypertension — Maintenance | 2 mg/kg | PO | Every 24 h | After the initial course. Reduce to 1 mg/kg daily if hypotensive; titration follows measured blood pressure. |
Indications
- Control of systemic hypertension in cats.
- Reduction of proteinuria associated with feline chronic kidney disease using a corresponding product or supported protocol.
- Extra-label reduction of renal proteinuria in selected dogs with proteinuric chronic kidney disease.
- Treatment of selected canine systemic hypertension within an individualized antihypertensive plan.
Contraindications
- Do not initiate in a dehydrated, hypovolaemic or hypotensive patient without stabilisation.
- Pregnancy and breeding safety are not established.
Interactions
- Dual RAAS blockade with an ACE inhibitor may increase renal injury, hypotension and hyperkalaemia.
- Other antihypertensives may increase hypotension; NSAIDs can increase renal risk in volume depletion.
Adverse effects
- Vomiting, diarrhoea, hypersalivation, lethargy, hypotension, anaemia and altered renal indices.
Toxicity
Support blood pressure and hydration after overdose; monitor renal function, potassium and red-cell indices.
Preparations
| Preparation | Form | Strength | Route |
|---|---|---|---|
| Semintra oral solution 10 mg/mL | Oral Liquid | 10 mg / mL | PO |
| Telmisartan 20 mg tablet | Tablet | 20 mg / tablet | PO |
| Telmisartan 40 mg tablet | Tablet | 40 mg / tablet | PO |
| Telmisartan 80 mg tablet | Tablet | 80 mg / tablet | PO |
Monitoring and Administration
Check blood pressure within 7-10 days of starting or adjusting treatment; also assess creatinine, potassium, hydration and urinary protein response.
Do not interchange the 4 and 10 mg/mL oral solutions by syringe volume. Give directly or with a small amount of food according to the specific product directions.
For symptomatic hypotension reduce or withhold treatment and reassess; avoid combining starting and maintenance regimens.