Telmisartan + Amlodipine brands and prices in Pakistan

About Telmisartan with amlodipine

This is a prescription tablet that contains two blood pressure medicines. Telmisartan is an angiotensin II receptor blocker (ARB): it blocks a natural substance that makes blood vessels narrow. Amlodipine is a calcium channel blocker: it relaxes and widens blood vessels. Working in two different ways, they let the blood vessels relax so blood flows more easily and blood pressure goes down.

Who should not take it, or should take care

• Do not take it if you are pregnant or could become pregnant without using effective contraception. If you find out you are pregnant, contact your doctor straight away.
• Breastfeeding: it is not recommended. Your doctor will usually choose a different treatment.
• Do not take it if you are allergic to telmisartan, amlodipine or any of the other ingredients, including if they have ever caused angioedema (swelling under the skin).
• Do not take it with a blood pressure medicine containing aliskiren if you have diabetes or kidney problems.
• Do not take it if you have severe liver problems or a blocked bile duct.
• Tell your doctor if you have kidney disease, a kidney transplant, or narrowed arteries to the kidneys.
• Tell your doctor if you have heart failure, narrowed heart valves (such as aortic stenosis), severe heart artery disease, or have recently had a heart attack.
• Tell your doctor if you have low blood pressure, high potassium, diabetes or raised aldosterone levels.
• Tell your doctor if you are dehydrated, on a low-salt diet, take water tablets (diuretics), or have vomiting or diarrhoea, as your blood pressure may drop too low.
• Tell your doctor before any operation or anaesthetic.
• Some tablets contain lactose; check the leaflet if you cannot have some sugars.

Medicines and drinks that can interact

• Aliskiren, ACE inhibitors (such as ramipril) and other ARBs: taking these together raises the risk of low blood pressure, high potassium and kidney problems
• Potassium supplements, salt substitutes that contain potassium, potassium-sparing water tablets, heparin and trimethoprim, which can raise potassium
• Anti-inflammatory painkillers (NSAIDs) such as ibuprofen, naproxen and aspirin, which can harm the kidneys and weaken the blood pressure effect
• Lithium (for some mood disorders)
• Digoxin (a heart medicine)
• Simvastatin (a statin)
• Ciclosporin and tacrolimus (medicines that calm the immune system)
• Some antifungal medicines (such as fluconazole and ketoconazole), some HIV medicines (such as ritonavir) and some antibiotics (such as rifampicin)
• Water tablets (diuretics), steroid medicines and other medicines that lower blood pressure
• St John's wort (a herbal medicine)
• Grapefruit and grapefruit juice can increase the side effects of amlodipine
• Alcohol can make low blood pressure and dizziness more likely

Always tell your doctor and pharmacist about every medicine, supplement and herbal product you take.

Using it safely

• Take it at about the same time each day, with or without food, and swallow it with water.
• Keep taking it even if you feel well. Do not stop without talking to your doctor, as stopping suddenly can be dangerous.
• Keep tablets in their blister pack until you are ready to take one.
• If you forget a dose, check the leaflet or ask your pharmacist. Never take two doses together to make up for a missed one.
• Tell your doctor if you have diarrhoea or vomiting, sweat a lot or are not drinking enough, as your blood pressure may drop too low.
• Do not use salt substitutes that contain potassium unless your doctor agrees.
• Go to your check-ups. Your doctor may check your blood pressure and do blood tests for your kidneys and potassium.
• If you feel dizzy, sleepy or tired, do not drive, cycle or use machines until it passes.
• Tell every doctor, dentist and pharmacist you see that you take it, and keep a list of all your medicines and supplements.

Common questions

Why are two medicines combined in one tablet?
Telmisartan and amlodipine lower blood pressure in two different ways. Many people need more than one medicine to control their blood pressure, and the US prescribing information says this combination can be used when more than one medicine is likely to be needed.

Can I drink alcohol while taking it?
Keep alcohol low. Alcohol can add to the blood pressure lowering effect and make you dizzy or faint.

Can I eat grapefruit?
No. NHS advice for amlodipine, one of the two medicines in this tablet, is to avoid grapefruit and grapefruit juice because they can increase side effects.

My ankles are swollen. Is this the medicine?
It may be. Ankle and leg swelling is a common side effect of amlodipine, though it happens less often when amlodipine is combined with telmisartan. Keep taking the tablets and talk to your doctor or pharmacist. Get help straight away if your face, lips, tongue or throat swell.

What if I become pregnant?
Contact your doctor straight away. Medicines like telmisartan can seriously harm an unborn baby, so your doctor will stop this medicine and choose a safer one. If you are planning a pregnancy, talk to your doctor first.

Prepared from the sources listed by the MedInfoBase team. General information, not medical advice: it gives no doses. Your doctor or pharmacist decides the medicine and dose for you.