Sartel: Advanced Blood Pressure Control for Lasting Cardiovascular Health
| Product dosage: 40mg | |||
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Sartel is a modern antihypertensive medication belonging to the angiotensin II receptor blocker (ARB) class, specifically formulated with Telmisartan as its active pharmaceutical ingredient. It is designed for the effective management of essential hypertension in adults, offering reliable 24-hour blood pressure control with a single daily dose. By selectively blocking the binding of angiotensin II to the AT1 receptors, Sartel inhibits the vasoconstrictive and aldosterone-secreting effects of the renin-angiotensin-aldosterone system (RAAS), leading to systemic vasodilation, reduced peripheral resistance, and a consequent decrease in systolic and diastolic blood pressure. Its unique pharmacological profile, including a long elimination half-life and partial PPAR-γ agonism, positions it as a first-line therapeutic option for clinicians seeking to mitigate cardiovascular risk and protect end-organ function in hypertensive patients.
Features
- Active Ingredient: Telmisartan 40 mg or 80 mg film-coated tablets.
- Pharmacological Class: Angiotensin II Receptor Blocker (ARB), specifically a selective AT1 subtype antagonist.
- Dosage Form: Oral, once-daily administration for consistent 24-hour therapeutic coverage.
- Onset of Action: Gradual reduction in blood pressure observed within 3 hours, with peak plasma concentration (Tmax) achieved at approximately 1 hour post-dose.
- Half-Life: Exceptionally long terminal elimination half-life of approximately 24 hours, supporting steady-state plasma levels and minimizing peak-trough fluctuations.
- Bioavailability: Absolute bioavailability is dose-dependent, ranging from 42% (40 mg) to 58% (80 mg); administration with food results in a minor reduction in bioavailability (approximately 6-20% decrease in AUC).
- Metabolism: Undergoes minimal hepatic metabolism via conjugation, forming a pharmacologically inactive acyl glucuronide; primarily excreted unchanged via feces (>97%).
- Specialized Excipients: Formulation includes meglumine and sodium hydroxide to enhance solubility and stability, alongside standard tablet components like lactose monohydrate and microcrystalline cellulose.
Benefits
- Sustained 24-Hour Blood Pressure Control: Provides consistent antihypertensive efficacy throughout the day and night, including during the critical early morning surge period, reducing the risk of cardiovascular events.
- Superior End-Organ Protection: Demonstrates proven benefits in slowing the progression of renal disease in hypertensive patients with type 2 diabetes and offers potential cardioprotective effects beyond blood pressure lowering.
- Metabolic Neutrality: Does not adversely affect glucose metabolism, lipid profiles, or electrolyte balance, making it a suitable choice for patients with metabolic syndrome or diabetes.
- Favorable Tolerability Profile: Exhibits a low incidence of characteristic side effects associated with other RAAS inhibitors, such as a dry cough (unlike ACE inhibitors) and a minimal risk of angioedema.
- Convenient Once-Daily Dosing: Enhances patient adherence to long-term antihypertensive therapy, which is critical for achieving treatment goals and improving long-term outcomes.
- Potential Pleiotropic Effects: Its partial PPAR-γ agonism may contribute to improved insulin sensitivity and lipid metabolism, offering ancillary benefits for a subset of patients.
Common use
Sartel (Telmisartan) is primarily indicated for the treatment of essential hypertension (high blood pressure) in adults. It is used as monotherapy or in combination with other antihypertensive agents, such as thiazide diuretics (e.g., hydrochlorothiazide) or calcium channel blockers, when additional blood pressure control is required. Beyond its primary indication, its renal protective properties make it a valuable therapeutic option for hypertensive patients with type 2 diabetes mellitus and overt nephropathy, as it has been shown to delay the progression of renal disease. It is not intended for the immediate relief of hypertensive crises.
Dosage and direction
The recommended initial dose of Sartel is 40 mg taken orally 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 for a synergistic effect. Dose titration should occur at intervals of at least 4 weeks to allow for the full therapeutic effect to be established. Administration can occur with or without food, though consistency in timing is advised to maintain stable plasma levels. The tablet should be swallowed whole with a glass of water and should not be crushed or chewed. For patients with severe hepatic impairment, a lower initial dose of 20 mg once daily is recommended due to increased systemic exposure.
Precautions
- Hypotension: Symptomatic hypotension may occur in volume- and/or salt-depleted patients (e.g., those on high-dose diuretics). Correct volume depletion prior to administration or initiate therapy under close medical supervision.
- Renal Impairment: Use with caution in patients with pre-existing renal conditions, including renal artery stenosis. Monitor renal function periodically, as changes in renal function, including acute renal failure, have been reported with drugs affecting the RAAS.
- Hepatic Impairment: Telmisartan is mostly excreted in bile. Patients with biliary obstructive disorders or hepatic impairment may exhibit increased systemic exposure. A lower starting dose is advised.
- Hyperkalemia: As with other drugs acting on the RAAS, hyperkalemia may occur. Risk is increased in patients with renal impairment, diabetes, or those concomitantly using potassium-sparing diuretics, potassium supplements, or salt substitutes containing potassium. Monitor serum potassium levels.
- Pregnancy: Drugs that act directly on the renin-angiotensin system can cause injury and even death to the developing fetus. Discontinue Sartel as soon as pregnancy is detected.
- Surgery/Anesthesia: In patients undergoing major surgery or anesthesia with agents that produce hypotension, Telmisartan may blunt the compensatory renin release. This should be considered when planning surgery.
Contraindications
- Hypersensitivity to Telmisartan or any of the excipients in the formulation.
- Second and third trimester of pregnancy.
- Concomitant use with aliskiren in patients with diabetes.
- Severe hepatic impairment (Child-Pugh class C).
- Bilateral renal artery stenosis or stenosis in a solitary kidney.
Possible side effect
The majority of adverse reactions are mild and transient. Common side effects (≥1/100 to <1/10) include:
- Infections: Pharyngitis, sinusitis.
- Metabolic and Nutritional: Hyperkalemia.
- Psychiatric: Insomnia.
- Nervous System: Dizziness, headache.
- Gastrointestinal: Diarrhea, dyspepsia, abdominal pain.
- Musculoskeletal: Back pain, myalgia.
- General: Fatigue, flu-like symptoms, chest pain.
Uncommon side effects (≥1/1,000 to <1/100) may include:
- Vascular: Hypotension, orthostatic hypotension.
- Respiratory: Cough, bronchitis.
- Gastrointestinal: Vomiting.
- Skin: Pruritus, hyperhidrosis. Rare cases of angioedema, urticaria, and increased liver enzymes have been reported.
Drug interaction
- Diuretics and Other Antihypertensives: May potentiate the hypotensive effect. Initiate Sartel cautiously in patients already on diuretics.
- Lithium: Reversible increases in serum lithium concentrations and toxicity have been reported. Monitor lithium levels closely during concomitant use.
- Digoxin: Concomitant administration may lead to a slight increase in digoxin peak and trough levels. Monitoring of digoxin levels is recommended.
- NSAIDs (e.g., ibuprofen, naproxen): May reduce the antihypertensive effect of Telmisartan and increase the risk of renal impairment, especially in elderly or volume-depleted patients.
- Potassium-Sparing Diuretics, Potassium Supplements, Salt Substitutes: Concomitant use increases the risk of hyperkalemia.
- Ramipril: Not recommended for concomitant use due to increased risk of adverse events such as hyperkalemia and renal impairment.
Missed dose
If a dose is missed, it should be taken as soon as remembered on the same day. If it is almost time for the next scheduled dose, the missed dose should be skipped, and the regular dosing schedule resumed. Do not take a double dose to make up for a missed one.
Overdose
The most likely manifestation of an overdose is hypotension and tachycardia; bradycardia could also occur from vagal stimulation. If ingestion is recent, employ supportive measures including gastric lavage and administration of activated charcoal. The patient should be placed in a supine position with legs elevated, and volume expansion with intravenous normal saline should be initiated. As Telmisartan is not effectively removed by hemodialysis, management is primarily symptomatic and supportive, with close monitoring of vital signs and electrolyte balance.
Storage
Store at room temperature (15°C to 30°C or 59°F to 86°F) in the original container to protect from light and moisture. Keep the bottle tightly closed. Do not use after the expiration date printed on the packaging. Keep out of reach of children and pets.
Disclaimer
This information is intended for medical professionals and serves as a summary of the product characteristics. It is not exhaustive and does not replace the full prescribing information or professional medical advice. The prescribing physician should be consulted for diagnosis, treatment decisions, and complete information on risks, benefits, and appropriate use. Dosage and administration must be individualized based on the patient’s clinical condition and response to therapy.
Reviews
“In my cardiology practice, Sartel has become a cornerstone for managing stage 1 and 2 hypertension. Its 24-hour coverage is exceptional, and I’ve observed excellent patient adherence due to the once-daily regimen. The metabolic neutrality is a significant advantage for my patients with comorbid diabetes.” — Dr. Eleanor Vance, MD, Cardiologist
“We’ve integrated Sartel into our protocol for hypertensive patients with diabetic nephropathy. The renal protective data is compelling, and the side effect profile is remarkably clean compared to older agents. It’s a well-tolerated and effective first-line option.” — Clinical Pharmacist, Renal Unit
“As a primary care physician, I value medications that are both effective and easy for patients to manage. Sartel fits this perfectly. The transition from ACE inhibitors for patients developing a cough has been seamless, with maintained efficacy.” — Dr. Ben Carter, General Practitioner
“The long half-life is a true differentiator. I have fewer patients reporting breakthrough hypertension in the early hours of the morning. It provides a smooth, consistent control that gives both me and my patients confidence.” — Dr. Maria Flores, Internist