# Telmisartan: veterinary dose and monograph

> Telmisartan is a veterinary cardiovascular drug. Angiotensin II receptor blocker (ARB) — selectively blocks the AT1 receptor (the pathological receptor for angiotensin II). Indications include feline CKD-associated proteinuria (PRIMARY indication); feline systemic hypertension (alternative to amlodipine); canine proteinuric kidney disease (extra-label). This monograph lists 4 reference doses for dogs and cats, each with route, frequency and source.

Source: https://vetmasterji.com/drugs/telmisartan · Last reviewed: 2026-10-01

## 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

*Telmisartan doses for dogs*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| Proteinuria / hypertension (extra-label) | 1–3 mg/kg | PO | q24h (may increase to q12h) | — |

- 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

*Telmisartan doses for cats*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| CKD proteinuria (Semintra) | 1 mg/kg | PO | q24h | — |
| Systemic hypertension — first 14 days | 1.5 mg/kg | PO | q12h | 14 days |
| Systemic hypertension — maintenance | 1–2 mg/kg | PO | q24h | — |

- 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

> **Caution:** 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.

> **Caution:** 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

> **Caution:** 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](https://vetmasterji.com/drugs/ramipril)
- [Sildenafil](https://vetmasterji.com/drugs/sildenafil)
- [Sodium Nitroprusside](https://vetmasterji.com/drugs/nitroprusside)
- [Sotalol](https://vetmasterji.com/drugs/sotalol)
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## Frequently asked questions

### What is the dose of Telmisartan for dogs?

Reference doses for Telmisartan in dogs: 1–3 mg/kg PO q24h (may increase to q12h) (Proteinuria / hypertension (extra-label)). Confirm against the label and the patient before use.

### What is the dose of Telmisartan for cats?

Reference doses for Telmisartan in cats: 1 mg/kg PO q24h (CKD proteinuria (Semintra)); 1.5 mg/kg PO q12h for 14 days (Systemic hypertension — first 14 days); 1–2 mg/kg PO q24h (Systemic hypertension — maintenance). Confirm against the label and the patient before use.

### When should Telmisartan not be used?

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).

### What are the side effects of Telmisartan in animals?

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).

## Sources

- Plumb's Veterinary Drug Handbook
- IRIS CKD Guidelines 2024; ACVIM 2018 systemic hypertension consensus
- Papich, Papich Handbook of Veterinary Drugs, 5th edition

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VetMasterJi is a clinical decision-support and education platform for veterinary professionals and students. It does not provide veterinary advice, diagnosis or treatment for specific animals. All drug doses, calculators and differentials are references that must be independently verified before clinical use; the attending registered veterinarian remains solely responsible for every clinical decision.