Brand Name Twynsta Common Name amlodipine - telmisartan
The content of this page:
How does this medication work? What will it do for me?
This is a combination medication that contains amlodipine and telmisartan. Amlodipine belongs to the group of medications called calcium channel blockers and telmisartan belongs to the group of medications called angiotensin II receptor blockers (ARBs).
Amlodipine - telmisartan is used to treat mild to moderate high blood pressure for people who have been taking amlodipine and telmisartan as separate tablets. It works by relaxing blood vessel walls.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
How should I use this medication?
The usual dose of this medication depends on the dose of amlodipine and telmisartan taken separately before starting this medication. The dose is taken once daily, the same time of day, preferably in the morning.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
Amlodipine - telmisartan may be taken with or without food.
It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store this medication at room temperature in the original package, protect it from light and moisture, and keep it out of the reach of children.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
What form(s) does this medication come in?
40 mg/5 mg
Each oval-shaped, biconvex, uncoated, bilayer tablet with one layer white to off-white and the other layer blue, marked with the company logo and "A1" contains 40 mg telmisartan and 5 mg amlodipine. Nonmedicinal ingredients: colloidal anhydrous silica, FD&C Blue No. 1 Aluminium Lake (E 133), ferric oxide black (E172), ferric oxide yellow (E172), magnesium stearate, maize starch, meglumine, microcrystalline cellulose, povidone K25, pregelatinized starch, sodium hydroxide, and sorbitol (E420).
40 mg/10 mg
Each oval-shaped, biconvex, uncoated, bilayer tablet with one layer white to off-white and the other layer blue, marked with the company logo and "A2" contains 40 mg telmisartan and 10 mg amlodipine. Nonmedicinal ingredients: colloidal anhydrous silica, FD&C Blue No. 1 Aluminium Lake (E 133), ferric oxide black (E172), ferric oxide yellow (E172), magnesium stearate, maize starch, meglumine, microcrystalline cellulose, povidone K25, pregelatinized starch, sodium hydroxide, and sorbitol (E420).
80 mg/5 mg
Each oval-shaped, biconvex, uncoated, bilayer tablet with one layer white to off-white and the other layer blue, marked with the company logo and "A3" contains 80 mg telmisartan and 5 mg amlodipine. Nonmedicinal ingredients: colloidal anhydrous silica, FD&C Blue No. 1 Aluminium Lake (E 133), ferric oxide black (E172), ferric oxide yellow (E172), magnesium stearate, maize starch, meglumine, microcrystalline cellulose, povidone K25, pregelatinized starch, sodium hydroxide, and sorbitol (E420).
80 mg/10 mg
Each oval-shaped, biconvex, uncoated, bilayer tablet with one layer white to off-white and the other layer blue, marked with the company logo and "A4" contains 80 mg telmisartan and 10 mg amlodipine. Nonmedicinal ingredients: colloidal anhydrous silica, FD&C Blue No. 1 Aluminium Lake (E 133), ferric oxide black (E172), ferric oxide yellow (E172), magnesium stearate, maize starch, meglumine, microcrystalline cellulose, povidone K25, pregelatinized starch, sodium hydroxide, and sorbitol (E420).
Who should NOT take this medication?
Do not take this medication if you:
- are allergic to amlodipine, telmisartan, or any ingredients of the medication
- are allergic to similar medications (e.g., calcium channel blockers, ARBs)
- are breast-feeding
- are pregnant
- have diabetes or kidney disease and are taking the medication aliskiren
- have had angioedema (a serious allergic reaction which causes the area around the throat and tongue to swell) after taking any other ARBs (e.g., candesartan, losartan) or angiotensin-converting-enzyme inhibitors (ACEIs)
- have a rare hereditary condition of fructose intolerance (this medication contains sorbitol)
- have biliary obstruction (problems with the draining of bile from the liver and gall bladder)
- have severely decreased liver function
- have low heart output because of a serious heart problem
What side effects are possible with this medication?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- ankle swelling
- back pain
- decreased sexual ability (men)
- difficulty sleeping
- shortness of breath
- unusual tiredness or weakness
- upper respiratory tract infection (such as colds or sinus infections)
- weight changes
Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- abnormal heartbeat (e.g., pounding heartbeat, slow heartbeat, fast heartbeat)
- chest pain
- easy bruising or bleeding
- enlarged breasts (men)
- low blood pressure (e.g., dizziness, fainting, dizziness when standing up)
- shortness of breath
- skin rash, hives
- symptoms of depression (e.g., feeling sad, weight changes, sleep changes, hopelessness, guilt, loss of interest in activities)
- symptoms of kidney problems (e.g., difficulty urinating, producing little or no urine, swelling of ankles or feet)
- symptoms of liver problems (e.g., nausea, abdominal pain, tiredness, loss of appetite, feeling unwell, yellowing of the skin or eyes)
- symptoms of low blood sugar (e.g., cold sweat, cool pale skin, headache, fast heart beat, weakness
- symptoms of too much potassium in the body (e.g., muscle fatigue, weakness, difficulty moving, abnormal heart rhythms, nausea)
- symptoms of a urinary tract infection (e.g. pain when urinating, urinating more often than usual, low back or flank pain)
- tingling or prickling sensations in the hands and feet
- symptoms of muscle breakdown (e.g., unexplained muscle tenderness, cramps or wasting, dark brown urine)
- vertigo (feeling of spinning)
- vision changes
Stop taking the medication and seek immediate medical attention if any of the following occur:
- signs of a severe skin reaction such as blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort
- symptoms of a heart attack (e.g., chest pain, pressure or heaviness; nausea; shortness of breath; cool, clammy skin; anxiety)
- symptoms of a severe allergic reaction (e.g., hives; difficulty breathing; swelling of the mouth, tongue, face, or throat)
- symptoms of sepsis (blood infection; e.g., chills, confusion, fever or low body temperature, irregular heartbeat, shakiness)
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Angioedema: Angioedema (a serious allergic reaction that causes the area around the throat and tongue to swell) may occur with ARBs, such as telmisartan, although rarely. If you experience swelling of the face, tongue, or throat, you should stop taking this medication at once and get immediate medical attention.
Dizziness, fainting, spinning sensations: This medication can cause dizziness, fainting, or spinning sensations.
Do not drive, operate machinery, or perform other potentially hazardous tasks until you have determined how this medication affects you.
Heart attack and stroke: If you have a history of heart problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
If you have heart disease, problems with blood supply to the brain, or have had a recent heart attack, there is a risk that this medication may cause a heart attack or a stroke.
If you develop symptoms of a heart attack (e.g., chest pain, pressure, or heaviness; nausea; shortness of breath; anxiety; cool, clammy skin) or a stroke (e.g., sudden dizziness, difficulty speaking, headache, difficulty walking, confusion, blurred vision), get immediate medical attention.
Kidney function: Telmisartan can cause changes to kidney function that may result in decreased kidney function, kidney failure, or possibly death. Certain people have experienced changes in kidney function (e.g., people with narrowed blood vessels in their kidneys, or those with severe congestive heart failure). The use of diuretics (water pills), nonsteroidal anti-inflammatory drugs (NSAIDs), or aliskiren may further increase risk of kidney problems for people already at risk of this problem. If you have reduced kidney function, renal artery stenosis (narrowing of blood vessels in the kidneys), or congestive heart failure, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you have reduced kidney function, you may require lower doses of this medication.
Taking aliskiren may further increase the risk of kidney problems. If you have kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
This medication should not be taken by people with severely decreased kidney function.
People who have kidney problems and take this medication are more likely to experience increased levels of potassium in the blood. If you experience an irregular or slow heartbeat or nausea, contact your doctor as soon as possible.
Liver function: Amlodipine - telmisartan is removed from the body by the liver. People with reduced liver function are more likely to experience side effects related to this medication.
If you have mild to moderate liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you have severe liver problems or have biliary obstruction, you should not use this medication.
Low blood pressure: This medication may cause low blood pressure. Low blood pressure is more likely to occur if you are dehydrated, are taking aliskiren, other diuretics ("water pills"), are on a low-salt diet, or have diarrhea or vomiting. If you experience dizziness or lightheadedness, lie down until the symptoms go away and contact your doctor.
Potassium levels: This medication can increase potassium levels in the blood. Your doctor may monitor your potassium levels with blood tests. Do not use potassium supplements or salt substitutes with potassium unless recommended by your doctor.
Pregnancy: As with other medications related to telmisartan, this medication can cause serious harm or even death to the developing baby if taken during pregnancy. This medication should not be used during pregnancy. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: It is not known if amlodipine or telmisartan pass into breast milk. If you are a breast-feeding mother and taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using this medication have not been established for adolescents and children under the age of 18.
Seniors: Seniors may be more sensitive to the side effects of this medication.
What other drugs could interact with this medication?
There may be an interaction between amlodipine - telmisartan and any of the following:
- abiraterone acetate
- alpha blockers (e.g., alfuzosin, doxazosin, tamsulosin)
- alpha agonists (e.g., clonidine, methyldopa)
- amphetamines (e.g., dextroamphetamine, lisdexamphetamine)
- angiotensin-converting-enzyme inhibitors (ACEIs; captopril, enalapril, ramipril)
- angiotensin receptor blockers (ARBs; e.g., candasartan, irbesartan, losartan)
- "azole" antifungal medications (e.g., fluconazole, itraconazole, ketoconazole, voriconazole)
- barbiturates (e.g., butalbital, pentobarbital phenobarbital)
- beta-adrenergic blockers (e.g., atenolol, propranolol, sotalol)
- calcium channel blockers (e.g., amlodipine, diltiazem, nifedipine, verapamil)
- calcium supplements (e.g., calcium carbonate, calcium citrate)
- certain anti-psychotics (e.g., clozapine, olanzapine, quetiapine, risperidone)
- diuretics (water pills; e.g., furosemide, hydrochlorothiazide, triamterene)
- grapefruit juice
- hepatitis C antiviral combinations (e.g., ombitasvir - paritaprevir - ritonavir - dasabuvir, ombitasvir - paritaprevir - ritonavir)
- HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delavirdine, efavirenz, etravirine, nevirapine)
- HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
- low-molecular-weight heparins (e.g., dalteparin, enoxaparin, tinzaparin)
- macrolide antibiotics (e.g., clarithromycin, erythromycin, telithromycin)
- medications that increase the level of potassium in the blood (e.g., spironolactone, amiloride, triamterene, or salt substitutes that contain potassium)
- nitrates (e.g., nitroglycerin, isosorbide dinitrate, isosorbide mononitrate)
- nonsteroidal anti-inflammatory medications (NSAIDs; e.g., ASA, naproxen, diclofenac)
- opioid pain medications (e.g., codeine, morphine, oxycodone)
- phosphodiesterase-5 inhibitors (e.g., sildenafil, tadalafil, vardenafil)
- potassium supplements
- St. John's wort
- sodium phosphate
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
All material copyright MediResource Inc. 1996 – 2018. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Twynsta