telmisartan / amlodipine
Telmisartan / amlodipine is a combination medication containing an angiotensin II receptor blocker (telmisartan) and a calcium channel blocker (amlodipine). It's used to treat adults with high blood pressure. The typical dosage is to take one tablet by mouth once a day. Common side effects include swelling and dizziness. Although the brand Twynsta has been discontinued, the generic medication is still available.
What is Telmisartan / amlodipine?
What is Telmisartan / amlodipine used for?
- High blood pressure
How Telmisartan / amlodipine works
Telmisartan / amlodipine is a combination of two medications that work together to lower blood pressure.
- Telmisartan is an angiotensin II receptor blocker (ARB). It stops the hormone angiotensin II from tightening blood vessels. This allows the blood vessels to relax, which lowers your blood pressure.
- Amlodipine is a calcium channel blocker (CCB) that lowers blood pressure by relaxing your blood vessels.
Drug facts
Side effects of Telmisartan / amlodipine
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Swelling (5%)
- Dizziness (3%)
- Back pain (2%)
Less Common Side Effects
- Low blood pressure
- Fainting
Telmisartan / amlodipine serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Heart problems: cold and clammy skin, sweating, dizziness, tightness and pain in the chest, neck, arms, or back
- High blood potassium levels: nausea, vomiting, tingling sensation, muscle weakness, fluttering heartbeat
- Muscle problems: stiffness, tremor, abnormal movement
The following Telmisartan / amlodipine side effects have also been reported
Along with its needed effects, a medicine 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:
More common
Bloating or swelling of the face, arms, hands, lower legs, or feet
body aches or pain
chills
difficulty breathing
ear congestion
headache
loss of voice
rapid weight gain
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
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
nervousness
pounding in the ears
shivering
slow or fast heartbeat
sweating
trouble sleeping
vomiting
Rare
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
cough or hoarseness
dark urine
difficult or labored breathing
difficulty swallowing
extreme fatigue
fast, irregular, pounding, or racing heartbeat or pulse
feeling of warmth
flushed, dry skin
fruit-like breath odor
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
yellow eyes or skin
Some side effects 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
indigestion
pain or tenderness around the eyes and cheekbones
sleepiness or unusual drowsiness
Rare
Abnormal dreams
ankle, knee, or great toe joint pain
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
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
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Telmisartan / amlodipine
Pros
- Contains two first-choice medications for treating high blood pressure
- Convenient to take a single pill that's a combination of two medications
- Taken once a day by mouth with or without food
- Available as a lower-cost generic
Cons
- Can cause swelling in the arms and legs
- More difficult to adjust the amount of each individual ingredient in the medication
- Can interact with other medications
- Not safe in pregnancy or breastfeeding
Pharmacist tips for Telmisartan / amlodipine
- Take telmisartan / amlodipine with or without food at any time of day. If it hurts your stomach, try taking it with food to help.
- Take telmisartan / amlodipine exactly as prescribed. Don't change your dose or suddenly stop taking the medication without talking to your provider first. Doing so can cause your blood pressure to rise quickly.
- To help see how well telmisartan / amlodipine is working for you, Check your blood pressure regularly at home. Record your readings and bring your log to your medical appointments. Based on your results, your provider might recommend any dose changes if needed.
- If you accidentally forget to take telmisartan / amlodipine, take it as soon as you remember. But if the time you typically take your medication next is soon, then skip the missed dose. Never take two doses at the same time to make up any missed doses.
- You might feel dizzy when you first start taking telmisartan / amlodipine and when your dose is raised. It should lessen over time as you continue taking the medication and as your body gets used to your new blood pressure.
- Stand up slowly or hold onto something when moving from sitting or lying down to prevent a sudden drop in blood pressure. If you feel dizzy or lightheaded while taking telmisartan / amlodipine, contact your provider, as your dose might need adjusting.
- Swelling in your feet, ankles, legs, or hands can happen when taking telmisartan / amlodipine. Talk with your provider if you notice swelling. They might recommend tips to ease the swelling, such as sitting or lying down with your legs raised or wearing compression socks.
- Eat a healthy diet, including a low-salt diet, while taking telmisartan / amlodipine to help lower your blood pressure.
- Try to limit foods high in potassium and potassium-containing salt substitutes. Eating them with telmisartan / amlodipine might raise your potassium levels too much, which can lead to nausea, vomiting, or muscle weakness.
Common questions about Telmisartan / amlodipine
Yes, it's safe to take amlodipine and telmisartan together because they work differently from each other to lower blood pressure. Also, both medications are first-choice treatment options for high blood pressure. Depending on how high your blood pressure is and your risk for other problems caused by high blood pressure (e.g., heart attack or stroke), your provider might recommend that you take a combination blood pressure medication like telmisartan / amlodipine.
No, telmisartan / amlodipine isn't a blood thinner and doesn't raise your risk for bleeding. It's a combination medication that works to lower your blood pressure by relaxing your blood vessels.
In general, it's not completely clear when the best time of day to take blood pressure medications like telmisartan / amlodipine is. While studies are mixed, the most important thing is to take telmisartan / amlodipine consistently at the same time every day so it can work as best as possible.
The manufacturer of telmisartan / amlodipine doesn't specify if the tablets can be cut in half or not. The tablets aren't made with a special coating around them, which means it might be safe to cut them. But, the tablets also aren't scored (an indented line in the middle of the tablet), so cutting them in half might be difficult. If you're having trouble swallowing the tablets, talk to your provider
It typically takes about 2 weeks for telmisartan / amlodipine to lower your blood pressure. If needed, your provider can raise your dose as long as you're not having side effects from the medication. Keep in mind that it can take some time before you reach a dose that controls your blood pressure. So make sure to be patient, continue taking telmisartan / amlodipine, and follow up with your provider regularly.
Yes, telmisartan / amlodipine is only available as a lower-cost generic. The brand, Twynsta, was discontinued by the manufacturer and is no longer available.
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Risks and warnings for Telmisartan / amlodipine
Telmisartan / amlodipine can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Harm to unborn baby
Telmisartan / amlodipine shouldn't be taken during pregnancy because it can cause severe, and sometimes life-threatening harm, to unborn babies. Tell your provider before starting treatment if you're pregnant or thinking of becoming pregnant. They'll discuss with you about safer options to lower your blood pressure. If you find out that you're pregnant while taking telmisartan / amlodipine, stop the medication and let your provider know right away.
Low blood pressure
- Risk factors: Not enough fluid in your body | Having diarrhea or vomiting for a long time | Low salt levels in your body | Taking high doses of diuretic medications | History of narrow heart valves (aortic stenosis)
Telmisartan / amlodipine can cause your blood pressure to drop too much, which can make you feel dizzy, tired, or lightheaded. This side effect is more common when you first start telmisartan / amlodipine or when the dose is raised. Make sure to stay well hydrated to avoid having blood pressure that's too low. If your blood pressure drops too much and you feel dizzy, sit down slowly while holding onto something and let your provider know. If you fall and hit your head, get medical help right away.
High potassium levels
- Risk factors: Taking other medications that can raise potassium levels | Heart failure | Kidney problems
Telmisartan / amlodipine can cause high potassium levels in the blood, even in people with healthy kidneys. Your risk is higher if you take other medications that can raise potassium, such as spironolactone (Aldactone). While taking telmisartan / amlodipine, your provider will order blood tests to check your potassium on a regular basis. If you experience signs of high potassium levels, such as nausea, muscle weakness, or irregular heartbeat, tell your healthcare provider right away. If left untreated, high potassium levels can be dangerous.
Risk of heart attack or chest pain
- Risk factors: Severe coronary artery disease
It's possible for some people to experience worsening chest pain or develop a heart attack while taking telmisartan / amlodipine. The risk is higher when you first start this medication or when your dose is raised. Your risk is also higher if you have severe coronary artery disease (CAD). Get medical help right away if you experience chest pain, pressure in the chest, heartburn, dizziness, or trouble breathing.
Possible kidney damage in certain people
- Risk factors: Heart failure | Certain kidney problems | Taking other medications that can cause kidney damage
Sometimes, telmisartan / amlodipine can affect your kidneys and cause them to not work as well. The risk is higher for people who have certain types of kidney problems, such as renal artery stenosis or severe heart failure. Your provider might order lab tests every so often to make sure your kidneys are healthy and working properly. If you develop kidney problems, or if your kidney problems worsen while taking telmisartan / amlodipine, your provider might recommend that you stop taking this medication. Let your provider know if you're urinating less often than usual, as this could be a sign that your kidneys aren't working as well.
Telmisartan / amlodipine dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 80mg/5mg | 30 tablets | $44.32 | $1.48 |
| 80mg/10mg | 90 tablets | $123.85 | $1.38 |
| 40mg/5mg | 30 tablets | $44.12 | $1.47 |
| 40mg/10mg | 30 tablets | $46.56 | $1.55 |
Typical dosage for Telmisartan / amlodipine
The typical starting dose is either 40 mg / 5 mg (telmisartan / amlodipine) or 80 mg / 5mg (telmisartan / amlodipine) by mouth once daily.
The maximum dose is 80 mg / 10 mg (telmisartan / amlodipine) once daily.
Interactions between Telmisartan / amlodipine and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Abametapir
- Atazanavir
- Benazepril
- Captopril
- Ceritinib
- Clarithromycin
- Clopidogrel
- Conivaptan
- Cyclosporine
- Dantrolene
- Digoxin
- Domperidone
- Droperidol
- Enalapril
- Enalaprilat
- Epirubicin
- Fosinopril
- Fosnetupitant
- Lacosamide
- Lisinopril
- Lithium
- Moexipril
- Mycophenolate Mofetil
- Netupitant
- Perindopril
- Piperaquine
- Potassium Phosphate
- Quinapril
- Ramipril
- Rifampin
- Ritonavir
- Simvastatin
- Tacrolimus
- Tegafur
- Telaprevir
- Trandolapril
- Trimethoprim
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Bromfenac
- Bufexamac
- Celecoxib
- Choline Salicylate
- Clonixin
- Dexibuprofen
- Dexketoprofen
- Diclofenac
- Diflunisal
- Dipyrone
- Droxicam
- Etodolac
- Etofenamate
- Etoricoxib
- Felbinac
- Fenoprofen
- Fepradinol
- Feprazone
- Floctafenine
- Flufenamic Acid
- Flurbiprofen
- Ibuprofen
- Indinavir
- Indomethacin
- Ketoprofen
- Ketorolac
- Lornoxicam
- Loxoprofen
- Lumiracoxib
- Meclofenamate
- Mefenamic Acid
- Meloxicam
- Morniflumate
- Nabumetone
- Naproxen
- Nepafenac
- Niflumic Acid
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Oxaprozin
- Oxyphenbutazone
- Parecoxib
- Phenylbutazone
- Piketoprofen
- Piroxicam
- Proglumetacin
- Propionic Acid
- Propyphenazone
- Proquazone
- Rifapentine
- Rofecoxib
- Salicylic Acid
- Salsalate
- Sodium Salicylate
- Sulindac
- Tenoxicam
- Tiaprofenic Acid
- Tolfenamic Acid
- Tolmetin
- Valdecoxib
How much does Telmisartan / amlodipine cost?
$44.12
Telmisartan / amlodipine contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Telmisartan / amlodipine will not be safe for you to take.
- Taking telmisartan / amlodipine with aliskiren (Tekturna) while having diabetes
What are alternatives to Telmisartan / amlodipine?
