Generic Name: telmisartan/amlodipine (TEL-mi-SAR-tan/am-LOE-di-peen)
Brand Name: Twynsta
Twynsta may cause birth defects or fetal or newborn death if you take it while you are pregnant. If you think you may be pregnant, contact your doctor right away. If you are planning to become pregnant, talk with your doctor about other treatment options.
Twynsta is used for:
Treating high blood pressure. It may be used alone or with other medicines. It may also be used for other conditions as determined by your doctor.
Twynsta is a calcium channel blocker and angiotensin II receptor blocker combination. It works by relaxing the blood vessels.
Do NOT use Twynsta if:
- you are allergic to any ingredient in Twynsta
- you are pregnant
- you are taking a medicine that contains aliskiren and you also have diabetes or kidney problems. Check with your doctor or pharmacist if you are not sure if a medicine you take contains aliskiren
- you are taking ramipril
Contact your doctor or health care provider right away if any of these apply to you.
Before using Twynsta:
Some medical conditions may interact with Twynsta. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are able to become pregnant
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have a history of angioedema (eg, swelling of the hands, face, lips, eyes, throat, or tongue; difficulty swallowing or breathing; hoarseness), including angioedema caused by treatment with another angiotensin II receptor blocker (eg, losartan) or an angiotensin-converting enzyme (ACE) inhibitor (eg, lisinopril)
- if you are dehydrated; have low blood volume, low blood sodium levels, or high blood potassium levels; or are on a low-salt (sodium) diet
- if you have a history of gallbladder or liver problems, kidney problems (eg, renal artery stenosis), low blood pressure, blood vessel problems, stroke, diabetes, swelling or fluid retention, or heart problems (eg, heart attack, heart failure, angina, narrowing of heart blood vessels)
- if you are on dialysis or are scheduled to have surgery
- if you are taking another medicine for blood pressure or heart problems
Some MEDICINES MAY INTERACT with Twynsta. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Diuretics (eg, furosemide, hydrochlorothiazide) because the risk of low blood pressure may be increased
- Nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, celecoxib, ibuprofen, indomethacin) because the risk of kidney problems may be increased and they may decrease Twynsta's effectiveness
- Potassium-sparing diuretics (eg, triamterene) or potassium supplements because the risk of high blood potassium levels may be increased
- ACE inhibitors (eg, lisinopril, ramipril) or aliskiren because the risk of certain side effects (eg, kidney problems, high blood potassium levels, low blood pressure) may be increased
- Azole antifungals (eg, itraconazole, ketoconazole), cobicistat, conivaptan, diltiazem, macrolide antibiotics (eg, clarithromycin), or protease inhibitors (eg, ritonavir, telaprevir) because they may increase the risk of Twynsta's side effects
- Cyclosporine, digoxin, lithium, simvastatin, or tacrolimus because the risk of their side effects may be increased by Twynsta
- Carbamazepine, hydantoins (eg, phenytoin), phenobarbital, primidone, rifamycins (eg, rifampin), or St. John's wort because they may decrease Twynsta's effectiveness
This may not be a complete list of all interactions that may occur. Ask your health care provider if Twynsta may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
How to use Twynsta:
Use Twynsta as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- An extra patient leaflet is available with Twynsta. Talk to your pharmacist if you have questions about this information.
- Take Twynsta by mouth with or without food.
- If Twynsta comes in a blister pack, do not take a tablet out of the blister until you are ready to take Twynsta. To remove a tablet from the blister, peel the paper layer away from the foil, then push the tablet through the foil.
- You will need to take care not to become dehydrated while you are taking Twynsta. Dehydration may increase your risk of low blood pressure. Talk with your doctor if you have questions about avoiding dehydration.
- Be sure to drink enough liquids while you are taking Twynsta. If you do not, you may become dehydrated, which may increase your risk of low blood pressure. Discuss any questions or concerns with your doctor.
- Take Twynsta on a regular schedule to get the most benefit from it. Taking Twynsta at the same time each day will help you remember to take it.
- Continue to take Twynsta even if you feel well. Do not miss any doses.
- If you miss a dose of Twynsta, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
Ask your health care provider any questions you may have about how to use Twynsta.
Important safety information:
- Twynsta may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Twynsta with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
- Twynsta may cause dizziness, light-headedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
- It may take up to 4 weeks to get the full benefit from Twynsta. Do not stop using Twynsta or change your dose of Twynsta without checking with your doctor.
- Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms.
- If you have high blood pressure, do not use nonprescription products that contain stimulants. These products may include diet pills or cold medicines. Contact your doctor if you have any questions or concerns.
- Check with your doctor before you use a salt substitute or a product that has potassium in it.
- If vomiting, diarrhea, or excessive sweating occur, you will need to take care not to become dehydrated. This could increase your risk for low blood pressure. Contact your doctor for instructions.
- Tell your doctor or dentist that you take Twynsta before you receive any medical or dental care, emergency care, or surgery.
- Although rare, a component of Twynsta (amlodipine) has been known to increase chest pain and increase the risk of a heart attack, mainly in patients with severe heart disease.
- Lab tests, including blood pressure, liver and kidney function, and blood electrolyte levels, may be performed while you use Twynsta. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
- Use Twynsta with caution in the ELDERLY; they may be more sensitive to its effects.
- Twynsta should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
- PREGNANCY and BREAST-FEEDING: Twynsta may cause birth defects, or fetal or newborn death if you take it while you are pregnant. If you think you may be pregnant, contact your doctor right away. It is not known if this medicine is found in breast milk. Do not breast-feed while taking Twynsta.
Possible side effects of Twynsta:
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Seek medical attention right away if any of these SEVERE side effects occur:
Diarrhea; dizziness; drowsiness; flushing of the face and neck; headache; mild back pain; mild sore throat; nausea; stomach pain; tiredness.
Severe allergic reactions (rash; hives; itching; difficulty breathing or swallowing; tightness in the chest; swelling of the mouth, face, lips, throat, or tongue; unusual hoarseness); change in the amount of urine produced; chest, jaw, or arm pain; fainting; fast, slow, or irregular heartbeat; fever, chills, or persistent sore throat; mental or mood changes (eg, depression); muscle pain, aches, or weakness; severe or persistent diarrhea or stomach pain; severe or persistent dizziness or light-headedness; shortness of breath; stiff muscles, tremors, or muscle movements that are not normal; sudden, severe nausea or vomiting; sudden, unexplained weight gain; swelling of the feet, ankles, or hands; symptoms of liver problems (eg, dark urine, loss of appetite, pale stools, severe or persistent stomach pain, yellowing of the eyes or skin); worsening of angina pain (eg, longer, more often, more severe); unusual sweating or weakness.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.Proper storage of Twynsta:
Store Twynsta between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Twynsta out of the reach of children and away from pets.
- If you have any questions about Twynsta, please talk with your doctor, pharmacist, or other health care provider.
- Twynsta is to be used only by the patient for whom it is prescribed. Do not share it with other people.
- If your symptoms do not improve or if they become worse, check with your doctor.
- Check with your pharmacist about how to dispose of unused medicine.
This information should not be used to decide whether or not to take Twynsta or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about Twynsta. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to Twynsta. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your health care provider for complete information about the risks and benefits of using Twynsta.
Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.