Twynsta contains a combination of amlodipine and telmisartan. Amlodipine is a calcium channel blocker. Amlodipine relaxes (widens) blood vessels and improves blood flow.
Telmisartan is an angiotensin II receptor antagonist. Telmisartan keeps blood vessels from narrowing, which lowers blood pressure and improves blood flow.
Twynsta is used to treat high blood pressure (hypertension). Lowering blood pressure may lower your risk of a stroke or heart attack.
Twynsta may also be used for purposes not listed in this medication guide.
Important information
Do not use Twynsta if you are pregnant. Stop using and tell your doctor right away if you become pregnant. Twynsta can cause injury or death to the unborn baby if you take the medicine during your second or third trimester. Use effective birth control.
You should not use Twynsta if you are allergic to amlodipine (Norvasc) or telmisartan (Micardis).
Before you use Twynsta, tell your doctor about all your medical conditions and allergies. Also make sure your doctor knows if you are pregnant or breast-feeding. In some cases, you may not be able to use Twynsta, or you may need a dose adjustment or special precautions.
Certain other drugs may interact with amlodipine and telmisartan or should not be used at the same time. Tell each of your healthcare providers about all medicines you use now, and any medicine you start or stop using.
Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking this medication, which can lead to severely low blood pressure or a serious electrolyte imbalance.
In rare cases, Twynsta can cause a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, and dark colored urine.
Before taking this medicine
You should not use this medicine if you are allergic to amlodipine (Norvasc) or telmisartan (Micardis).
If you have diabetes, do not use Twynsta together with any medication that contains aliskiren (Amturnide, Tekturna, Tekamlo, Valturna).
You may also need to avoid taking Twynsta with aliskiren if you have kidney disease.
To make sure Twynsta is safe for you, tell your doctor if you have:
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kidney disease (or if you are on dialysis);
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liver disease;
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heart disease;
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an electrolyte imbalance (such as low levels of potassium or magnesium in your blood); or
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if you are on a low-salt diet.
Do not use if you are pregnant. Stop using and tell your doctor right away if you become pregnant. Twynsta can cause injury or death to the unborn baby if you take the medicine during your second or third trimester. Use effective birth control.
It is not known whether amlodipine and telmisartan passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using this medication.
How should I take Twynsta?
Take Twynsta exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.
Your doctor may occasionally change your dose to make sure you get the best results.
You may take Twynsta with or without food, at the same time each day.
You may have very low blood pressure while taking this medicine. Call your doctor if you are sick with vomiting or diarrhea, or if you are sweating more than usual.
Your blood pressure will need to be checked often. You may also need frequent blood tests.
Keep using Twynsta as directed, even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life.
Store at room temperature away from moisture and heat. Keep each tablet in the blister pack until you are ready to take one.
Twynsta dosing information
Usual Adult Dose for Hypertension:
Initial dose: 40/5 to 80/5 mg orally once daily. Dosage should be individualized and may be increased after at least 2 weeks.
Maximum dose: 80/10 mg orally once daily
What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while taking Twynsta?
Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.
Do not use potassium supplements or salt substitutes while you are taking Twynsta, unless your doctor has told you to.
Twynsta side effects
Get emergency medical help if you have signs of an allergic reaction to Twynsta: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
In rare cases, Twynsta can cause a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, and dark colored urine.
Call your doctor at once if you have:
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a light-headed feeling, like you might pass out;
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swelling in your hands or feet, rapid weight gain;
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new or worsened chest pain;
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pounding heartbeats or fluttering in your chest; or
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high potassium--nausea, slow or unusual heart rate, weakness, loss of movement.
Common Twynsta side effects may include:
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swelling in your hands or feet;
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fast heartbeats;
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dizziness, drowsiness, tired feeling;
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flushing (warmth, redness, or tingly feeling);
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back pain; or
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nausea, diarrhea, stomach pain.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
What other drugs will affect Twynsta?
Tell your doctor about all your current medicines and any you start or stop using, especially:
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digoxin;
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a diuretic or "water pill";
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lithium;
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simvastatin (Zocor, Vytorin);
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an ACE inhibitor--benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, trandolapril; or
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a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen, naproxen, celecoxib, diclofenac, indomethacin, meloxicam, and others.
This list is not complete. Other drugs may interact with amlodipine or telmisartan, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
