Telmisartan and Amlodipine

Angiotensin-II Antagonist · Angiotensin II antagonist/Calcium antagonist

Indications

Hypertension, not adequately controlled by amlodipine or telmisartan alone.

Dosage

Adults: 1 tab daily using the strength as clinically appropriate. Children: Not recommended.

Adverse Effects

Headache, oedema, fatigue, nausea, flushing and dizziness, rash, gingival hyperplasia. Rarely, alopecia, pruritus, angioedema, palpitations, dyspnoea, abdominal pain, back pain, dyspepsia, muscle cramps, asthaenia, somnolence, altered bowel habit, diarrhoea, myalgia, arthralgia, peripheral neuropathy, pancreatitis, mood changes, dry mouth, increased micturition, hyperglycaemia, impotence, sweating, syncope, thrombocytopenia, vasculitis, visual disturbances. Upper respiratory tract infection, sinusitis, pharyngitis. Influenza-like symptoms, pain, chest pain, fever.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Cardiogenic shock, aortic stenosis, unstable angina. Hypersensitivity to dihydropyridines. Cholestasis & biliary obstructive disorders, severe hepatic impairment. Refractory hypokalaemia, hypercalcaemia. Precautions: Within one month of MI. Impaired hepatic function. Hypertensive crisis. Bilateral renal artery stenosis or stenosis of the artery to single functioning kidney. Mild to moderate renal impairment. Patients who are vol-&/or Na-depleted by vigorous diuretic therapy, dietary salt restriction, diarrhoea or vomiting. Severe CHF; primary aldosteronism; aortic or mitral stenosis, obstructive hypertrophic cardiomyopathy. May impair glucose tolerance. Hereditary fructose intolerance; ischaemic cardiopathy or CV disease. Monitor serum K in patients at risk of hyperkalaemia.

Interactions

Monitor digoxin & lithium levels during concomitant use. Other kaliuretic diuretics, laxatives. Corticosteroids, ACTH, amphotericin, carbenoxolone, penicillin-G potassium, salicylic acid & derivatives.

Advice to Patient

Take with or without meals. Take out medication from pack just before use. Contact prescriber immediately if there is allergic reaction (rash, hives, itching, difficulty in breathing, swelling on face/lips/tongue), fast/slow/irregular heartbeat, change in frequency of urination, muscle weakness. Change position slowly from sitting or lying to standing. Do not take diets and supplements containing potassium without consulting prescriber. Avoid driving, operating machinery and doing tasks that require alertness. Reduce alcohol intake.

Pharmacokinetics

TELMISARTAN: Onset of action: 1-2 hrs. Duration: Up to 24 hrs. Metabolism: Hepatic. Bioavailability (dose dependent): 42%-58%. Hepatic impairment: Reaches 100%. Half-life elimination: Terminal: 24 hrs. Time to peak, plasma: 0.5-1 hr. Excretion: Faeces (97%). AMLODIPINE: Onset of action: Antihypertensive effect: Significant reductions in blood pressure at 24-48 hrs after first dose. Duration: Antihypertensive effect: At least 24 hrs. Discontinuation after 6-7 wks of treatment: Duration extends to at least 72 hrs. Absorption: Well absorbed. Metabolism: Hepatic. Bioavailability: 64%-90%. Half-life elimination: Terminal (biphasic): 30-50 hrs. Time to peak, plasma: 6-12 hrs. Excretion: Urine.

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.