{"id":25207,"date":"2022-09-12T07:40:34","date_gmt":"2022-09-12T07:40:34","guid":{"rendered":"https:\/\/zeepedia.com\/?p=25207"},"modified":"2022-09-13T06:57:15","modified_gmt":"2022-09-13T06:57:15","slug":"tolura","status":"publish","type":"post","link":"https:\/\/zeepedia.com\/medical\/medicines\/tolura\/","title":{"rendered":"Tolura &#8211; Telmisartan uses, dose and side effects"},"content":{"rendered":"\n<p>40 mg, 80 mg&nbsp;tablets<br>telmisartan<a><\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What Tolura is and what it is used for<\/h2>\n\n\n\n<p>Tolura belongs to a group of medicines called\u00a0angiotensin\u00a0II inhibitors.\u00a0Angiotensin\u00a0II is a body-specific substance that causes the blood vessels to constrict, leading to\u00a0a rise in\u00a0blood pressure.\u00a0Tolura inhibits this effect of\u00a0angiotensin\u00a0II, which leads to the dilation of the blood vessels and lowering of\u00a0blood pressure\u00a0et al.<\/p>\n\n\n\n<p>Tolura is used to treat elevated\u00a0blood pressure, so-called\u00a0essential\u00a0<a href=\"https:\/\/zeepedia.com\/medical\/diseases\/hypertension\/\">hypertension<\/a>\u00a0in adults.\u00a0Essential\u00a0means that high\u00a0blood pressure\u00a0is not caused by any other disease.<\/p>\n\n\n\n<p>High\u00a0blood pressure\u00a0that is not treated can cause damage to the blood vessels in several organs.\u00a0This can lead to heart attacks, heart or\u00a0kidney failure,\u00a0stroke,\u00a0or blindness.\u00a0Most of the time, high\u00a0blood pressure\u00a0causes no symptoms before the damage occurs.\u00a0It is therefore important to regularly measure\u00a0blood pressure\u00a0et to check if it is within normal values.<\/p>\n\n\n\n<p>Tolura is also used to reduce the number of cardiovascular events (such as heart attack or stroke\/bleeding in the brain) in adults who are at risk because of reduced or blocked blood supply to the heart or legs, or who have had a&nbsp;stroke&nbsp;or have high-risk diabetes.&nbsp;Your doctor can tell you if you are at high risk of such events.<br><a><\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What you need to know before you use Tolura<\/h2>\n\n\n\n<h2 class=\"wp-block-heading\">Do not use Tolura<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>if you are allergic to telmisartan or any of the other ingredients of this medicine (listed in section 6).<\/li><li>pregnant women should not use Tolura during the last 6 months of pregnancy.&nbsp;(Even earlier in pregnancy it is good to avoid Tolura, see Pregnancy and breastfeeding).<\/li><li>if you have severe liver problems such as cholestasis or biliary obstruction (problems with the outflow of bile from the liver and gallbladder) or any other severe liver disease.<\/li><li>if you have&nbsp;diabetes&nbsp;or impaired kidney function and are being treated with an antihypertensive medicine containing aliskiren.<\/li><\/ul>\n\n\n\n<p>If any of the above apply to you, tell your doctor or pharmacist before using Tolura.<a><\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Warnings and precautions<\/h2>\n\n\n\n<p><strong>Talk to your doctor if you have or have had any of the following diseases or conditions:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Kidney disease or kidney transplant.<\/li><li>Renal artery stenosis (narrowing of the blood vessels in one or both kidneys).<\/li><li>Liver disease.<\/li><li>Heart problems.<\/li><li>Increased aldosterone levels (water or salt accumulations in the body and altered mineral balance in the blood).<\/li><li>Low\u00a0blood pressure\u00a0(\u00a0hypotension\u00a0), can occur if you are dehydrated (have lost a lot of body fluid) or have a lack of salt due to diuretic treatment (water-reducing treatment), a diet with low salt intake, diarrhea, or vomiting.<\/li><li>High level of potassium in the blood.<\/li><li>Diabetes.<\/li><\/ul>\n\n\n\n<p><strong>Talk to your doctor before taking Tolura:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>if you take\u00a0digoxin.<\/li><li>if you are taking any of the following medicines used to treat high blood pressure:<ul><li>an ACE inhibitor (eg\u00a0enalapril, lisinopril, ramipril), especially if you have diabetes-related kidney problems.<\/li><li>the aliskiren<\/li><\/ul><\/li><\/ul>\n\n\n\n<p>If you think you are pregnant (or become pregnant) during treatment, contact your doctor.\u00a0Tolura is not recommended during pregnancy and should not be used during the last 6 months of pregnancy as it can then cause birth defects, see Pregnancy and breastfeeding.<\/p>\n\n\n\n<p>During surgery or anesthesia, you must tell your doctor that you are using Tolura.<\/p>\n\n\n\n<p>Tolura may be less effective in treating&nbsp;blood pressure&nbsp;et in patients of color.<\/p>\n\n\n\n<p>Your doctor may need to check your kidney function,\u00a0blood pressure,\u00a0and the number of\u00a0electrolytes\u00a0(eg\u00a0potassium\u00a0) in your blood at regular intervals.<\/p>\n\n\n\n<p>See also the information under the heading &#8220;Do not use Tolura&#8221;.<a><\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Children and young people<\/h2>\n\n\n\n<p>Tolura is not recommended for the treatment of children or adolescents up to the age of 18.<a><\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Other medicines and Tolura<\/h2>\n\n\n\n<p>Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines.\u00a0Your doctor may need to change the\u00a0dose\u00a0of other medicines or take other precautions.\u00a0In some cases, you may need to stop treatment with a medicine.\u00a0This is especially true if the medicines below are taken at the same time as Tolura:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Medicines containing lithium treat certain types of depression.<\/li><li>Medicines that increase the level of potassium in the blood, e.g.\u00a0potassium-containing salt substitutes, potassium-sparing\u00a0diuretics\u00a0(some diuretics),\u00a0ACE inhibitors,\u00a0angiotensin\u00a0II inhibitors, non-steroidal anti-inflammatory drugs (\u00a0NSAIDs, e.g.\u00a0aspirin\u00a0or\u00a0ibuprofen\u00a0),\u00a0heparin, immunosuppressive drugs (eg ciclosporin or tacrolimus) and trimethoprim (\u00a0antibiotics\u00a0).<\/li><li>Diuretics\u00a0(water tablets), especially if taken in high\u00a0doses\u00a0together with Tolura, can lead to excessive fluid loss and low\u00a0blood pressure\u00a0(\u00a0hypotension\u00a0).<\/li><li>If you are taking an\u00a0ACE inhibitor\u00a0or aliskiren (see also the information under the headings &#8220;Do not use Tolura&#8221; and &#8220;Warnings and precautions&#8221;).<\/li><li>Digoxin.<\/li><\/ul>\n\n\n\n<p>The effect of Tolura can be reduced when you take\u00a0NSAIDs\u00a0(non-steroidal anti-inflammatory drugs, eg\u00a0aspirin\u00a0or\u00a0ibuprofen\u00a0) or\u00a0corticosteroids.<\/p>\n\n\n\n<p>Tolura may increase the blood pressure-lowering effect of other medicines used to treat high&nbsp;blood pressure&nbsp;or medicines that can lower&nbsp;blood pressure&nbsp;et al (eg baclofen, amifostine).<\/p>\n\n\n\n<p>In addition, low\u00a0blood pressure\u00a0can be worsened by alcohol,\u00a0barbiturates, narcotics, and antidepressants.\u00a0You may notice it as dizziness when you stand up.\u00a0You should consult a doctor if you need to adjust the\u00a0dose\u00a0of one of your other medicines while taking Tolura.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Pregnancy, breastfeeding, and fertility<\/h2>\n\n\n\n<p><strong>Pregnancy<\/strong><\/p>\n\n\n\n<p>If you think you are (&nbsp;<strong>or may become<\/strong>&nbsp;) pregnant during treatment, contact your doctor.&nbsp;Usually, your doctor will suggest that you stop taking Tolura before pregnancy or as soon as you know you are pregnant and instead recommend another medicine for you.&nbsp;Tolura should not be used in early pregnancy and should not be used during the last 6 months of pregnancy as it may cause birth defects.<\/p>\n\n\n\n<p><strong>Breast-feeding<\/strong><\/p>\n\n\n\n<p>Tell your doctor if you are breastfeeding or intend to start breastfeeding.\u00a0Tolura is not recommended during breastfeeding and your doctor may choose another treatment for you if you wish to breastfeed your baby, especially if your baby is a newborn or was born prematurely.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Driving ability and use of machinery<\/h2>\n\n\n\n<p>Some people feel dizzy and tired when taking Tolura.&nbsp;If you feel dizzy or tired, do not drive or operate machinery.<a><\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Tolura contains lactose and sorbitol (E 420)<\/h2>\n\n\n\n<p>If you have an intolerance to certain sugars, you should consult your doctor before taking this medication.<\/p>\n\n\n\n<p>This medicine contains 149.8 mg of sorbitol per tablet.\u00a0Sorbitol is a source of fructose.\u00a0If you have an intolerance to certain sugars, or if you have been diagnosed with\u00a0hereditary\u00a0fructose intolerance, a rare, inherited disease that makes it impossible to break down fructose, consult a doctor before using this medicine.<br><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">How to use Tolura<\/h2>\n\n\n\n<p>Always use this medicine as directed by your doctor.&nbsp;Ask your doctor or pharmacist if you are unsure.<\/p>\n\n\n\n<p>The recommended\u00a0dose\u00a0of Tolura is one tablet a day.\u00a0Try to take the tablet at the same time each day.<\/p>\n\n\n\n<p>You can take Tolura with or without food.&nbsp;You should swallow the tablets with a glass of water or another non-alcoholic drink.&nbsp;It is important to take Tolura every day until the doctor gives other instructions.&nbsp;Contact your doctor or pharmacist if you feel that the effect of Tolura is too strong or too weak.<\/p>\n\n\n\n<p>For the treatment of high\u00a0blood pressure, the normal dose of Tolura for most patients is one 40 mg tablet once a day to control\u00a0blood pressure\u00a0it for 24 hours.\u00a0In some cases, the doctor may recommend a lower\u00a0dose, 20 mg daily, or a higher\u00a0dose, 80 mg daily.\u00a0Tolura tablets are not divisible, therefore they are unsuitable for patients who require a\u00a0dose\u00a0of 20 mg telmisartan.\u00a0For these patients, an equivalent product with the same active substance is available.\u00a0Alternatively, Tolura can be used together with a diuretic (fluid-reducing medicine) such as\u00a0hydrochlorothiazide, which has been shown to have an additional blood pressure-lowering effect together with Tolura.<\/p>\n\n\n\n<p>To reduce the number of cardiovascular events, the usual&nbsp;dose&nbsp;is one Tolura 80 mg tablet once a day.&nbsp;At the beginning of preventive treatment with Tolura 80 mg,&nbsp;blood pressure&nbsp;must be checked frequently.<\/p>\n\n\n\n<p>If you have impaired liver function, the normal dose should not exceed 40 mg once a day.<a><\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you have used too much Tolura&nbsp;<\/h2>\n\n\n\n<p>If you have taken too much,\u00a0contact\u00a0your doctor, pharmacist, or nearest emergency department immediately.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you forget to use Tolura<\/h2>\n\n\n\n<p>If you should forget to take the medicine, do not worry.\u00a0Take one\u00a0dose\u00a0as soon as you remember and continue as before. If you forget the medicine one day, take the usual\u00a0dose\u00a0the next day.\u00a0You should not take a double\u00a0dose\u00a0to compensate.<\/p>\n\n\n\n<p>If you have further questions about this medicine, contact your doctor or pharmacist.<a><\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Possible side effects<\/h2>\n\n\n\n<p>Like all medicines, this medicine can cause\u00a0side effects, although not everybody gets them.<\/p>\n\n\n\n<p><em><strong>Some&nbsp;side effects&nbsp;can be serious and require immediate medical treatment.<\/strong><\/em><\/p>\n\n\n\n<p>Contact your doctor immediately if you experience any of the following symptoms:<\/p>\n\n\n\n<p>Sepsis* (which is often called &#8220;blood poisoning&#8221; is a severe&nbsp;infection&nbsp;with inflammatory reactions throughout the body), rapid swelling of the skin and mucous membranes (&nbsp;angioedema&nbsp;).&nbsp;These&nbsp;side effects&nbsp;are rare (may affect up to 1 in 1,000 users) but extremely serious and patients should stop taking the medicine and see a doctor immediately.&nbsp;The conditions can be fatal if left untreated.<\/p>\n\n\n\n<p><em><strong>Possible&nbsp;side effects&nbsp;of Tolura<\/strong><\/em><\/p>\n\n\n\n<p><em>Common&nbsp;side effects&nbsp;(may affect up to 1 in 10 users):<\/em><\/p>\n\n\n\n<p>Low&nbsp;blood pressure&nbsp;(&nbsp;hypotension&nbsp;) in users treated to reduce the number of cardiovascular events.<\/p>\n\n\n\n<p><em>Uncommon&nbsp;side effects&nbsp;(may affect up to 1 in 100 users):<\/em><\/p>\n\n\n\n<p>Urinary tract infections, upper respiratory infection (eg, <a href=\"https:\/\/zeepedia.com\/medical\/diseases\/sore-throat\/\">sore throat<\/a>, inflamed sinuses, the common cold), lack of red blood cells\u00a0(\u00a0anemia\u00a0), high potassium levels, difficulty sleeping, low mood (depression), fainting (\u00a0syncope\u00a0), a feeling of dizziness (\u00a0vertigo\u00a0), slow heart rhythm (\u00a0bradycardia\u00a0), low\u00a0blood pressure\u00a0(\u00a0hypotension\u00a0) in users treated for high\u00a0blood pressure, dizziness when standing up (\u00a0orthostatic\u00a0hypotension\u00a0), shortness of breath, cough, stomach pain, diarrhea, gastrointestinal discomfort, swelling, vomiting,\u00a0itching, sweating, skin rash due to medication, <a href=\"https:\/\/zeepedia.com\/medical\/diseases\/back-hurts\/\">back pain<\/a>, <a href=\"https:\/\/zeepedia.com\/medical\/diseases\/muscle-cramp-transmission\/\">muscle spasm<\/a>, muscle pain (\u00a0myalgia\u00a0), reduced kidney function including\u00a0acute\u00a0kidney failure, chest pain, weakness and increased level of\u00a0creatinine\u00a0in the blood.<\/p>\n\n\n\n<p><em>Rare&nbsp;side effects&nbsp;(may affect up to 1 in 1,000 users):<\/em><\/p>\n\n\n\n<p>Sepsis* (which is often called &#8220;blood poisoning&#8221;, is a severe&nbsp;infection&nbsp;with inflammatory reactions throughout the body, which can lead to death), increased number of certain&nbsp;white blood cells&nbsp;(eosinophilia), low&nbsp;platelet count&nbsp;(&nbsp;thrombocytopenia&nbsp;), severe allergic reactions (&nbsp;anaphylactic reaction&nbsp;), allergic reactions (e.g. skin rash,&nbsp;itching&nbsp;, difficulty breathing, wheezing, facial swelling or low&nbsp;blood pressure&nbsp;), low blood sugar (in patients with&nbsp;diabetes&nbsp;), restlessness,&nbsp;somnolence&nbsp;, visual disturbances, rapid heartbeat (&nbsp;tachycardia&nbsp;),&nbsp;dry mouth, upset stomach, altered sense of taste (&nbsp;dysgeusia&nbsp;), abnormal liver function (Japanese patients are at greater risk of this side effect), rapid swelling of the skin and mucous membranes that can lead to death (&nbsp;angioedema&nbsp;even with a fatal outcome),&nbsp;eczema&nbsp;(a skin disease), skin redness ,&nbsp;hives&nbsp;, severe skin rashes due to medicines, <a href=\"https:\/\/zeepedia.com\/medical\/diseases\/joint-pain\/\">joint pain<\/a> (&nbsp;arthralgia&nbsp;), pain in the&nbsp;extremities&nbsp;, pain in the tendons, flu-like illness, reduced levels of&nbsp;hemoglobin&nbsp;(a blood protein), increased levels of&nbsp;uric acid&nbsp;, increased levels of liver enzymes or creatine phosphokinase in the blood.<\/p>\n\n\n\n<p><em>Very rare&nbsp;side effects&nbsp;(may affect up to 1 in 10,000 users):<\/em><\/p>\n\n\n\n<p>Progressive&nbsp;scarring of lung tissue (interstitial lung disease)**<\/p>\n\n\n\n<p>* These&nbsp;side effects&nbsp;may be coincidental or related to a mechanism that is currently unknown.<\/p>\n\n\n\n<p>** Cases of&nbsp;progressive&nbsp;scarring of lung tissue have been reported during treatment with telmisartan.&nbsp;However, it is not known whether telmisartan is the cause.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">How Tolura should be stored<\/h2>\n\n\n\n<p>Keep this medicine out of the sight and reach of children.<\/p>\n\n\n\n<p>Use before the expiry date stated on the carton after &#8220;EXP&#8221;.&nbsp;The expiration date is the last day of the specified month.<\/p>\n\n\n\n<p>Store at a maximum of 30\u00b0C.<\/p>\n\n\n\n<p>Store in the original packaging.&nbsp;Light sensitive.<\/p>\n\n\n\n<p>Medicines must not be thrown into the drain or among the household waste.\u00a0Ask the pharmacist how to dispose of medicines that are no longer used.\u00a0These measures will help to protect the environment.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Contents of the packaging and other information<\/h2>\n\n\n\n<h2 class=\"wp-block-heading\">Contents declaration<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>The active substance is telmisartan.\u00a0Each tablet contains 20 mg, 40 mg, and 80 mg of telmisartan, respectively.<\/li><li>Other ingredients in Tolura 20 mg are povidone, meglumine, sodium hydroxide,\u00a0lactose monohydrate, sorbitol (E 420), and magnesium stearate.<\/li><li>Other ingredients in Tolura 40 mg are povidone, meglumine, sodium hydroxide,\u00a0lactose monohydrate, sorbitol (E 420), and magnesium stearate.<\/li><li>Other ingredients in Tolura 80 mg are povidone, meglumine, sodium hydroxide,\u00a0lactose monohydrate, sorbitol (E 420), and magnesium stearate.<br>See section 2 &#8220;Tolura contains\u00a0lactose\u00a0and sorbitol (E 420)&#8221;.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Appearance and package sizes of the medicine<\/h2>\n\n\n\n<p>Tolura 40 mg tablets are white to off-white, biconvex, oval tablets.<\/p>\n\n\n\n<p>Tolura 80 mg tablets are white to almost white, biconvex, oval tablets, and capsule-shaped tablets.<\/p>\n\n\n\n<p>Tolura is available in blister packs of 14, 28, 30, 56, 84, 90, 98 or 100 tablets.<\/p>\n\n\n\n<p>Not all pack sizes may be marketed.<a><\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Marketing authorization holder and manufacturer<\/h2>\n\n\n\n<p><strong>Marketing Authorisation Holder:<\/strong><\/p>\n\n\n\n<p>KRKA, dd, Novo mesto, \u0160marje\u0161ka cesta 6, 8501 Novo mesto, Slovenia<\/p>\n\n\n\n<p><strong>Manufacturer:<\/strong><\/p>\n\n\n\n<p>KRKA, dd, Novo mesto, \u0160marje\u0161ka cesta 6, 8501 Novo mesto, Slovenia<\/p>\n\n\n\n<p>KRKA-POLSKA Sp.&nbsp;z o. o., ul.&nbsp;R\u00f3wnoleg\u0142a 5, 02-235 Warsaw, Poland<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tolura is used to treat elevated\u00a0blood pressure\u00a0, so-called\u00a0essential\u00a0hypertension\u00a0in adults.\u00a0Essential\u00a0means that the high\u00a0blood pressure\u00a0is not caused by any other disease.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"cybocfi_hide_featured_image":"","footnotes":""},"categories":[2200,22500],"tags":[17468,17472,17471,26062,26066,26065,17469,26063,17470,26064],"class_list":["post-25207","post","type-post","status-publish","format-standard","hentry","category-medicines","category-t","tag-telmisartan","tag-telmisartan-side-effects","tag-telmisartan-tablet","tag-tolura","tag-tolura-side-effects","tag-tolura-tablet","tag-what-is-telmisartan","tag-what-is-tolura","tag-what-telmisartan-is-used-for","tag-what-tolura-is-used-for"],"_links":{"self":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/25207","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/comments?post=25207"}],"version-history":[{"count":4,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/25207\/revisions"}],"predecessor-version":[{"id":25257,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/25207\/revisions\/25257"}],"wp:attachment":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/media?parent=25207"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/categories?post=25207"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/tags?post=25207"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}