Twynsta

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

What is Twynsta?

Twynsta contains a combination of 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.

Twynsta is used to treat high blood pressure (hypertension). Lowering blood pressure may lower your risk of a stroke or heart attack.

Twynsta may also be used for purposes not listed in this medication guide.

Important information

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

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

Before you use Twynsta, tell your doctor about all your medical conditions and allergies. Also make sure your doctor knows if you are pregnant or breast-feeding. In some cases, you may not be able to use Twynsta, or you may need a dose adjustment or special precautions.

Slideshow: 2014 Update: First Time Brand-to-Generic Switches

Certain other drugs may interact with Twynsta or should not be used at the same time. Tell each of your healthcare providers about all medicines you use now, and any medicine you start or stop using.

Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking this medication, which can lead to severely low blood pressure or a serious electrolyte imbalance.

In rare cases, Twynsta 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.

Before taking this medicine

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

If you have diabetes or kidney disease, you may not be able to take Twynsta if you are also taking a blood pressure medication that contains aliskiren Amturnide, Tekturna, Tekamlo, or Valturna).

To make sure Twynsta 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.

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

See also: Pregnancy and breastfeeding warnings (in more detail)

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

How should I take Twynsta?

Take Twynsta exactly as prescribed by your doctor. 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 Twynsta with or without food. Take the medicine at the same time each day.

You may have very low blood pressure while taking Twynsta. 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 medication even if you feel fine. High blood pressure often has no symptoms.

Store Twynsta 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?

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 Twynsta, unless your doctor has told you to.

Twynsta side effects

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

In rare cases, Twynsta 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:

  • 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;

Other common Twynsta side effects may include:

  • 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)

What other drugs will affect Twynsta?

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with Twynsta, especially:

  • digoxin;

  • a diuretic or "water pill";

  • lithium;

  • rifabutin, rifapentine, rifampin;

  • simvastatin;

  • St. John's wort;

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

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

  • the HIV medications efavirenz or nevirapine; or

  • the seizure medications carbamazepine, fosphenytoin, oxcarbazepine, phenobarbital, phenytoin, or primidone.

This list is not complete. Other drugs may interact with Twynsta, 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 Twynsta.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Twynsta 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 1996-2014 Cerner Multum, Inc. Version: 6.01. Revision Date: 2013-02-02, 7:11:52 PM.

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