Greetings, my first post here. As some of the queries in the last few posts referred to certain brands of Telmisartan that I frequently prescribe, I thought I would chip in with my inputs.
Telmikind (Mankind pharma): I routinely prescribe this particular brand, and other drugs from Mankind, as I have found them to be as good as some of the other more expensive (older and more established) brands.
Zydus (Cadila, German remedies): Is an older well established manufacturer whose drugs I have routinely prescribed to my Orthopaedic patients with good effect. Have not used their Telmisartan though.
Sun Pharma: Again an older, established manufacturer like Cadila with a very good reputation but I have personally not prescribed their medicines in large numbers.
To provide some context, I am a GP (Originally an Orthopod) practising in New Delhi, India. When I say Older, Mankind is a 30 year old company and the others are older than that.
Welcome @Kirtti. Thank you for this information. I was wondering about Mankind Telmikind because it is a different shape and color than what I had been used to seeing with the Sandoz.
Very much appreciated for sharing your professional opinion, may try to switch to them for my next order. Nevertheless, just ordered Glenmark Telma 80mg, how’s your opinion regarding Glenmark pharmaceutical? It just received FDA warning, is Glenmark a reliable brand?
FWIW: I have used several medications from Glenmark with no problems that I know of. I really don’t know what to make of them. They have an A+ rating with the BBB. Some of their facilities passed recent inspections with “zero observations”.
Glenmark Pharmaceuticals is a major global drugmaker headquartered in Mumbai, India, with a presence in over 80 countries. While it is a significant producer of generic and branded medications, its recent reputation has been marred by systemic manufacturing failures and a “repeat offender” status with the U.S. FDA.
Recent FDA Warnings & Reliability Concerns
Glenmark’s reliability has faced scrutiny due to regulatory issues and FDA warnings.
[image]Regulatory Affairs Professionals Society | RAPS +1
A notable warning letter was issued by the FDA on July 11, 2025, regarding violations at its Indore (Madhya Pradesh) facility. Issues included delayed testing and inadequate investigations into quality failures.
Over 50 million potassium chloride capsules were recalled due to dissolution problems, which could potentially lead to serious health issues.
The FDA has identified Glenmark as a “repeat offender,” noting that three of its five U.S.-supplying factories have had violations since 2019. Previous warnings involved facilities in Goa (2022) and North Carolina (2023).
While not definitively proven to be caused by the drug, eight patient deaths were reported between July and December 2023 in connection with the recalled potassium chloride medication.
[image]Food and Drug Administration (.gov) +6
Company Reputation and Operations
Despite these challenges, Glenmark is active in therapeutic areas like respiratory, dermatology, and oncology and remains a significant market player.
[image]Pharma Industrial India +4
The company has a mixed quality record; while some plants have faced sanctions (including an import ban), others like the Aurangabad facility passed recent inspections with “zero observations”.
Glenmark’s U.S. division is a Better Business Bureau accredited business with an A+ rating.
In October 2024, Glenmark agreed to a $55 million settlement concerning allegations of price-fixing.
[image]Pharma Industrial India +4
Summary Recommendation: Given the recent history of serious recalls and repeat manufacturing issues, Glenmark is currently facing heightened regulatory risk. Patients using medications manufactured by Glenmark, especially Ziac or potassium chloride, should consult the FDA recall notices.
FWIW, I avoid Glenmark like the plague. The violations are so frequent and persistent, and so serious (likely resulting in death), that I just cannot take any of their drugs based on hope that it’s not a bad batch. All manufacturers can have problems, but Glenmark seems in a class of their own. YMMV.
Glenmark was a fairly reliable brand but it has been facing a few issues of late as already mentioned in detail by @desertshores above. However the problems seem to be related to a few of their plants and to specific drug lines. Their brand of Telmisartan called Telma is one of the most prescribed brands of this drug and is not manufactured in the plants which have faced issues. I have prescribed Telma fairly regularly in my practice and have not faced any issues.
Angiotensin-Receptor Blockers and the Risk of Alzheimer´s Disease: A Meta-analysis
“Ten studies (1 RCT, 2 case-control and 7 cohort studies) met the inclusion criteria. When all observational studies (9) were analyzed, ARB use was associated with a reduced risk of incident AD (HR 0.72, 95% CI: 0.58-0.88, p<0.001). In the only RCT, decrease in the incidence of AD was also significant (HR= 0.31, 95% CI: 0.14-0.68).”
That’s an impressive hazard ratio for the single RCT. My cumulative view is that TM is proving to be a robust geroprotective for many people, perhaps one belonging to the top tier.
I’m not sure. To my eyes olmesartan is looking better and better. Super low AE (in some studies lower than TM), more effective in lowering dementia risk (than TM) and notably (to me) lower ACM (compared to TM which barely - if at all - affected it). I’m not saying it’s a slam dunk case, but something to keep an eye on if we’re looking for drugs that can really move the needle healthwise. TM is good, but possibly olmesartan is the one. To be continued. YMMV.
And yet, olmesartan outperformed telmisartan (and every other sartan) in lowering the risk of dementia, per the study Antoine posted:
And by quite a margin. I have long since given up treating the crossing of BBB as definitive proof that some molecule or other has no impact on the brain perhaps by indirect means.
Again, I’m not claiming that olmesartan is superior to telmisartan, just that the weight of evidence is slowly shifting and it’s worth re-examining one’s stack. I do that all the time. I look at each drug and supplement I take and regularly ask: is it still in my stack for a good reason, can better be had, is this optimal and so on. Telmisartan is what I take, but I’m keeping an eye out for olmesartan and keep reading the literature as it rolls in.
Interesting article by Saavedra, but perhaps too optimistic about ARBs than than the evidence suggests. Summarizer: “This is a useful compendium of the pleiotropic pharmacology of ARBs, and the core idea — that RAS dysregulation contributes to diverse pathology — is well-supported. But the leap from “ARBs do interesting things in cell cultures and rodents” to “ARBs should be used for Alzheimer’s, depression, and menopause” needs much more clinical trial evidence than currently exists. The review is better as a research roadmap than as clinical guidance.“
Look at table S4 “Adjusted Hazard Ratios for Dementia Risk Across Individual ARBs”. So this is within class of ARBs. Irbesartan was the reference (based on neutrality in previous studies), and olmesartan stood out for significance (p value >0.001). Within ARBs using Irb as reference (AHR 1.00) Olme was 0.55 Telmi 0.94 (NS). And the CI on Olme was 0.43-0.71, whereas Telmi was completely outside the Olme range 0.84-1.05.
For ACM see table S9 and the within class (ARBs) numbers - again Olme was the lowest 0.64 vs Telmi 0.91. And the CI were non overlapping with Olme 0.56-0.74 and Telmi 0.85-0.97.
Keeping in mind we are dealing with decent size cohorts, not a handful of subjects.
I don’t know that the thresholds are well understood for broader benefits. Taking 80 mg/day, the mean reduction in systolic blood pressure is approximately 12–13 mmHg and diastolic blood pressure is ~ 7–8 mmHg. For many, the limiting factor will be their baseline BP. A person with high normal BP can likely take a full 80 mg dose and still have adequate, perhaps optimal BP. That is my situation. A person with mid-normal or lower baseline BP will have to see if they can maintain adequate BP with 40 mg or 20 mg. Many normotensive people are reporting doing well and actually improving their BP profile taking either 20 or 40 mg/day. I do very well, with no dizziness or other symptoms with a mean BP of 104/62. Empirical. No hard formula and your minimums may vary.
