Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Twynsta.
Angioedema: Angioedema (a serious allergic reaction that causes the area around the throat and tongue to swell) may occur with ARBs, such as telmisartan, although rarely. If you experience swelling of the face, tongue, or throat, you should stop taking Twynsta at once and get immediate medical attention.
Dizziness, fainting, spinning sensations: Twynsta can cause dizziness, fainting, or spinning sensations.
Do not drive, operate machinery, or perform other potentially hazardous tasks until you have determined how Twynsta affects you.
Heart attack and Stroke: If you have a history of heart problems, discuss with your doctor how Twynsta may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Twynsta, and whether any special monitoring is needed.
If you have heart disease, problems with blood supply to the brain, low blood pressure, or have had a recent heart attack, there is a risk that Twynsta may cause a heart attack or a stroke.
If you develop symptoms of a heart attack (e.g., chest pain, pressure, or heaviness; nausea; shortness of breath; anxiety; cool, clammy skin) or a stroke (e.g., sudden dizziness, difficulty speaking, headache, difficulty walking, confusion, blurred vision), get immediate medical attention.
Kidney function: Telmisartan can cause changes to kidney function that may result in decreased kidney function, kidney failure, or possibly death. Certain people have experienced changes in kidney function (e.g., people with narrowed blood vessels in their kidneys, or those with severe Congestive Heart Failure). The use of diuretics (water pills), nonsteroidal anti-inflammatory drugs (NSAIDs), or aliskiren may further increase risk of kidney problems for people already at risk of this problem. If you have reduced kidney function, renal artery stenosis (narrowing of blood vessels in the kidneys), or congestive heart failure, discuss with your doctor how Twynsta may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Twynsta, and whether any special monitoring is needed. If you have reduced kidney function, you may require lower doses of Twynsta.
Taking aliskiren may further increase the risk of kidney problems. If you have kidney disease, discuss with your doctor how Twynsta may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Twynsta, and whether any special monitoring is needed.
Twynsta should not be taken by people with severely decreased kidney function.
People who have kidney problems and take Twynsta are more likely to experience increased levels of potassium in the blood. If you experience an irregular or slow heartbeat or nausea, contact your doctor as soon as possible.
Liver function: Amlodipine - telmisartan is removed from the body by the liver. People with reduced liver function are more likely to experience side effects related to Twynsta.
If you have mild-to-moderate liver problems, discuss with your doctor how Twynsta may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Twynsta, and whether any special monitoring is needed. If you have severe liver problems or have biliary obstruction, you should not use Twynsta.
Low blood pressure: Twynsta may cause low blood pressure. Low blood pressure is more likely to occur if you are dehydrated, are taking aliskiren, other diuretics ("water pills"), are on a low-salt diet, or have diarrhea or vomiting. If you experience dizziness or lightheadedness, lie down until the symptoms go away and contact your doctor.
Potassium levels: Twynsta can increase potassium levels in the blood. Your doctor may monitor your potassium levels with blood tests. Do not use potassium supplements or salt substitutes with potassium unless recommended by your doctor.
Pregnancy: As with other medications related to telmisartan, Twynsta can cause serious harm or even death to the developing baby if taken during pregnancy. Twynsta should not be used during pregnancy. If you become pregnant while taking Twynsta, contact your doctor immediately.
Breast-feeding: It is not known if telmisartan passes into breast milk. Amlodipine passes into breast milk. If you are a breast-feeding mother and taking Twynsta, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using Twynsta have not been established for adolescents and children under the age of 18.
Seniors: Seniors may be more sensitive to the side effects of Twynsta.
