ntroductionTelmidip 40/5 contains two medicines, both of which help to control high blood pressure. It lowers the blood pressure by relaxing the blood vessels and making it easier for your heart to pump blood around your body. This will reduce your risk of having a heart attack or a stroke. Telmidip 40/5 may be taken on an empty stomach or along with food. However, it is better to take it regularly at a fixed time each day, as prescribed by your doctor. The dose will depend on your condition and how you respond to the medicine. It's important to keep taking this medicine even if you feel well. By lowering your blood pressure, it is reducing your risk of heart attack or stroke so do not stop taking it unless your doctor tells you to. You can help this medicine work better by making a few changes to your lifestyle such as keeping active, stopping smoking, and eating a low salt and low fat diet. The most common side effects of this medicine include swelling in your ankles or feet (oedema), headache, sleepiness, dizziness, tiredness, and upset stomach. Since it may cause sleepiness and dizziness, do not drive or do anything requiring concentration until you know how it affects you. Talk to your doctor if any of the side effects bother you or will not go away. Before taking this medicine, let your doctor know if you have any kidney or liver problems or severe dehydration. Pregnant or breastfeeding women should also consult their doctor before taking it. While using this medicine, your blood pressure will need to be checked often and your kidney function may also need to be tested.Uses of Telmidip 40/5Hypertension (high blood pressure)Side effects of Telmidip 40/5CommonSleepinessAnkle swellingHeadacheFlushing (sense of warmth in the face, ears, neck and trunk)DizzinessTirednessPalpitationsUpset stomachIncreased potassium level in bloodHow to use Telmidip 40/5Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Telmidip 40/5 may be taken with or without food, but it is better to take it at a fixed time.How Telmidip 40/5 worksTelmidip 40/5 is a combination of two medicines: Telmisartan and Amlodipine. Telmisartan is an angiotensin receptor blocker (ARB) and Amlodipine is a calcium channel blocker (CCB). They work by relaxing the blood vessels and making the heart more efficient at pumping blood throughout the body. Together, they lower blood pressure effectively.Quick TipsTelmidip 40/5 is a combination of two medicines that provides better blood pressure control than either medicine alone.Telmidip 40/5 may cause dizziness or sleepiness. Do not drive or do anything requiring concentration until you know how it affects you.It may cause you to feel lightheaded or weak especially when you stand up. Rise slowly if you have been sitting or lying down.Avoid consuming alcohol as it may enhance the blood pressure lowering effect of this medicine.It can cause ankle or foot swelling. Raise your legs while you are sitting down and talk to your doctor if it does not go away.Do not take Telmidip 40/5 if you are pregnant, planning to conceive or breastfeeding.Brief DescriptionIndicationHypertension Initial Therapy: Patient may be initiated on Telmisartan/Amlodipine tablets if it is unlikely that control of blood pressure would be achieved with a single agent. The usual starting dose is 40/5 mg once daily. Patients requiring larger blood pressure reductions may be started with 80/5 mg once daily. OR Substitute for individually titrated components May increase dose after at least 2 weeks, not to exceed 80 mg/10 mg qDay Dosage range: Telmisartan 20-80 mg/amlodipine 2.5-10 mg PO qDay Initial therapy with Telmisartan/Amlodipine is not recommended in patients ?75 years old or with hepatic impairment. Hepatic Impairment Severe impairment: Titrate slowly; dose adjustment not recommended May be administered concomitantly with other anti-hypertensive agentsAdministrationAmlodipine relaxes peripheral and coronary vascular smooth muscle. It produces coronary vasodilation by inhibiting the entry of Ca ions into the slow channels or select voltage-sensitive channels of the vascular smooth muscle and myocardium during depolarisation. It also increases myocardial oxygen delivery in patients w/ vasospastic angina.Adult DoseMay increase frequency and/or severity of angina during treatment initiation or dosage increments. Heart failure or hepatic impairment. Avoid fetal or neonatal exposure Hypotension: Correct any volume or salt depletion before initiating therapy. Observe for signs and symptoms of hypotension. Titrate slowly in patients with hepatic or severe renal impairment Heart failure: Monitor for worsening Avoid concomitant use of an ACE inhibitor and angiotensin receptor blocker Myocardial infarction: Uncommonly, initiating a CCB in patients with severe obstructive coronary artery disease may precipitate myocardial infarction or increased angina Lactation: Discontinue..