Sartel: Advanced Angiotensin II Receptor Blockade for Hypertension Control
| Product dosage: 40mg | |||
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Sartel is a prescription medication containing the active ingredient Telmisartan, a potent angiotensin II receptor blocker (ARB) designed for the management of essential hypertension in adults. It works by selectively blocking the binding of angiotensin II to the AT1 receptor, resulting in vasodilation, reduced aldosterone secretion, and decreased blood pressure. Clinical studies demonstrate its efficacy in providing 24-hour hemodynamic control with a single daily dose, making it a cornerstone in modern antihypertensive therapy. Its unique pharmacokinetic profile offers reliable trough-to-peak ratios, ensuring consistent blood pressure reduction throughout the dosing interval.
Features
- Active ingredient: Telmisartan 40 mg or 80 mg film-coated tablets
- Pharmacologic class: Angiotensin II receptor blocker (ARB), selective for AT1 subtype
- Bioavailability: Approximately 42%, with dose-proportional increases in plasma concentration
- Time to peak plasma concentration (Tmax): 0.5–1 hour post-administration
- Elimination half-life: Approximately 24 hours, supporting once-daily dosing
- Protein binding: >99.5%, primarily to albumin and α-1-acid glycoprotein
- Metabolism: Minimal hepatic metabolism via conjugation; no active metabolites
- Excretion: Primarily fecal (>97%) as unchanged drug; renal elimination <2%
Benefits
- Provides sustained 24-hour blood pressure control with single daily dosing, supporting adherence
- Reduces risk of stroke, myocardial infarction, and cardiovascular mortality in hypertensive patients
- Demonstrates neutral metabolic effects with no significant impact on glucose tolerance or lipid profile
- Offers renal protective effects by reducing glomerular pressure and proteinuria in diabetic nephropathy
- Exhibits favorable tolerability with low incidence of typical ARB side effects like cough or angioedema
- May provide pleiotropic benefits including PPAR-γ modulation with potential metabolic advantages
Common use
Sartel is primarily indicated for the treatment of essential hypertension in adults, either as monotherapy or in combination with other antihypertensive agents. It is particularly valuable in patients who develop cough with ACE inhibitors, as it provides similar hemodynamic benefits without this adverse effect. Clinicians may also consider Sartel for cardiovascular risk reduction in patients with hypertension and established atherosclerotic cardiovascular disease or diabetes with end-organ damage. Off-label uses may include renal protection in diabetic patients with microalbuminuria, though this requires careful clinical evaluation.
Dosage and direction
The recommended initial dose is 40 mg once daily. For patients requiring further blood pressure reduction, the dose may be increased to 80 mg once daily. Alternatively, a diuretic may be added to the 40 mg dose. Dose titration should generally occur at intervals of at least 2 weeks to allow full therapeutic effect. May be taken with or without food, though consistency in administration relative to meals is recommended. Tablets should be swallowed whole with a glass of water; they should not be crushed or chewed. For patients with hepatic impairment, initiation with 20 mg once daily is recommended, with careful monitoring.
Precautions
Monitor renal function and electrolytes periodically, particularly in patients with renal artery stenosis, heart failure, or volume depletion. Use caution in patients with hepatic impairment due to increased bioavailability. May cause hyperkalemia, especially in patients with renal impairment, diabetes, or those taking potassium supplements or potassium-sparing diuretics. Not recommended during pregnancy due to potential fetal harm. Orthostatic hypotension may occur, particularly in volume-depleted patients. Regular blood pressure monitoring is essential to assess therapeutic response.
Contraindications
Hypersensitivity to Telmisartan or any component of the formulation. Concomitant use with aliskiren in patients with diabetes. Second and third trimester of pregnancy. Severe hepatic impairment (Child-Pugh class C). Bilateral renal artery stenosis or stenosis to a solitary kidney. Concomitant use with ACE inhibitors in patients with diabetic nephropathy requires extreme caution and is generally not recommended.
Possible side effects
Common (≥1/100 to <1/10): dizziness, headache, upper respiratory tract infection, back pain, sinusitis, diarrhea. Uncommon (≥1/1,000 to <1/100): hypotension, syncope, insomnia, anxiety, vomiting, dyspepsia, increased sweating, pruritus, muscle cramps, myalgia, chest pain, urinary tract infection. Rare (<1/1,000): angioedema, rash, urticaria, tachycardia, bradycardia, eosinophilia, thrombocytopenia, hyperkalemia, increased liver enzymes, renal impairment including acute renal failure.
Drug interaction
Increased risk of hyperkalemia with potassium-sparing diuretics, potassium supplements, salt substitutes containing potassium, or other drugs that may increase serum potassium. Enhanced hypotensive effect with other antihypertensive agents, diuretics, or alcohol. NSAIDs may reduce antihypertensive effect and increase risk of renal impairment. Lithium levels may increase due to reduced renal clearance. Digoxin peak plasma concentration may be increased by 20–50%. Ramipril may increase Telmisartan AUC by approximately 30%.
Missed dose
If a dose is missed, it should be taken as soon as remembered on the same day. If it is nearly time for the next dose, skip the missed dose and continue with the regular dosing schedule. Do not take a double dose to make up for a missed dose. Maintain consistent dosing intervals to ensure optimal blood pressure control.
Overdose
The most likely manifestation of overdose is hypotension and tachycardia. Bradycardia might also occur. If overdose occurs, symptomatic and supportive treatment should be instituted. The patient should be placed in supine position with elevated legs. Volume replacement with intravenous normal saline may be appropriate. Hemodialysis is not effective for removal due to high protein binding. Close monitoring of vital signs and electrolyte status is essential. Vasopressors may be required in severe cases.
Storage
Store at room temperature (15–30°C or 59–86°F) in the original container to protect from moisture. Keep tightly closed and out of reach of children. Do not use after the expiration date printed on the packaging. Protect from light and excessive humidity. Do not store in bathroom or near kitchen sink. Discard any tablets that appear discolored or show signs of deterioration.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Sartel is a prescription medication that should only be used under the supervision of a qualified healthcare professional. Individual response to therapy may vary. Patients should not adjust dosage or discontinue treatment without consulting their physician. The complete prescribing information should be consulted before initiating therapy.
Reviews
Clinical trials demonstrate Sartel (Telmisartan) 80 mg provides superior 24-hour blood pressure control compared to other ARBs, with mean reductions of 14.7/9.5 mmHg in sitting BP. 87% of patients achieved target BP (<140/90 mmHg) at 8 weeks. Long-term studies show maintained efficacy over 52 weeks with consistent tolerability profile. Patient satisfaction surveys indicate high adherence rates due to once-daily dosing and minimal side effects. Real-world evidence supports cardiovascular risk reduction benefits in hypertensive populations with metabolic syndrome.