Telmisartan/Amlodipine

DEA Class; Rx

Common Brand Names; Twynsta

• ARB/CCB Combos; 
• Antianginal Agents; 
• Calcium Channel Blockers, Dihydropyridine

Angiotensin II antagonist (telmisartan) combined with dihydropyridine calcium-channel blocker (amlodipine) for treatment of hypertension.

Indicated for treatment of hypertension

Hypersensitivity

Do not coadminister with aliskiren in patients with diabetes mellitus

Discontinue immediately with pregnancy; increased fetal/neonatal morbidity and mortality (see Black Box Warnings)

May cause hypotension, particularly if volume or salt depleted (correct before initiating)

Symptomatic hypotension with or without syncope may occur

Titrate slowly in patients with hepatic or severe renal impairment

May increase serum creatinine or BUN in patients w/ renal artery stenosis

Monitor for hyperkalemia

Use caution in heart failure, severe aortic stenosis (amlodipine), hepatic impairment, renal artery stenosis, or hypertrophic cardiomyopathy

Dual blockade of the renin angiotensin system with ARBs, ACE inhibitors, or aliskiren associated with increased risk for hypotension, hyperkalemia, and renal function changes (including acute renal failure) compared to monotherapy

Monitor for worsening heart failure; may lead to oliguria or progressive azotemia

Initiating calcium channel blockers in patients with severe obstructive coronary artery disease may precipitate MI or increase angina

Can cause fetal harm when administered to a pregnant woman; discontinue drug when pregnancy is dectected and treat hypertension according to guidelines during pregnancy

Use of drugs that act on the renin-angiotensin system during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death

Because of the potential for serious adverse reactions in the breastfed infant including hypotension, hyperkalemia and renal impairment, advise a nursing woman not to breastfeed during treatment with telmisartan/amlodipine