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Twynsta Side Effects

Generic Name: amlodipine / telmisartan

Note: This document contains side effect information about amlodipine / telmisartan. Some of the dosage forms listed on this page may not apply to the brand name Twynsta.

In Summary

Common side effects of Twynsta include: edema. Other side effects include: fatigue and palpitations. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to amlodipine / telmisartan: oral tablet

Along with its needed effects, amlodipine/telmisartan may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking amlodipine / telmisartan:

More common

  • Bloating or swelling of the face, arms, hands, lower legs, or feet
  • body aches or pain
  • chills
  • cough
  • difficulty breathing
  • ear congestion
  • fever
  • headache
  • loss of voice
  • nasal congestion
  • rapid weight gain
  • runny nose
  • sneezing
  • sore throat
  • tingling of the hands or feet
  • unusual tiredness or weakness
  • unusual weight gain or loss

Less common

  • Bladder pain
  • bloody or cloudy urine
  • blurred vision
  • chest pain
  • diarrhea
  • difficult, burning, or painful urination
  • dizziness
  • frequent urge to urinate
  • general feeling of discomfort or illness
  • joint pain
  • loss of appetite
  • lower back or side pain
  • muscle aches and pains
  • nausea
  • nervousness
  • pounding in the ears
  • shivering
  • slow or fast heartbeat
  • sweating
  • trouble sleeping
  • vomiting


  • Abdominal or stomach pain
  • arm, back, or jaw pain
  • black, tarry stools
  • bleeding gums
  • blistering, peeling, or loosening of the skin
  • blood in the urine or stools
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • chest tightness or heaviness
  • cold sweats
  • confusion
  • constipation
  • cough or hoarseness
  • dark urine
  • difficult or labored breathing
  • difficulty swallowing
  • dry mouth
  • extreme fatigue
  • fast, irregular, pounding, or racing heartbeat or pulse
  • feeling of warmth
  • flushed, dry skin
  • fruit-like breath odor
  • hives
  • increased hunger
  • increased sweating
  • increased thirst
  • increased volume of pale, dilute urine
  • irregular heartbeat
  • irritation in the mouth
  • joint or muscle pain
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • lightheadedness, dizziness, or fainting
  • loss of consciousness
  • muscle cramps or stiffness
  • pale, bluish-colored, or cold hands or feet
  • pinpoint red spots on the skin
  • rash
  • redness and swelling of the gums
  • redness, soreness, or itching skin
  • severe or sudden headache
  • sudden loss of coordination
  • sudden slurring of speech
  • swollen glands
  • tightness in the chest
  • trembling or shaking of the hands or feet
  • unexplained weight loss
  • unusual bleeding or bruising
  • vomiting of blood
  • weakness in the arms, hands, legs, or feet
  • weight gain
  • yellow eyes or skin

Some side effects of amlodipine / telmisartan may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

  • Acid or sour stomach
  • belching
  • difficulty with moving
  • heartburn
  • indigestion
  • pain or tenderness around the eyes and cheekbones
  • sleepiness or unusual drowsiness


  • Abnormal dreams
  • ankle, knee, or great toe joint pain
  • anxiety
  • bad, unusual, or unpleasant (after) taste
  • bleeding after defecation
  • blistering, crusting, irritation, itching, or reddening of the skin
  • bloody nose
  • burning feeling in the chest or stomach
  • burning, dry, or itching eyes
  • changes in vision
  • cold and clammy skin
  • continuing ringing or buzzing or other unexplained noise in the ears
  • cough producing mucus
  • cracked, dry, or scaly skin
  • decreased sexual performance or desire
  • depression
  • dry mouth
  • earache
  • excess air or gas in the stomach or intestines
  • feeling of constant movement of self or surroundings
  • feeling of warmth
  • full feeling
  • hair loss or thinning of the hair
  • headache, severe and throbbing
  • hearing loss
  • hives or welts
  • hyperventilation
  • inability to have or keep an erection
  • increased appetite
  • irritability
  • lack of feeling or emotion
  • lack or loss of strength
  • loose stools
  • loss of memory
  • redness of the skin
  • redness or swelling in the ear
  • redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
  • restlessness
  • tenderness in the stomach area
  • toothache
  • uncomfortable swelling around the anus

For Healthcare Professionals

Applies to amlodipine / telmisartan: oral tablet


The most common side effect was peripheral edema.[Ref]


Very common (10% or more): Peripheral edema (up to 11.3%)
Common (1% to 10%): Edema
Uncommon (0.1% to 1%): Vertigo, asthenia, fatigue
Rare (less than 0.1%): Malaise

Very common (10% or more): Peripheral edema (up to 17.8%), edema (10.8%)
Common (1% to 10%): Fatigue
Uncommon (0.1% to 1%): Vertigo, asthenia, malaise, pain, rigors, tinnitus, thirst
Frequency not reported: Gynecomastia

Uncommon (0.1% to 1%): Peripheral edema
Frequency not reported: Influenza-like symptoms, pain, fatigue, fever, malaise, dependent edema, vertigo, tinnitus, earache, blood creatine phosphokinase increased
Postmarketing reports: Asthenia, weakness, edema, face edema, lower limb edema[Ref]

Nervous system

Common (1% to 10%): Dizziness
Uncommon (0.1% to 1%): Somnolence, migraine, headache, paresthesia
Rare (less than 0.1%): Syncope, peripheral neuropathy, hypoesthesia, dysgeusia, tremor

Common (1% to 10%): Dizziness, headache, somnolence
Uncommon (0.1% to 1%): Syncope, postural dizziness, hypoesthesia, neuropathy peripheral, paresthesia, tremor
Frequency not reported: Ataxia, hypertonia, migraine, amnesia, parosmia, taste perversion

Frequency not reported: Headache, dizziness, somnolence, migraine, paresthesia, hypoesthesia, cerebrovascular disorder
Postmarketing reports: Syncope[Ref]


Common (1% to 10%): Back pain
Uncommon (0.1% to 1%): Arthralgia, muscle spasms, myalgia
Rare (less than 0.1%): Pain in extremity

Common (1% to 10%): Back pain
Uncommon (0.1% to 1%): Arthralgia, arthrosis, muscle cramps, myalgia
Frequency not reported: Muscle weakness, twitching

Common (1% to 10%): Back pain
Frequency not reported: Myalgia, leg pain, involuntary muscle contractions, arthritis, arthralgia, leg cramps, tendon pain, tendonitis
Postmarketing reports: Muscle cramps, tenosynovitis, rhabdomyolysis[Ref]


Uncommon (0.1% to 1%): Abdominal pain, diarrhea, nausea
Rare (less than 0.1%): Vomiting, gingival hypertrophy, dyspepsia, dry mouth

Common (1% to 10%): Nausea, abdominal pain, dysphagia
Uncommon (0.1% to 1%): Constipation, dyspepsia, diarrhea, flatulence, vomiting, gingival hyperplasia, change of bowel habit, dry mouth
Frequency not reported: Gastritis, loose stools

Common (1% to 10%): Diarrhea
Frequency not reported: Dyspepsia, abdominal pain, nausea, flatulence, constipation, gastritis, vomiting, dry mouth, hemorrhoids, gastroenteritis, enteritis, gastroesophageal reflux, toothache, non-specific gastrointestinal disorders, stomach discomfort[Ref]


Uncommon (0.1% to 1%): Pruritus
Rare (less than 0.1%): Eczema, erythema, rash

Common (1% to 10%): Rash, rash erythematous
Uncommon (0.1% to 1%): Angioedema, erythema multiforme, pruritus, rash maculopapular, sweating increased, purpura
Frequency not reported: Skin discoloration, urticaria, skin dryness, alopecia, dermatitis, cold and clammy skin, hyperhidrosis, exfoliative dermatitis, Stevens-Johnson syndrome, photosensitivity reaction

Very rare (less than 0.01): Angioedema
Frequency not reported: Increased sweating, dermatitis, rash, eczema, pruritus, urticaria, drug eruption, hyperhidrosis, toxic skin eruption
Postmarketing reports: Angioneurotic edema, erythema, toxicoderma[Ref]


Uncommon (0.1% to 1%): Erectile dysfunction
Rare (less than 0.1%): Cystitis, nocturia

Common (1% to 10%): Sexual dysfunction
Uncommon (0.1% to 1%): Micturition frequency, micturition disorder, nocturia
Frequency not reported: Dysuria, polyuria, pollakiuria

Frequency not reported: Urinary tract infection, impotence, micturition frequency, cystitis
Postmarketing reports: Erectile dysfunction[Ref]


Uncommon (0.1% to 1%): Bradycardia, palpitations, hypotension, orthostatic hypotension, flushing, chest pain

Common (1% to 10%): Flushing, palpitations
Uncommon (0.1% to 1%): Arrhythmia, bradycardia, chest pain, hypotension, peripheral ischemia, tachycardia, postural hypotension, vasculitis, hot flushes
Frequency not reported: Cardiac failure, pulse irregularity, extrasystoles, myocardial infarction, angina, ventricular tachycardia, atrial fibrillation

Frequency not reported: Hypertension, chest pain, flushing, palpitation, angina pectoris, tachycardia, abnormal ECG
Postmarketing reports: Atrial fibrillation, congestive heart failure, myocardial infarction, blood pressure increased, hypertension aggravated, hypotension, bradycardia[Ref]


Uncommon (0.1% to 1%): Cough

Common (1% to 10%): Epistaxis
Uncommon (0.1% to 1%): Dyspnea
Frequency not reported: Coughing, rhinitis

Common (1% to 10%): Upper respiratory tract infection, sinusitis, pharyngitis, cough
Frequency not reported: Asthma, bronchitis, rhinitis, dyspnea, epistaxis[Ref]


Uncommon (0.1% to 1%): Hepatic enzymes increased

Uncommon (0.1% to 1%): Pancreatitis
Frequency not reported: Hepatitis, jaundice, hepatic enzyme elevations

Frequency not reported: Liver chemistries elevated, abnormal hepatic function[Ref]


Rare (less than 0.1%): Depression, anxiety, insomnia

Uncommon (0.1% to 1%): Insomnia, nervousness, depression, abnormal dreams, anxiety, depersonalization, mood change
Frequency not reported: Apathy, agitation, confusional state

Frequency not reported: Insomnia, anxiety, depression, nervousness[Ref]


Rare (less than 0.1%): Blood uric acid increased

Uncommon (0.1% to 1%): Anorexia, weight gain, weight decrease, hyperglycemia
Frequency not reported: Increased appetite

Frequency not reported: Gout, hypercholesterolemia, diabetes mellitus, hyperkalemia, hypoglycemia
Postmarketing reports: Uric acid increased[Ref]


Uncommon (0.1% to 1%): Abnormal vision, conjunctivitis, diplopia, eye pain
Frequency not reported: Abnormal visual accommodation, xerophthalmia, visual impairment

Frequency not reported: Abnormal vision, conjunctivitis, visual disturbance[Ref]


Uncommon (0.1% to 1%): Leukopenia, thrombocytopenia

Uncommon (0.1% to 1%): Greater than 2 g/dL decrease in hemoglobin
Frequency not reported: Anemia, thrombocytopenia, hemoglobin decreased[Ref]


Uncommon (0.1% to 1%): Allergic reaction
Frequency not reported: Hypersensitivity

Frequency not reported: Allergy, infection, fungal infection, abscess, otitis media, sepsis, eosinophilia, anaphylactic reaction, hypersensitivity[Ref]


Uncommon (0.1% to 1%): 0.5 mg/dL or greater rise in creatinine
Frequency not reported: BUN increased, renal impairment, acute renal failure, blood creatinine increased[Ref]


1. "Product Information. Twynsta (amlodipine-telmisartan)." Boehringer-Ingelheim, Ridgefield, CT.

2. Cerner Multum, Inc. "Australian Product Information." O 0

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.