Twynsta

Twynsta

telmisartan + amlodipine

Manufacturer:

Boehringer Ingelheim

Distributor:

Metro Drug
Concise Prescribing Info
Contents
Per 40 mg/5 mg tab Telmisartan 40 mg, amlodipine besilate 5 mg. Per 40 mg/10 mg tab Telmisartan 40 mg, amlodipine besilate 10 mg. Per 80 mg/5 mg tab Telmisartan 80 mg, amlodipine besilate 5 mg. Per 80 mg/10 mg tab Telmisartan 80 mg, amlodipine besilate 10 mg
Dosage/Direction for Use
Adult Initially 40 mg/5 mg once daily. May be increased to a max of 80 mg/10 mg. Patient requiring larger BP reduction Initially 80 mg/5 mg once daily. May titrate up to a max of 80 mg/10 mg once daily if additional BP lowering is needed after at least 2 wk. Hepatic impairment Should not exceed 40 mg of telmisartan.
Administration
May be taken with or without food.
Contraindications
Hypersensitivity to telmisartan, amlodipine or to dihydropyridine derivatives. Biliary obstructive disorders. Severe hepatic impairment. Cardiogenic shock. Concomitant use of aliskiren in patients w/ DM or renal impairment (GFR <60 mL/min/1.73 m2). Pregnancy (2nd & 3rd trimester) & lactation.
Special Precautions
Renovascular HTN, intravascular hypovolemia, dual blockade of the renin-angiotensin-aldosterone system, primary aldosteronism, aortic or mitral valve stenosis, obstructive hypertrophic cardiomyopathy, hyperkalemia; DM. NYHA III & IV heart failure of nonischemic etiology. Fructose intolerance. Periodic monitoring of serum K & creatinine levels is recommended in patients w/ renal impairment. Hepatic impairment. May impair ability to drive or operate machinery. Pregnancy (1st trimester). Childn & adolescents <18 yr.
Adverse Reactions
Cystitis; depression, anxiety, insomnia; dizziness, somnolence, migraine, headache, paraesthesia, syncope, peripheral neuropathy, hypoaesthesia, dysgeusia, tremor; vertigo; bradycardia, palpitations; hypotension, orthostatic hypotension, flushing; cough; abdominal pain, diarrhea, nausea, vomiting, gingival hypertrophy, dyspepsia, dry mouth; pruritus, eczema, erythema, rash; arthralgia, muscle spasm, myalgia, back pain, pain in extremity; nocturia; erectile dysfunction; peripheral edema, asthenia, chest pain, fatigue, edema, malaise; increased hepatic enzymes & blood uric acid.
Drug Interactions
Increased BP lowering effect w/ other antihypertensives, baclofen, amifostine, alcohol, barbiturates, narcotics or antidepressants. Reduction of anti-hypertensive effects w/ corticosteroids. Telmisartan: Increase plasma conc of digoxin & ramipril. Reversible increase conc of lithium. May potentiate acute renal insufficiency w/ NSAIDs. Amlodipine: Increased plasma conc w/ CYP3A4 inhibitors (ie, ketoconazole, itraconazole, ritonavir). Decreased plasma conc w/ CYP3A4 inducers (eg, anticonvulsants, rifampicin, Hypericum perforatum). Increase systemic exposure of simvastatin, ciclosporin or tacrolimus. Increased BP lowering effects w/ grapefruit & grapefruit juice.
MIMS Class
Angiotensin II Antagonists / Calcium Antagonists
ATC Classification
C09DB04 - telmisartan and amlodipine ; Belongs to the class of angiotensin II receptor blockers (ARBs) and calcium channel blockers. Used in the treatment of cardiovascular disease.
Presentation/Packing
Form
Twynsta 40 mg/10 mg tab
Packing/Price
30's (P1,119.27/pack)
Form
Twynsta 40 mg/5 mg tab
Packing/Price
30's (P1,119.27/pack)
Form
Twynsta 80 mg/10 mg tab
Packing/Price
30's (P1,598.3/pack)
Form
Twynsta 80 mg/5 mg tab
Packing/Price
30's (P1,598.3/pack)
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