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Precautions and Warnings With Telmisartan/Amlodipine

Let your healthcare provider know if you have any medical issues, such as problems with your kidneys, liver, or heart, before taking telmisartan/amlodipine. Precautions and warnings with this drug also apply to women who are pregnant or nursing. Also, some people should avoid this prescription medication altogether, including those who are taking certain medications or who have certain allergies.

What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking telmisartan/amlodipine (Twynsta®) if you have:
  • Liver disease, such as cirrhosis, liver failure, or hepatitis
  • Kidney disease, such as kidney failure (renal failure)
  • Any heart problems, such as congestive heart failure or chest pain (angina)
  • Ever been told you have low blood sodium (hyponatremia) or been put on a low-salt diet
  • Ever been told you have high blood potassium (hyperkalemia)
  • Any allergies, including to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
Make sure to tell your healthcare provider about all other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.

Specific Telmisartan/Amlodipine Precautions and Warnings

Some warnings and precautions to be aware of prior to taking this drug include the following:
  • Telmisartan/amlodipine can sometimes lower blood pressure too much. This is more likely to happen in people who are on a low-salt diet, who are taking diuretics (sometimes called "water pills"), or who are dehydrated (which can happen when you are sick with nausea and vomiting). If you become dizzy, lightheaded, or faint while taking this drug, lie down and contact your healthcare provider.
  • Telmisartan/amlodipine can increase blood potassium levels, which can be dangerous. People with kidney disease, heart failure, or who take potassium supplements are at an increased risk for this complication while taking telmisartan/amlodipine. If you take this medication, your healthcare provider should periodically check your potassium level with a simple blood test.
  • In some cases, telmisartan/amlodipine can worsen kidney problems in people who already have kidney disease or severe congestive heart failure. If you are at risk for this reaction, your healthcare provider will likely monitor your kidney function while you take this medication. Contact your healthcare provider if you experience swelling in your hands, legs, ankles, or feet, or have unexplained weight gain, which can be signs of kidney problems.
  • In rare cases, this drug may worsen chest pain or increase the risk for a heart attack in people who have heart disease. This reaction is not common, but is more likely to occur when the medication is first started or the telmisartan/amlodipine dosage is increased.
  • In general, calcium channel blockers (such as amlodipine, one of the components of telmisartan/amlodipine) should not be used by people who have congestive heart failure (CHF). Although amlodipine does not seem to cause problems in people with heart failure, if you do have heart failure, your healthcare provider may choose to monitor you more closely.
  • Telmisartan/amlodipine can react with a number of other medications (see Drug Interactions With Telmisartan/Amlodipine).
  • This product is considered a pregnancy Category D medication. This means that it may not be safe for use during pregnancy (see Twynsta and Pregnancy).
  • It is not known if telmisartan/amlodipine passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking this medication (see Twynsta and Breastfeeding).
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Telmisartan/Amlodipine Drug Information

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