October 24, 2014
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Drug Factsheets

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Twynsta

(amlodipine - telmisartan)

DIN (Drug Identification Number)

02371022 TWYNSTA 5MG / 40MG TABLET
02371030 TWYNSTA 10MG / 40MG TABLET
02371049 TWYNSTA 5MG / 80MG TABLET
02371057 TWYNSTA 10MG / 80MG TABLET

What side effects are possible with Twynsta?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • back pain
  • difficulty sleeping
  • headache
  • muscle aches
  • unusual tiredness or weakness
  • upper respiratory tract infection (such as colds or sinus infections)

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • abnormal heartbeat (e.g., pounding heartbeat, slow heartbeat, fast heartbeat)
  • dizziness
  • easy bruising or bleeding
  • low blood pressure (e.g., dizziness, fainting, dizziness when standing up)
  • skin rash
  • swelling of ankles or feet
  • symptoms of depression (e.g., feeling sad, weight changes, sleep changes, hopelessness, guilt, loss of interest in activities)
  • symptoms of kidney problesm (e.g., difficulty urinating, producing little or no urine)
  • symptoms of liver problems (e.g., nausea, abdominal pain, tiredness, loss of appetite, feeling unwell, yellowing of the skin or eyes)
  • tingling or prickling sensations in the hands and feet
  • vertigo (feeling of spinning)
  • vision changes

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • chest pain
  • symptoms of a heart attack (e.g., chest pain, pressure or heaviness; nausea; shortness of breath; cool, clammy skin; anxiety)
  • symptoms of a severe allergic reaction (e.g., hives; difficulty breathing; swelling of the mouth, tongue, face, or throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.





Are there any other precautions or warnings for Twynsta?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Dizziness, fainting, spinning sensations: This medication can cause dizziness, fainting, or spinning sensations.

Do not drive, operate machinery, or perform other potentially hazardous tasks until you have determined how this medication affects you.

Heart attack and stroke: If you have a history of heart problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

If you have heart disease, problems with blood supply to the brain, or have had a recent heart attack, there is a risk that this medication may cause a heart attack or a stroke.

If you develop symptoms of a heart attack (e.g., chest pain, pressure, or heaviness; nausea; shortness of breath; anxiety; cool, clammy skin) or a stroke (e.g., sudden dizziness, difficulty speaking, headache, difficulty walking, confusion, blurred vision), get immediate medical attention.

Kidney function: If you have a kidney problem (e.g., kidney disease, renal artery stenosis), discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

People that have kidney problems and take this medication are more likely to experience increased levels of potassium in the blood. If you experience an irregular or slow heartbeat or nausea, contact your doctor as soon as possible.

Liver function: Amlodipine - telmisartan is removed from the body by the liver. People with reduced liver function are more likely to experience side effects related to this medication.

If you have mild to moderate liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you have severe liver problems or have biliary obstruction, you should not use this medication.

Low blood pressure: This medication may cause low blood pressure. Low blood pressure is more likely to occur if you are dehydrated, are taking diuretics ("water pills"), are on a low-salt diet, or have diarrhea or vomiting. If you experience dizziness or lightheadedness, lie down until the symptoms go away and contact your doctor.

Potassium levels: This medication can increase potassium levels in the blood. Your doctor may monitor your potassium levels with blood tests. Do not use potassium supplements or salt substitutes with potassium unless recommended by your doctor.

Pregnancy: As with other medications related to telmisartan, this medication can cause serious harm or even death to the developing baby if taken during pregnancy. This medication should not be used during pregnancy. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if amlodipine or telmisartan pass into breast milk. If you are a breast-feeding mother and taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for adolescents and children under the age of 18.

Seniors: Seniors may be more sensitive to the side effects of this medication.

What other drugs could interact with Twynsta?

There may be an interaction between amlodipine - telmisartan and any of the following:

  • alcohol
  • amifostine
  • antidepressants (e.g., citalopram, amitriptyline)
  • atorvastatin
  • "azole" antifungal medications (e.g., fluconazole, itraconazole, ketoconazole)
  • baclofen
  • carbamazepine
  • conivaptan
  • corticosteroids (e.g., prednisone, dexamethasone)
  • digoxin
  • diltiazem
  • diuretics (e.g., furosemide)
  • fosphenytoin
  • lithium
  • macrolide antibiotics (e.g., clarithromycin, erythromycin, telithromycin)
  • medications that increase the level of potassium in the blood (e.g., spironolactone, amiloride, triamterene, or salt substitutes that contain potassium)
  • nefazodone
  • nonsteroidal anti-inflammatory medications (NSAIDs; e.g., ASA, naproxen, diclofenac)
  • opioid pain medications (e.g., codeine, morphine, oxycodone)
  • other medications used to treat high blood pressure such as ACE inhibitors (e.g., ramipril, enalapril) and beta-blockers (e.g., atenolol, metoprolol)
  • phenobarbital
  • phenytoin
  • pimozide
  • potassium supplements
  • primidone
  • protease inhibitors (e.g., atazanavir, indinavir, ritonavir)
  • quinidine
  • ramipril
  • rifampin
  • rituximab
  • sildenafil
  • simvastatin
  • sodium phosphate
  • St. John's wort
  • warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

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