Telmisartan + Amlodipine

Telmisartan + Amlodipine contains two medicines, both of which help to control high blood pressure. It lowers the blood pressure by relaxing the blood vessels and making it easier for your heart to pump blood around your body. This will reduce your risk of having a heart attack or a stroke. Telmisartan + Amlodipine may be taken on an empty stomach or along with food. However, it is better to take it regularly at a fixed time each day, as prescribed by your doctor. The dose will depend on your condition and how you respond to the medicine. It's important to keep taking this medicine even if you feel well. By lowering your blood pressure, it is reducing your risk of heart attack or stroke so do not stop taking it unless your doctor tells you to. You can help this medicine work better by making a few changes to your lifestyle such as keeping active, stopping smoking, and eating a low salt and low fat diet. The most common side effects of this medicine include swelling in your ankles or feet (oedema), headache, sleepiness, dizziness, tiredness, and upset stomach. Since it may cause sleepiness and dizziness, do not drive or do anything requiring concentration until you know how it affects you. Talk to your doctor if any of the side effects bother you or will not go away. Before taking this medicine, let your doctor know if you have any kidney or liver problems or severe dehydration. Pregnant or breastfeeding women should also consult their doctor before taking it. While using this medicine, your blood pressure will need to be checked often and your kidney function may also need to be tested. Telmisartan + Amlodipine is a combination of two medicines: Telmisartan and Amlodipine. Telmisartan is an angiotensin receptor blocker (ARB) and Amlodipine is a calcium channel blocker (CCB). They work by relaxing the blood vessels and making the heart more efficient at pumping blood throughout the body. Together, they lower blood pressure effectively.

Used for the treatment of hypertension (high blood pressure). Can be used alone or with other antihypertensive medicines. Effective for patients who do not achieve blood pressure control with a single medicine.

Antihypertensive medicine (ARB + CCB combination)

Telmisartan is an angiotensin II receptor blocker (ARB). It works by blocking angiotensin II from binding to AT1 receptors. This reduces vasoconstriction and lowers blood pressure. Amlodipine is a dihydropyridine calcium channel blocker (CCB). It inhibits calcium influx into vascular smooth muscle to dilate blood vessels. Amlodipine reduces peripheral vascular resistance and lowers blood pressure.

Telmisartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II. It selectively blocks AT1 receptors found in vascular smooth muscle and adrenal glands. Telmisartan has >3,000-fold greater affinity for AT1 receptors than AT2 receptors. It dilates blood vessels without affecting heart rate. Amlodipine inhibits calcium ion influx into vascular and cardiac muscle. Amlodipine acts directly on vascular smooth muscle to reduce peripheral vascular resistance.

Adult Dose: May increase frequency and/or severity of angina during treatment initiation or dosage increments. Heart failure or hepatic impairment. Avoid fetal or neonatal exposure Hypotension: Correct any volume or salt depletion before initiating therapy. Observe for signs and symptoms of hypotension. Titrate slowly in patients with hepatic or severe renal impairment Heart failure: Monitor for worsening Avoid concomitant use of an ACE inhibitor and angiotensin receptor blocker Myocardial infarction: Uncommonly, initiating a CCB in patients with severe obstructive coronary artery disease may precipitate myocardial infarction or increased angina Lactation: Discontinue drug or do not breast feed Child Dose: Pregnancy Category: C (1st trimester); D (2nd & 3rd trimesters) Renal Dose: Telmisartan, a non-peptide angiotensin receptor blocker (ARB), is specific angiotensin II antagonist acting on the AT1 subtype. Angiotensin II is the principal pressor agent of the renin-angiotensin system, with effects that include vasoconstriction, stimulation of synthesis and release of aldosterone, cardiac stimulation, and renal reabsorption of sodium, which leads to an increase in blood pressure (hypertension). Telmisartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor in many tissues, such as vascular smooth muscle and the adrenal gland. Therefore, Telmisartan dilates blood vessels and reduces blood pressure without affecting pulse rate. Telmisartan has much greater affinity (>3,000 fold) for the AT1 receptor than for the AT2 receptor. It does not bind or block other hormone receptors or ion channels known to be important in cardiovascular regulation. Amlodipine, a dihydropyridine calcium-channel blocker (CCB), inhibits the transmembrane influx of calcium ion into vascular smooth muscle and cardiac muscle. Amlodipine is a peripheral arterial vasodilator that acts directly on vascular smooth muscle to cause a reduction in peripheral vascular resistance and reduction in blood pressure.

Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Telmisartan + Amlodipine may be taken with or without food, but it is better to take it at a fixed time.

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose.

Common: • Sleepiness • Ankle swelling • Headache • Flushing (sense of warmth in the face, ears, neck and trunk) • Dizziness • Tiredness • Palpitations • Upset stomach • Increased potassium level in blood

[UNSAFE] Telmisartan + Amlodipine may cause side effects which could affect your ability to drive. It may cause dizziness, headaches, nausea or tiredness, all of which could affect your ability to concentrate and drive. Telmisartan + Amlodipine is a combination of two medicines that provides better blood pressure control than either medicine alone. Telmisartan + Amlodipine may cause dizziness or sleepiness. Do not drive or do anything requiring concentration until you know how it affects you. It may cause you to feel lightheaded or weak especially when you stand up. Rise slowly if you have been sitting or lying down. Avoid consuming alcohol as it may enhance the blood pressure lowering effect of this medicine. It can cause ankle or foot swelling. Raise your legs while you are sitting down and talk to your doctor if it does not go away. Do not take Telmisartan + Amlodipine if you are pregnant, planning to conceive or breastfeeding.

Hypersensitivity to Telmisartan, Amlodipine, or any component. Pregnancy and breastfeeding. Severe liver disease (biliary obstructive disorders). Severe hypotension (very low blood pressure). Cardiogenic shock. Left ventricle outflow tract obstruction (e.g., aortic stenosis).

Known hypersensitivity to this product or any of its components. Pregnancy & lactation. Biliary obstructive disorders, severe hepatic impairment, hypotension, cardiogenic shock, left ventricle outflow tract obstruction.

Alcohol consumption is unsafe as it may enhance the blood pressure lowering effect. Alcohol may increase the risk of dizziness, fainting, and excessive blood pressure reduction. Avoid high salt and high fat foods, as they may interfere with blood pressure control. A healthy diet (green leafy vegetables, fruits, low salt) enhances the effectiveness of this medicine.

[CONSULT YOUR DOCTOR] Telmisartan + Amlodipine is unsafe to use during pregnancy as there is definite evidence of risk to the developing baby. However, the doctor may rarely prescribe it in some life-threatening situations if the benefits are more than the potential risks. Please consult your doctor.

[SAFE IF PRESCRIBED] Telmisartan + Amlodipine is probably safe to use during breastfeeding. Limited human data suggests that the drug does not represent any significant risk to the baby.

Safety and effectiveness have not been established in children. Data on use in patients under 18 years is limited. Consult a pediatrician.

No dosage adjustment is necessary for elderly patients. However, patients over 65 years may have a higher risk of dizziness and swelling. Regular blood pressure monitoring is recommended.

[SAFE IF PRESCRIBED] Telmisartan + Amlodipine is safe to use in patients with kidney disease. No dose adjustment of Telmisartan + Amlodipine is recommended. [CAUTION] Telmisartan + Amlodipine should be used with caution in patients with liver disease. Dose adjustment of Telmisartan + Amlodipine may be needed. Please consult your doctor.

Overdose may cause excessive blood pressure reduction, dizziness, fainting, and slow heartbeat. There is no specific antidote. In the event of overdose, symptomatic and supportive treatment should be given. Contact a doctor immediately if you take an excessive dose.

Store below 30°C, protected from light and moisture. Keep out of reach of children. Do not use after the expiry date.