Generic name: amlodipine and telmisartan [ am-LOE-de-peen-and-TEL-me-SAR-tan ]
Drug class: Angiotensin II inhibitors with calcium channel blockers

Medically reviewed by Sophia Entringer, PharmD. Last updated on Sep 25, 2023.

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.

Warnings

Do not use Twynsta if you are pregnant. It could harm the unborn baby. Use effective birth control. Stop using Twynsta and tell your doctor right away if you become pregnant.

You should not use Twynsta if you are allergic to amlodipine (Norvasc) or telmisartan (Micardis), or if you have diabetes and are taking aliskiren.

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.

Certain other drugs may interact with amlodipine and telmisartan 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 this medicine if you are allergic to amlodipine (Norvasc) or telmisartan (Micardis).

If you have diabetes, do not use Twynsta together with any medication that contains aliskiren (such as Amturnide, Tekturna, Tekamlo).

You may also need to avoid taking Twynsta with aliskiren if you have kidney disease.

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.

Do not use Twynsta if you are pregnant. If you become pregnant, stop taking this medicine and tell your doctor right away. 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 breast-feed while you are using Twynsta before speaking with your doctor.

This medicine is not FDA-approved for use by anyone younger than 18 years old.

How should I take Twynsta?

Take Twynsta exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

You may take Twynsta 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 Twynsta 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.

Dosing information

Usual Adult Dose for Hypertension:

Initial dose: 40/5 to 80/5 mg orally once daily. Dosage should be individualized and may be increased after at least 2 weeks.

Maximum dose: 80/10 mg orally once daily

Related/similar drugs

amlodipine, lisinopril, metoprolol, losartan, furosemide, hydrochlorothiazide

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

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

What to 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 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, or dark colored urine.

Call your doctor at once if you have:

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

• shortness of breath (even with mild exertion), swelling, rapid weight gain;

• new or worsened chest pain;

• pounding heartbeats or fluttering in your chest;

• tremors, muscle stiffness or twitching; or

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

Common Twynsta side effects may include:

• swelling in your hands or feet;

• fast or pounding heartbeats;

• dizziness, drowsiness;

• 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.

What other drugs will affect Twynsta?

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

• digoxin;

• a diuretic or "water pill";

• lithium;

• potassium supplements;

• simvastatin (Zocor, Vytorin);

• medicine to prevent organ transplant rejection - cyclosporine, tacrolimus;

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

• NSAIDs (nonsteroidal anti-inflammatory drugs) - aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

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

Further information

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.

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

Medical Disclaimer

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