Drugs Q & A

Does Telmisartan (Micardis) Cause Hair Loss?

According to the NIH, alopecia areata is a disease that happens when the immune system attacks hair follicles and causes hair loss. Hair follicles are the structures in the skin that form hair. While hair can be lost from any part of the body, alopecia areata usually affects the head and face. Hair typically falls out in small, round patches about the size of a quarter, but in some cases, hair loss is more extensive. Most people with the disease are healthy and have no other symptoms.

The course of alopecia areata varies from person to person. Some have bouts of hair loss throughout their lives, while others only have one episode. Recovery is unpredictable too, with hair regrowing fully in some people but not in others.

There is no cure for alopecia areata, but there are treatments that help hair grow back more quickly. There are also resources to help people cope with hair loss.

Who Gets Alopecia Areata?

Anyone can have alopecia areata. Men and women get it equally, and it affects all racial and ethnic groups. The onset can be at any age, but most people get it in their teens, twenties, or thirties. When it occurs in children younger than age 10, it tends to be more extensive and progressive.

If you have a close family member with the disease, you may have a higher risk of getting it, but for many people, there is no family history. Scientists have linked a number of genes to the disease, which suggests that genetics play a role in alopecia areata. Many of the genes they have found are important for the functioning of the immune system.

People with certain autoimmune diseases, such as psoriasis, thyroid disease, or vitiligo, are more likely to get alopecia areata, as are those with allergic conditions such as hay fever.

It is possible that emotional stress or an illness can bring on alopecia areata in people who are at risk, but in most cases, there is no obvious trigger. Hair loss can be a side effect of certain drugs, such as those used for cancer, arthritis, depression, heart problems, gout, and high blood pressure.

Types of Alopecia Areata

There are three main types of alopecia areata:

•              Patchy alopecia areata. In this type, which is the most common, hair loss happens in one or more coin-sized patches on the scalp or other parts of the body.

•              Alopecia totalis. People with this type lose all or nearly all of the hair on their scalp.

•              Alopecia universalis. In this type, which is rare, there is a complete or nearly complete loss of hair on the scalp, face, and rest of the body.

What is Telmisartan?

Telmisartan is an angiotensin II receptor blocker (ARB). It works by blocking a substance in the body that causes blood vessels to tighten. As a result, telmisartan relaxes the blood vessels. This lowers blood pressure and increases the supply of blood and oxygen to the heart.

Telmisartan is used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. Lowering blood pressure can reduce the risk of strokes and heart attacks.

Telmisartan is also used to lower the risk of heart attacks or stroke in patients 55 years of age and older who have diabetes or heart problems.

How should Telmisartan be used?

Telmisartan comes as a tablet to take by mouth. It is usually taken once a day with or without food. To help you remember to take telmisartan, take it around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take telmisartan exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Telmisartan tablets come in individual blister packs that can be opened by peeling back the paper layer from the foil and pushing the tablet through the foil. Do not open a blister pack until you are ready to swallow the tablet it contains.

Your doctor may start you on a low dose of telmisartan and gradually increase your dose.

Telmisartan controls high blood pressure but does not cure it. Your blood pressure may decrease during the first 2 weeks of your treatment, but it may take 4 weeks for you to notice the full benefit of telmisartan. Continue to take telmisartan even if you feel well. Do not stop taking telmisartan without talking to your doctor.

Does Telmisartan (Micardis) Cause Hair Loss?

Yes, hair loss and or thinning of the hair is one of the common side effects of telmisartan. If you are taking telmisartan and it is causing hair loss, call your doctor to discuss switching to an alternative. Once people stop taking the telmisartan, they may start to see hair growing back within 6 months. In most cases, hair will grow back by itself once a person stops taking the medication.

Another good news is that another drug (Minoxidil) developed for the treatment of high blood pressure turns out to help with hair loss as an unexpected side effect.  Minoxidil is used to stimulate hair growth and slow balding. It is most effective for people under 40 years of age whose hair loss is recent. Minoxidil has no effect on receding hairlines. It does not cure baldness; most new hair is lost within a few months after the drug is stopped.

More common side effects of Telmisartan

The more common side effects that occur with telmisartan include:

•              back pain

•              diarrhea

•              dizziness

•              fatigue

•              flu-like symptoms, such as fever and body aches

•              headache

•              muscle pain

•              nausea

•              sinus pain and congestion

•              sore throat

•              upset stomach

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have any of these serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

•              Low blood pressure. Symptoms include:

o             faintness

o             dizziness

•              Kidney disease. If you already have kidney disease, this drug may make it worse. Symptoms include:

o             swelling in your feet, ankles, or hands

o             unexplained weight gain

•              Allergic reaction. Symptoms include:

o             swelling of your face, tongue, or throat

o             trouble breathing

o             skin rash

Telmisartan may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088)

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Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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