Twynsta tablets contain two active substances called telmisartan and amlodipine. Each of these substances help to control high blood pressure, Telmisartan belongs to a group of substances called “angiotensin II – receptor antagonists.”
Twynsta. 80 mg. / 5 mg .28tab
Twynsta WHAT IS AND WHAT IT IS USED
Twynsta tablets contain two active substances called telmisartan and amlodipine. Each of these substances help to control high blood pressure, Telmisartan belongs to a group of substances called “angiotensin II – receptor antagonists.” Angiotensin II is a substance produced in the body which causes the blood vessels, thereby increasing blood pressure. Telmisartan works by blocking the effect of angiotensin II. -Amlodipine belongs to a group of substances called “calcium channel blockers”. Amlodipine prevents movement of calcium in the blood vessel wall, thereby stopping the contraction of blood vessels. This means that both active substances work together to help to prevent the contraction of blood vessels. As a result, blood vessels relax and blood pressure is lowered.
Twynsta used to treat high blood pressure
In adult patients whose blood pressure is not adequately controlled with amlodipine alone.
In adult patients already receiving telmisartan and amlodipine from separate tablets and wishing for comfort for them to take the same dose in one tablet.
If left untreated, high blood pressure can damage blood vessels in several organs, which puts patients at risk of serious adverse events such as heart attack, heart or kidney failure, stroke, or blindness. Usually high blood pressure has no symptoms before damage occurs. It is important to regularly measure blood pressure to verify if it is within normal limits.
BEFORE YOU TAKE Twynsta
Do not take Twynsta
if you are allergic (hypersensitive) to telmisartan or amlodipine or any other ingredient Twynsta tablets (see section Further information for a list of other ingredients)
if you are allergic to other drugs of the dihydropyridine type (type calcium channel blockers)
if you are pregnant after the third month (using Twynsta is better to avoid too early pregnancy – see Take special care with Twynsta and Pregnancy section)
if you have severe liver problems or biliary obstruction (problems with drainage of bile from the liver and gallbladder
if you have very low blood pressure (including shock)
if you suffer from heart failure due to serious heart problems
If any of these apply to you, tell your doctor or pharmacist before taking Twynsta
Take special care with Twynsta
Tell your doctor if you have or have ever suffered from any of the following conditions or diseases:
Kidney disease or kidney transplant
narrowing of the blood vessels to one or both kidneys (renal artery stenosis)
liver disease
heart problems
increased levels of aldosterone (causing retention of water and salts in the body, accompanied by imbalance of various blood minerals)
Low blood pressure (hypotension), which is likely to occur akostedehidratirani (excessive loss of body water) or have salt deficiency due to diuretic therapy (water tablets), a diet low in salt, diarrhea or vomiting
increased levels of potassium in the blood
Diabetes
narrowing of the aorta (aortic stenosis)
pain in the chest that can connect with the heart at rest or with minimal exertion (angina pectoris)
heart attack in the last four weeks
In case of surgery or anesthesia is required to tell your doctor that Twynsta
Children
Twynsta use in children and adolescents under 18 years of age is not recommended.
Taking other medicines
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription. You may need your doctor to adjust the dose of these medicines or take other precautions. In some cases you may need to stop taking any medicines. This applies especially to the medicines listed below, when taken together with Twynsta:
medicines containing lithium, used to treat some types of depression
drugs that may increase blood potassium levels such as potassium-containing salt substitutes, potassium-sparing diuretics (certain ‘water tablets)
NSAIDs (nonsteroidal anti-inflammatory drugs such as aspirin or ibuprofen), heparin, immunosuppressives (eg cyclosporin or tacrolimus) and the antibiotic trimethoprim
rifampicin, St John’s Wort
medicines for HIV / AIDS (eg ritonavir) or for treatment of fungal infections (eg ketoconazole)
erythromycin (antibiotic)
diltiazem (a drug for heart)
As with other medicines to lower blood pressure Twynsta effect can be reduced when you take NSAIDs (nonsteroidal anti-inflammatory drugs such as aspirin or ibuprofen) or corticosteroids.
Twynsta can increase the effects of blood pressure lowering other medicines used to treat high blood pressure or drugs that could potentially lower blood pressure (such as baclofen, amifostine, neuroleptics or antidepressants). Additional reduction in blood pressure can be caused by alcohol. You may notice this as dizziness when standing.
Taking Twynsta with food and drink
You can take Twynsta with water or other beverages with or without food.
Pregnancy and lactation
Pregnancy
You must tell your doctor if you think you are (or might become) pregnant. Usually, your doctor will advise you to stop taking Twynsta, before you become pregnant or as soon as you know you are pregnant and will advise you to take another medicine instead Twynsta. Twynsta not recommended in early pregnancy, and must not be taken if you are pregnant after three months, as it may cause serious harm to your baby if used after the third
Breastfeeding
Tell your doctor if you are breast-feeding or intend to breast-feed. Twynsta not recommended for mothers who are breastfeeding, your doctor may prescribe other treatments if you want to breast-feed, especially if your baby is newborn, or was born prematurely.
Consult your doctor or pharmacist before taking any medicine.
Driving and operating machinery
Some people may experience side effects such as fainting, sleepiness, dizziness, feeling of dizziness (vertigo) when undergoing treatment for high blood pressure. If you experience any side effects, do not drive or operate machinery.
Important information about some of the ingredients of Twynsta
Twynsta contains sorbitol. If you have been told by your doctor that you have intolerance to some sugars, talk to him before you start taking this medicine.
HOW TO TAKE Twynsta
Always Twynsta exactly as your doctor tells you. If you’re not sure, ask your doctor or pharmacist.
The usual dose is one tablet Twynsta day. Try to take the tablet at the same time each day. Take Twynsta tablet from the blister immediately before use. You can take Twynsta with or without food. Tablets should be swallowed with some water or soft drink. If your liver is not functioning properly, the usual dose should not exceed one tablet of 40 mg / 5 mg or tablet 40 mg/10 mg once daily.
If you take more than the dose Twynsta
If you accidentally take too many tablets, contact your doctor, pharmacist or nearest hospital emergency department. You may have low blood pressure or heart rate. Syobshteni are also reduced heart rate, dizziness, impaired renal function, including renal failure, significant and prolonged decrease in blood pressure, including shock and death.
If you forget to take Twynsta
If you forget to take a dose, take it as soon as you remember and then continue on as before. If you do not take your tablet on one day, take obichaynat adoza the next day. Do not take a double dose to make up.
If you stop taking Twynsta
It is picking up every day, unless your doctor tells you otherwise. If you feel that the effect of Twynsta is too strong or too weak, talk to your doctor.
POSSIBLE SIDE EFFECTS
Common: dizziness, swelling of the ankles
Uncommon: somnolence, migraine headaches, tingling or numbness of the hands or feet, feeling of dizziness, slow heartbeat, palpitations, low blood pressure, dizziness, flushing, cough, stomach pain, diarrhea, nausea, itching, joint pain, muscle cramps, muscle pain, inability to obtain an erection, weakness, pain in the chest, fatigue, swelling, elevated liver enzymes
Rare side effects are:
Bladder infection, feeling sad (depression), feelings of anxiety, insomnia, fainting, nerve damage and peripheral nervous system, decreased sensitivity to touch, distortion of taste sensations, tremors, vomiting, expansion of the gums, stomach discomfort, dry mouth, eczema (a skin disorder), skin redness, rash, back pain, limb pain, leg pain, need for nighttime urination, feeling of not feeling well (malaise), increased levels of uric acid in the blood.
The following adverse reactions have been reported with telmisartan or amlodipine ingredients and can occur in Twynsta.
Telmisartan
In patients taking telmisartan alone have the following additional adverse reactions:
Uncommon side effects are:
Urinary tract infections, infections of the upper respiratory tract (eg, sore throat, inflamed sinuses, common cold), reduced number of red blood cells (anemia), high levels of potassium in the blood, shortness of breath, bloating, frequent sweating, kidney damage suddenly stop working kidneys, elevated creatinine.
Rare side effects are:
“Sepsis (often called” blood poisoning “, representing a severe infection with an inflammatory response throughout the body, which can lead to death), proliferation of certain white blood cells (eosinophilia), deficiency of blood platelets (thrombocytopenia) allergic reaction (eg, hives, itching, difficulty breathing, wheezing, swelling of the face or low blood pressure), visual disturbance, increased heart rate, upset stomach, abnormal liver function, rapid swelling of the skin and mucosa (angioedema), hives ( urticaria), drug rash, inflammation of tendons, influenza-like illness (such as muscle pain, weakness), decreased hemoglobin (a blood protein), increased levels of creatine in the blood.
Amlodipine
In patients taking amlodipine alone have the following additional adverse reactions:
Uncommon side effects are:
mood changes, tingling or numbness of the skin (paraesthesia), visual disturbance, ringing in the ears, shortness of breath, sneezing / discharge from the nose, changes in bowel movements, hair loss, unusual bruising or bleeding (a disorder of red blood cells ), skin discoloration, increased sweating, difficulty in urinating, increased frequency of urination, especially at night, breast enlargement in men, pain, weight gain, weight loss.
Rare side effects are: confusion
Very rare side effects are: Reduce the number of white blood cells (leukopenia), decreased number of blood platelets (thrombocytopenia), allergic reaction (eg, hives, itching, difficulty breathing, wheezing, swelling of the face or low blood pressure), high blood sugar (diabetes), pain or numbness in the hands and feet (peripheral neuropathy), isolated cases of uncontrollable twitching or cramps, heart attack, irregular heart beats, blood vessel inflammation, inflammation of the pancreas, inflammation of the stomach lining (gastritis) inflammation of the liver, yellowing of the skin (jaundice), elevated liver enzymes with jaundice, rapid swelling of the skin and mucosa (angioedema), severe skin reactions, hives (urticaria), severe allergic reactions with rash in the form of bubbles skin and mucous membranes (exfoliative dermatitis, Stevens-Johnson syndrome), increased sensitivity of the skin to sunlight.
If any of the side effects gets serious, or you notice other effects not listed in this leaflet, please tell your doctor or pharmacist.
