Telmisartan: veterinary dose and monograph

At a glance

Drug class

Cardiovascular

Also known as

Semintra, Micardis

Species with doses

Dogs and Cats

General dose range

1–3 mg/kg PO q24h — check the species tables for the indication

Routes

PO

Last reviewed

1 October 2026

Indications

• Feline CKD-associated proteinuria (PRIMARY indication)
• Feline systemic hypertension (alternative to amlodipine)
• Canine proteinuric kidney disease (extra-label)
• Canine MMVD / DCM (alternative to ACE-I in ACE-intolerant patients)
• Canine hypertension

Telmisartan dose by species

Doses are per administration unless stated. mg/kg doses scale with body weight; per-animal, per-quarter and infusion-rate doses are shown as the reference writes them.

Dogs

• Proteinuria / hypertension (extra-label): Papich 5e: 1 mg/kg PO once daily as a starting dose; increase to 3 mg/kg once daily and then twice daily if needed. Monitor creatinine, potassium and blood pressure.

Cats

• CKD proteinuria (Semintra): Label dose (Semintra, oral solution): 1 mg/kg PO once daily for proteinuria in feline CKD. Give directly or with a small amount of food.
• Systemic hypertension — first 14 days: Papich 5e: 1.5 mg/kg PO q12h for the first 14 days, then 2 mg/kg PO q24h. Monitor blood pressure.
• Systemic hypertension — maintenance: Papich 5e: 2 mg/kg PO q24h after the 14-day induction (0.2 mL/kg of the 10 mg/mL solution). Adjust in 0.5 mg/kg steps by blood pressure; hypotensive cats usually go down to 1 mg/kg.

Contraindications

Severe hepatic impairment (telmisartan metabolised by liver). Pregnancy / breeding (fetal renal failure). Hypotension, dehydration, hypovolaemia. Hyperkalaemia. Concurrent ACE-I (excessive RAAS blockade — additive hyperkalaemia / hypotension). Concurrent K-sparing diuretic (hyperkalaemia).

Species-specific warnings

Cats: First-line for CKD proteinuria and hypertension per IRIS 2024 guidelines. Semintra is highly palatable; preferred over ACE-I in most cases. NEVER combine with enalapril.

Dogs: Extra-label use for proteinuric CKD and ACE-intolerant MMVD. 0.5–1 mg/kg PO q24h. Same pregnancy contraindication as ACE-I.

Adverse effects

• Hypotension (mild)
• GI upset (vomiting, anorexia) — uncommon
• Hyperkalaemia (mild — monitor if combined with spironolactone)
• Mild azotaemia (much less than ACE-I)
• Rare hepatic enzyme elevation
• Dizziness / sedation (very uncommon)

Drug interactions

• ACE inhibitors (enalapril, benazepril): additive RAAS blockade — hyperkalaemia / hypotension risk. AVOID combination unless under specialist supervision.
• K-sparing diuretics (spironolactone): additive hyperkalaemia
• K supplements / KCl salt substitutes: hyperkalaemia
• NSAIDs: blunt antihypertensive effect; additive nephrotoxicity in dehydration
• Diuretics (furosemide): synergistic antihypertensive effect — caution for first-dose hypotension
• Lithium: reduced clearance (rarely relevant in vet practice)

Pregnancy and lactation

CONTRAINDICATED in pregnancy — fetal renal failure, oligohydramnios, pulmonary hypoplasia, skull deformities (similar to ACE-I). FDA Category D (1st tri) / X (2nd–3rd tri). NEVER initiate in pregnant animals; discontinue if pregnancy diagnosed.

Monitoring

• Blood pressure at baseline, 1 week after starting, then every 3 months
• Renal function (BUN, creatinine, urinalysis with UPC ratio) baseline, 1 week, then every 3 months
• Electrolytes (K+, Na+) on same schedule
• Hepatic enzymes if used >6 months
• Pregnancy status documented before every prescription in intact females
• Proteinuria response — UPC at 4–6 weeks; target <0.5

Toxicity and overdose

Wide therapeutic margin. Overdose: hypotension, dizziness, mild azotaemia. Hyperkalaemia rare in vet patients. No teratogenicity reported at therapeutic doses in adult animals (but contraindicated in pregnancy).

Management: Supportive — IV fluids for hypotension, electrolyte correction for K abnormality. No specific antidote. Most overdoses resolve within 24–48 h. Vasopressor (norepinephrine) for refractory hypotension.

Clinical pearls

• Cats with CKD-associated proteinuria (IRIS stage 2–4 with UPC >0.4): Semintra 1 mg/kg PO q24h — first-line per IRIS 2024 guidelines
• Cats with systemic hypertension: 1.5–3 mg/kg PO q24h — comparable to amlodipine for BP control with proteinuria reduction
• Cats palatability is excellent — many cats voluntarily accept Semintra liquid
• Renoprotective effect independent of BP — reduces glomerular hyperfiltration
• No dose reduction needed in CKD (biliary excretion) — advantage over ACE-I
• NEVER combine with ACE-I (enalapril) routinely — hyperkalaemia / hypotension risk; specialist-only combo for refractory cases
• Pregnancy contraindicated — fetal renal failure same as ACE-I
• Replaces benazepril / enalapril in many feline CKD practices due to better tolerability
• Cats often need higher doses for BP than for proteinuria (1.5–3 vs 1 mg/kg)

Mechanism of action

Angiotensin II type 1 receptor (AT1) blocker. Selectively binds AT1 — blocks vasoconstriction, aldosterone secretion, sympathetic activation, and pathological cardiac/renal remodelling driven by angiotensin II. Leaves AT2 receptor unopposed (potentially beneficial — AT2 may promote tissue repair). Hepatically metabolised; biliary excretion (no dose reduction needed in CKD — major advantage in renal patients).

Formulations and products

• Semintra 4 mg/mL oral solution (cats)
• Semintra 10 mg/mL oral solution (cats, higher concentration)
• Micardis 20 / 40 / 80 mg human tablet
• Semintra 4 mg/mL (Boehringer Ingelheim) — 4 mg/mL, Oral solution (cats)
• Semintra 10 mg/mL (Boehringer Ingelheim) — 10 mg/mL, Oral solution (cats, higher conc.)
• Micardis — 20 / 40 / 80 mg, Tablet (human-label)

Storage

Semintra oral solution: 15–25 °C, do not refrigerate, discard 6 months after opening. Tablets: 15–30 °C, dry, protected from light.

Before you use this dose

Reference doses for veterinary professionals. Confirm the dose against the product label, the patient’s condition, current guidance and local regulations before use; the attending veterinarian remains responsible for every clinical decision.

Other cardiovascular drugs

• Ramipril
• Sildenafil
• Sodium Nitroprusside
• Sotalol
• Vasopressin (Arginine Vasopressin)

Frequently asked questions