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Generic Name:

amlodipine-telmisartan, Oral tablet

All Brands

  • Twynsta
SECTION 1 of 4

Highlights for amlodipine-telmisartan

Oral tablet
1

Telmisartan/amlodipine is a combination of two drugs in a single form that work in different ways to treat high blood pressure. It’s given when you need more than one medication to control your blood pressure.

2

This drug is taken once a day with or without food. Your doctor will decide the best dose for you.

3

Common side effects include swelling in your hands, ankles, or feet, feeling like your heart is pounding or racing, dizziness, tiredness, stomach pain, nausea, or diarrhea.

4

You shouldn’t take this drug if you’re pregnant or plan to become pregnant. Telmisartan/amlodipine can harm or even be fatal to your unborn baby.

5

This drug can cause low blood pressure, especially during the first few days of starting treatment. Tell your doctor if you feel lightheaded or faint.

IMPORTANT INFORMATION

FDA warning

This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to potentially dangerous effects.

Use during pregnancy warning. If you find out that you’re pregnant, you should stop taking this drug right away. This drug can harm and even be fatal to your unborn baby. Ask your doctor about other ways to lower your blood pressure if you plan to become pregnant.

Low blood pressure

This drug can cause low blood pressure, especially during the first few days of starting treatment. Tell your doctor if you feel dizzy or have any fainting spells. You may have a higher risk of low blood pressure if you:

  • aren’t drinking enough fluids
  • are sweating a lot
  • have diarrhea or vomiting

What is telmisartan/amlodipine?

This drug is a prescription drug. It’s available as an oral tablet.

This drug is available as a generic drug. Generic drugs usually cost less. In some cases they may not be available in every strength or form as the brand. Talk to your healthcare provider to see if the generic will work for you.

This drug is a combination of two drugs in a single form. It’s important to know about all the drugs in the combination because they each may have unique traits.

This drug may be taken as part of a combination therapy with other medications that lower your blood pressure.

Why it's used

This drug is used to treat high blood pressure. It’s given when one of these medicines (or a similar one) isn’t enough to lower your high blood pressure.

How it works

Telmisartan belongs to a class of drugs called angiotensin II receptor blockers (ARBs).

More Details

How it works

Telmisartan belongs to a class of drugs called angiotensin II receptor blockers (ARBs). Amlodipine belongs to a class of drugs called dihydrophyridine calcium channel blockers (DHP-CCBs). A class of drugs refers to medications that work similarly. They have a similar chemical structure and are often used to treat similar conditions.

Telmisartan and amlodipine work in different way to relax your blood vessels. Telmisartan blocks the action of angiotensin II, a chemical in your body that causes blood vessels to tighten and narrow. This helps to relax and widen your blood vessels. Amlodipine blocks calcium channels. This relaxes the muscles that tighten and narrow blood vessels. This allows your blood to flow more easily through your body. It also decreases the amount of work your heart needs to do. These effects lower your blood pressure.

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SECTION 2 of 4

amlodipine-telmisartan Side Effects

Oral tablet

More Common Side Effects

The most common side effects that occur with telmisartan/amlodipine include:

  • swelling in your hands, ankles, or feet

  • feeling like your heart is pounding or racing

  • sudden redness of your face and neck (flushing)

  • dizziness

  • back pain

  • tiredness

  • stomach pain, nausea, or diarrhea

  • low blood pressure or a sudden drop in blood pressure with fainting

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life threatening or if you think you’re experiencing a medical emergency, call 9-1-1.

  • low blood pressure. Symptoms include:

    • dizziness
    • tiredness
    • lightheadedness
  • kidney problems. Symptoms include:

    • swelling in your feet, ankles, or hands
    • unexplained weight gain
  • heart problems or heart attack. Symptoms include:

    • chest, neck, or arm pain
    • shortness of breath
  • serious allergic reaction. Symptoms include:

    • swelling of your face, tongue, or throat
    • trouble breathing
    • skin rash
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug may cause drowsiness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 4

amlodipine-telmisartan May Interact with Other Medications

Oral tablet

Telmisartan/amlodipine can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Alcohol interaction

Alcohol may increase the blood pressure lowering effect of telmisartan/amlodipine. Use caution when you drink alcohol.

Medications that might interact with this drug

Antibiotics

Certain antibiotics can increase the level of amlodipine in your body. This can lead to more side effects.

These drugs include:

  • clarithromycin

Antifungal drugs

Certain antifungal drugs can increase the level of amlodipine in your body. This can lead to more side effects.

These drugs include:

  • ketoconazole
  • itraconazole
  • voriconazole

Blood pressure drugs

Certain blood pressure drugs can increase the level of telmisartan in your body. This can lead to more side effects.

These drugs include:

  • aliskiren. If you have diabetes, taking telmisartan with aliskiren can increase your risk for kidney problems. 

Telmisartan can increase the concentration of other blood pressure drugs in your body. This can cause more side effects from your blood pressure drug.

These drugs include:

  • ramipril

Depression drugs

Certain depression drugs can increase the level of amlodipine in your body. This can lead to more side effects.

These drugs include:

  • nefazodone

Diltiazem

Diltiazem can increase the level of amlodipine in your body: This can lead to more side effects.

Heart drugs

Telmisartan can increase the level digoxin in your body. This can cause more side effects from digoxin.

Human immunodeficiency virus (HIV) drugs

Certain drugs used to treat HIV can increase the level of amlodipine in your body. This can lead to more side effects.

These drugs include:

  • ritonavir
  • saquinavir

Drugs used to prevent rejection of an organ transplant

Amlodipine can increase the concentration of certain immunosuppresants drugs used to prevent the rejection of an organ transplant in your body. This increases your risk of side effects. If you take an immunosuppressant drug, your doctor will monitor you closely and adjust your dose if needed.

These drugs include:

  • cyclosporine
  • tacrolimus

Mood stabilizer drugs

Telmisartan can increase the concentration of lithium in your body. This can cause more side effects from lithium, such as vomiting, seizures, or a coma.

Pain drugs

Telmisartan can increase the concentration of certain pain drugs in your body. This can cause more side effects from your pain drugs, such as vomiting, seizures, or a coma.

These drugs include:

  • nonsteroidal anti-inflammatory drugs (NSAIDs), such as:
    • naproxen
    • ibuprofen

Seizure drugs

Certain seizure drugs can lower the level of amlodipine in your body: This means that it may not work as well.

These drugs include:

  • carbamazepine
  • phenobarbital
  • primidone
  • phenytoin

Tuberculosis drugs

Certain tuberculosis drugs can lower the level of amlodipine in your body: This means that it may not work as well.

These drugs include:

  • rifampin

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Drug warnings
liver problems
People with liver problems

This drug is broken down by your liver. If you have liver problems, more of the drug can build up in your body and cause side effects. Tell your doctor if you have liver problems before you start taking this drug.

kidney problems
People with kidney problems

This drug can make your kidney problems worse. You may have changes in your kidney test results, and you may need a lower dose of this drug. Your doctor will increase your dose very slowly if you have severe kidney disease. Call your doctor if you get swelling in your feet, ankles, or hands or have unexplained weight gain.

heart problems
People with heart problems

Your heart problems may get worse while you take this drug. This is more likely to happen when you first start taking this drug or during dose increases.  Seek medical help right away if you get worse chest pain or chest pain that doesn’t go away.

diabetes
People with diabetes

If you have diabetes and are taking this drug, you shouldn’t take aliskiren. It can harm your kidneys.

Pregnant women
Pregnant women

This drug is a category D pregnancy drug. That means two things:

  1. Research in humans has shown adverse effects to the fetus when the mother takes the drug.
  2. This drug should only be used during pregnancy in serious cases where it's needed to treat a dangerous condition in the mother.

Talk to your doctor if you’re pregnant or planning to become pregnant. Ask your doctor to tell you about the specific harm that may be done to the fetus. This drug should be only used if the potential risk to the fetus is acceptable given the drug’s potential benefit.

breast-feeding
Women who are breast-feeding

It isn’t known if this drug passes into breast milk. If it does, it may cause side effects in a child who is breast-fed.

Talk to your doctor if you breast-feed your baby. You may need to decide whether to stop breast-feeding or stop taking this medication.

seniors
For seniors

Older adults may process drugs more slowly. A normal adult dose may cause levels of the drug to be higher than normal. If you’re a senior, you may need a lower dose or a different schedule, especially if you’re 75 years or older.

children
For children

The safety and effectiveness of this drug haven’t been studied in children younger than 18 years old.

call the doctor
When to call the doctor

Call your doctor if your blood pressure is still high even though you’re taking this drug.

allergies
Allergies

This drug can cause a severe allergic reaction. Symptoms include:

  • trouble breathing
  • swelling of your throat or tongue
  • hives

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

SECTION 4 of 4

How to Take amlodipine-telmisartan (Dosage)

Oral tablet

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Hypertension

Brand: Twynsta

Form: Oral tablet
Strengths:
  • 40 mg telmisartan/5 mg amlodipine
  • 40 mg telmisartan/10 mg amlodipine
  • 80 mg telmisartan/5 mg amlodipine
  • 80 mg telmisartan/10 mg amlodipine

Generic: telmisartan/amlodipine

Form: Oral tablet
Strengths:
  • 40 mg telmisartan/5 mg amlodipine
  • 40 mg telmisartan/10 mg amlodipine
  • 80 mg telmisartan/5 mg amlodipine
  • 80 mg telmisartan/10 mg amlodipine
Adult dosage (ages 18–64 years)
  • starting dose: 40 mg telmisartan/5 mg amlodipine or 40 mg telmisartan/10 mg amlodipine taken by mouth once per day.
  • dose adjustment: Your doctor may adjust your dose after at least 2 weeks.
  • maximum dose: 80 mg telmisartan/10 mg amlodipine taken once per day.
Child dosage (ages 0–17 years)

This drug hasn’t been studied in children and shouldn’t be used in children under the age of 18 years.

Senior dosage (ages 65–74 years)

There are no specific recommendations for dosing for this age group. Older adults may process drugs more slowly. A normal adult dose may cause levels of the drug to be higher than normal. If you’re a senior, you may need a lower dose or a different schedule.

Senior dosage (ages 75 years and older)

Adults ages 75 years and older may process amlodipine more slowly. Amlodipine should be started alone or a dose of 2.5 mg should be added to telmisartan. The lowest dose of this drug combination is 40 mg telmisartan/5 mg amlodipine. This drug shouldn’t be used as the first drug to lower your blood pressure.

Special considerations

Liver disease: If you have severe liver disease and have never taken amlodipine, you shouldn’t be started on telmisartan/amlodipine. If you have severe liver disease, amlodipine should be started at a dose of 2.5 mg, but this strength isn’t available in the telmisartan/amlodipine combination.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug comes with serious risks if you don't take it as prescribed.

If you don't take it at all

If you don’t take this medication, your blood pressure may get worse. High blood pressure can lead to a heart attack or stroke.

If you stop taking it suddenly

Don’t stop taking this drug without talking to your doctor. High blood pressure can occur if you stop taking the drug suddenly. This may increase your chance for a heart attack or stroke.

If you don't take it on schedule

Your blood pressure won’t be controlled as well. You may not feel any different but your blood pressure may get worse.

If you take too much

If you take too much of this drug, you might have the following symptoms:

  • weakness
  • dizziness
  • feeling like your heart is pounding or beating slower

If you think you’ve taken too much of the drug, act right away. Call your doctor or local Poison Control Center, or go to the nearest emergency room. 

What to do if you miss a dose

If you forget to take your dose, take it as soon as you remember. If it’s just a few hours until the time for your next dose, then wait and only take one dose at that time.

Never try to catch up by taking two doses at once. This could cause toxic side effects.

How to tell if the drug is working

You may be able to tell that this drug is working if your blood pressure is lower. Your doctor will monitor your blood pressure at your checkups. You can also check your blood pressure at home. Keep a log with the date, time of day, and your blood pressure readings. Bring this diary with you to your doctor appointments.

This drug is used for long-term treatment.

Important considerations for taking this drug
take with or without food
You can take this drug with or without food
timing
Take this drug at the same time each day
Don’t cut or crush
Don’t cut or crush the tablets
storage
Store this drug from 59–86°F (15–30°C)
See Details
refillable
Prescription is refillable
Travel
Travel
See Details
Self-management
Self-management
See Details
Clinical monitoring
Clinical monitoring
See Details
not usually stocked
Not every pharmacy stocks this drug, so call ahead
Hidden costs
Hidden costs
See Details
Insurance
Insurance
See Details

Store this drug from 59–86°F (15–30°C)

Don’t take this drug out of the medicine packets until right before you take it. 

Keep this drug away from light and high temperature.

Keep your drugs away from areas where they could get wet, such as bathrooms. Store this drug away from moisture and damp locations.

Keep this drug and all drugs out of the reach of children.

Travel

When traveling with your medication:

  • Always carry your medication with you, such as in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Self-management

You may need to check your blood pressure at home. You should keep a log with the date, time of day, and your blood pressure readings. Bring this diary with you to your doctor appointments.

You may need a blood pressure monitor to check your blood pressure at home.

Clinical monitoring

During treatment with this drug, your doctor will check the following to make sure the medication is working for you:

  • blood pressure

Hidden costs

You may need to buy a home blood pressure monitor to check your blood pressure.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.


Show Sources

Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on February 17, 2016

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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