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amlodipine and telmisartan

Generic Name: amlodipine and telmisartan (am LOE de peen and TEL me SAR tan)
Brand Name: Twynsta

What is amlodipine and telmisartan?

Amlodipine is a calcium channel blocker. Amlodipine relaxes (widens) blood vessels and improves blood flow.

Telmisartan is an angiotensin II receptor antagonist. Telmisartan keeps blood vessels from narrowing, which lowers blood pressure and improves blood flow.

Amlodipine and telmisartan is a combination medicine used to treat high blood pressure (hypertension). Lowering blood pressure may lower your risk of a stroke or heart attack.

Amlodipine and telmisartan may also be used for purposes not listed in this medication guide.

What is the most important information I should know about amlodipine and telmisartan?

Stop using this medicine and tell your doctor right away if you become pregnant. Telmisartan can cause injury or death to the unborn baby if you take the medicine during your second or third trimester.

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If you have diabetes, do not use amlodipine and telmisartan together with any medication that contains aliskiren (Amturnide, Tekturna, Tekamlo, Valturna).

What should I discuss with my healthcare provider before taking amlodipine and telmisartan?

You should not use this medicine if you are allergic to amlodipine (Norvasc) or telmisartan (Micardis).

If you have diabetes, do not use amlodipine and telmisartan together with any medication that contains aliskiren (Amturnide, Tekturna, Tekamlo, Valturna).

You may also need to avoid taking amlodipine and telmisartan with aliskiren if you have kidney disease.

To make sure amlodipine and telmisartan is safe for you, tell your doctor if you have:

  • kidney disease (or if you are on dialysis);

  • liver disease;

  • heart disease;

  • an electrolyte imbalance (such as low levels of potassium or magnesium in your blood); or

  • if you are on a low-salt diet.

Do not use if you are pregnant. Stop using and tell your doctor right away if you become pregnant. Amlodipine and telmisartan can cause injury or death to the unborn baby if you take the medicine during your second or third trimester. Use effective birth control.

It is not known whether amlodipine and telmisartan passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using this medication.

How should I take amlodipine and telmisartan?

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Your doctor may occasionally change your dose to make sure you get the best results.

You may take this medicine with or without food, at the same time each day.

You may have very low blood pressure while taking this medicine. Call your doctor if you are sick with vomiting or diarrhea, or if you are sweating more than usual.

Your blood pressure will need to be checked often. You may also need frequent blood tests.

Keep using this medicine as directed, even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life.

Store at room temperature away from moisture and heat. Keep each tablet in the blister pack until you are ready to take one.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking amlodipine and telmisartan?

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Do not use potassium supplements or salt substitutes while you are taking amlodipine and telmisartan, unless your doctor has told you to.

Amlodipine and telmisartan side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

In rare cases, amlodipine and telmisartan can cause a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, and dark colored urine.

Call your doctor at once if you have:

  • a light-headed feeling, like you might pass out;

  • swelling in your hands or feet, rapid weight gain;

  • new or worsened chest pain;

  • pounding heartbeats or fluttering in your chest; or

  • high potassium--nausea, slow or unusual heart rate, weakness, loss of movement.

Common side effects may include:

  • swelling in your hands or feet;

  • fast heartbeats;

  • dizziness, drowsiness, tired feeling;

  • flushing (warmth, redness, or tingly feeling);

  • back pain; or

  • nausea, diarrhea, stomach pain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Amlodipine and telmisartan dosing information

Usual Adult Dose for Hypertension:

Amlodipine 5 to 10 mg-Telmisartan 40 to 80 mg orally once a day

Maximum dose: Amlodipine 10 mg-Telmisartan 80 mg orally once a day

-Correct volume and salt depletion before initiating therapy.
-Dose titration with the individual components is recommended before switching to this drug; treatment may be initiated with this drug if it is unlikely that blood pressure would be controlled with monotherapy; the usual starting dose for treatment initiation is amlodipine 5 mg-telmisartan 40 mg once a day.
-Patients who experience any dose limiting adverse reactions with amlodipine 10 mg monotherapy may be switched to amlodipine 5 mg-telmisartan 40 mg once a day to reduce the amlodipine dose without reducing the overall expected antihypertensive response.
-Start with a low initial amlodipine dose in patients 65 years or older; initial therapy with this drug is not recommended in patients 75 years or older.
-May increase dose after 2 weeks.

What other drugs will affect amlodipine and telmisartan?

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • digoxin;

  • a diuretic or "water pill";

  • lithium;

  • simvastatin (Zocor, Vytorin);

  • an ACE inhibitor--benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, trandolapril; or

  • a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen, naproxen, celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may interact with amlodipine and telmisartan, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about amlodipine and telmisartan.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 7.01. Revision Date: 2015-02-10, 3:28:23 PM.