Telmisartan may cause a 13% rise in trough
serum digoxin levels and a 50% rise in peak
serum levels.
The small increase in the trough levels suggests that the dose of
digoxin need not automatically be reduced when
telmisartan is started, but consideration should be given to monitoring for
digoxin adverse effects such as bradycardia, taking
digoxin levels if necessary. Candesartan, eprosartan,
irbesartan, losartan, and
valsartan appear not to affect
digoxin levels.