See Supplemental Patient Information
- Suspend therapy as early as possible if pregnancy is detected during therapy [US Black Box warning]
- Do not use drugs that act on the renin-angiotensin system in second or third trimester as they can cause injury or death to the developing fetus
- Symptomatic hypotension has been reported after administration of telmisartan especially in volume or salt-depleted patients. Correct this condition before starting treatment or closely monitor the patient with a reduced dose
- Use with caution in patients with severe aortic stenosis as acute hypotension has been reported with amlodipine therapy
- Periodically determine serum electrolyte levels as hyperkalemia has been reported with telmisartan use
- In impaired hepatic patients initiate telmisartan at low dose and titrate it slowly, start amlodipine at 2.5 mg. As the lowest dose of amlodipine/telmisartan is 5/40 mg, initial therapy with amlodipine/telmisartan is not recommended in hepatic impairment
- Closely monitor renal function for dual blockade of renin-angiotensin-aldosterone system during the therapy
- Amlodipine may develop increased frequency, duration, or severity of angina or acute myocardial infarction particularly in patients with severe obstructive coronary artery disease
- Cautiously use in cardiovascular disorder as events of heart failure occurred with amlodipine therapy
Cautions: Use cautiously in
- Severe Renal impairment
- Severe hepatic impairment
- Severe aortic stenosis
- Elderly patients
- CHF
- Severe volume depletion
- Renal artery stenosis
- Hyponatremia
- Severe CAD
- Post-MI
Supplemental Patient Information
- Female patients of childbearing age should be warned about the effects of the drug on the fetus; discuss other treatment options with female patients planning to become pregnant
Pregnancy Category:C (First trimester); D (Second and third trimester )
Breastfeeding: Safety unknown; prefer an alternative drug during breastfeeding as appropriate literature on the use of amlodipine as well as telmisartan is unavailable. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 14 December 2010). According to the manufacturer data, it is not known whether amlodipine and telmisartan are excreted in human milk. It is recommended to discontinue nursing while amlodipine is administered. Due to the potential for serious adverse reactions in nursing infants, manufacturer recommends discontinuation of nursing or discontinuation of telmisartan, taking into account the importance of the drug to the mother.
US Trade Name(s)
US Availability
amlodipine/telmisartan (generic)
- TABS:
- 5 mg/40 mg
- 10 mg/40 mg
- 5 mg/80 mg
- 10 mg/80 mg
Twynsta (amlodipine/telmisartan)
- TABS:
- 5 mg/40 mg
- 10 mg/40 mg
- 5 mg/80 mg
- 10 mg/80 mg
Canadian Trade Name(s)
Canadian Availability
UK Trade Name(s)
UK Availability
Australian Trade Name(s)
Australian Availability
[Outline]
Pricing data from www.DrugStore.com in U.S.A.
- Twynsta 80-5 MG TABS [Box] (BOEHRINGER INGELHEIM)
30 mg = $129.99
90 mg = $365.98
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.