Abbildung 13: Telmisartan - Wechselwirkung
Telmisartan is not metabolized by cytochrome P450, an enzyme that is important for the oxidative metabolism of a number of other drugs. Therefore, the potential for interaction with drugs metabolized by this pathway is low.1 Telmisartan is primarily metabolized by glucuronidation.2 Other drugs metabolized by glucuronidation include paracetamol (acetaminophen) and ibuprofen. There is no effect of telmisartan on the pharmacokinetics of these drugs.3 Telmisartan has been assessed for interaction with a number of other drugs that are likely to be used concomitantly, with no evidence of a significant effect.4–7 Telmisartan can result in elevated serum digoxin in some patients. However, clinical trials and post-marketing surveillance has revealed no evidence of a clinically significant interaction.8 1. Wienen W, et al. A review on telmisartan: a novel, long-acting angiotensin II-receptor antagonist. Cardiovasc Drug Rev 2000; 18: 127–156. 2. Stangier J, et al. Absorption, metabolism and excretion of intravenously and orally administered [14C]telmisartan in healthy volunteers. J Clin Pharmacol 2000; 40: 1312–1322. 3. Stangier J, et al. Pharmacokinetics of acetaminophen and ibuprofen when coadministered with telmisartan in healthy volunteers. J Clin Pharmacol 2000; 40: 1338–1346. 4. Stangier J, Su CAPF. Pharmacokinetics of repeated oral doses of amlodipine and amlodipine plus telmisartan in healthy volunteers. J Clin Pharmacol 2000; 40: 1338–1346. 5. Heuer HJ, et al. Influence of repeated oral doses of telmisartan on the clinical pharmacology of glibenclamide in healthy volunteers. Eur J Clin Pharmacol 1998; 54: A12 (abstract 38). 6. Stangier J, et al. Steady-state pharmacodynamics and pharmacokinetics of warfarin in the presence and absence of telmisartan in healthy volunteers. J Clin Pharmacol 2000; 40: 1331–1337. 7. Dunselman PHJM, and the replacement of angiotensin converting enzyme inhibition (REPLACE) investigators. Effects of the replacement of the angiotensin converting enzyme inhibitor enalapril by the angiotensin II receptor blocker telmisartan in patients with congestive heart failure. Int J Cardiol 2001; 77: 131–138. 8. Unger T, Kaschina E. Drug interactions with angiotensin receptor blockers: a comparison with other antihypertensives. Drug Safety 2003; 26: 707–720.