Telmidip 5/40 tab

ntroduction

Telmidip 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 40/5

• Hypertension (high blood pressure)

Side effects of Telmidip 40/5

• Sleepiness
• Ankle swelling
• Headache
• Flushing (sense of warmth in the face, ears, neck and trunk)
• Dizziness
• Tiredness
• Palpitations
• Upset stomach
• Increased potassium level in blood

How to use Telmidip 40/5

Take 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 works

Telmidip 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.

Indication

Hypertension 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 agents

Administration

Amlodipine 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 Dose

May 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 drug or do not breast feed

Child Dose

Pregnancy Category: C (1st trimester); D (2nd & 3rd trimesters)

Renal Dose

Telmisartan, a non-peptide angiotensin receptor blocker (ARB), is specific angiotensin II antagonist acting on the AT1 subtype. Angiotensin II is the principal pressor agent of the renin-angiotensin system, with effects that include vasoconstriction, stimulation of synthesis and release of aldosterone, cardiac stimulation, and renal reabsorption of sodium, which leads to an increase in blood pressure (hypertension). Telmisartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor in many tissues, such as vascular smooth muscle and the adrenal gland. Therefore, Telmisartan dilates blood vessels and reduces blood pressure without affecting pulse rate. Telmisartan has much greater affinity (>3,000 fold) for the AT1 receptor than for the AT2 receptor. It does not bind or block other hormone receptors or ion channels known to be important in cardiovascular regulation. Amlodipine, a dihydropyridine calcium-channel blocker (CCB), inhibits the transmembrane influx of calcium ion into vascular smooth muscle and cardiac muscle. Amlodipine is a peripheral arterial vasodilator that acts directly on vascular smooth muscle to cause a reduction in peripheral vascular resistance and reduction in blood pressure.

Mode of Action

May be taken with or without food.

Precaution

Treatment of hypertension, alone or with other anti-hypertensive agents. It may also be used as initial therapy in patients who are likely to need multiple drugs to achieve their blood pressure goals.

Side Effect

Mild to moderate impairment: Dose adjustment not recommended

Pregnancy Category Note

>10% Peripheral edema (1-11%) 1-10% Dizziness (3%),Orthostatic hypotension (6%),Syncope (2%),Back pain (2%)

Interaction

Known hypersensitivity to this product or any of its components. Pregnancy & lactation. Biliary obstructive disorders, severe hepatic impairment, hypotension, cardiogenic shock, left ventricle outflow tract obstruction.