This is a combination medication that contains Amlodipine and Telmisartan. Amlodipine belongs to the group of medications called calcium channel blockers and telmisartan belongs to the group of medications called angiotensin II receptor blockers (ARBs).

Amlodipine - telmisartan is used to treat mild-to-moderate high blood pressure for people who have been taking amlodipine and telmisartan as separate tablets. It works by relaxing blood vessel walls.

Your doctor may have suggested Twynsta for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking Twynsta, speak to your doctor. Do not stop taking Twynsta without consulting your doctor.

Do not give Twynsta to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take Twynsta if their doctor has not prescribed it.

Free Delivery

Your medication is delivered directly to you at no added cost. We even offer same-day delivery in select locations.

The usual dose of Twynsta depends on the doses of amlodipine and telmisartan taken separately before starting Twynsta. The dose is taken once daily, at the same time of day, preferably in the morning.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

Amlodipine - telmisartan may be taken with or without food.

It is important to take Twynsta exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Twynsta at room temperature in the original package, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Twynsta. If you are concerned about side effects, discuss the risks and benefits of Twynsta with your doctor.

The following side effects have been reported by at least 1% of people taking Twynsta. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• ankle swelling
• back, leg, or joint pain
• burping
• changed sense of taste
• Constipation
• decreased sexual ability (men)
• Diarrhea
• difficulty sleeping
• drowsiness
• Dry Mouth
• hair loss
• headache
• increased need to urinate during the night
• increased sensitivity to sunlight
• increased sweating
• joint swelling
• muscle cramps
• nausea
• shortness of breath
• skin rash or itching
• unusual tiredness or weakness
• upper respiratory tract infection (such as colds or sinus infections)
• vomiting
• weight changes

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• abnormal heartbeat (e.g., pounding heartbeat, slow heartbeat, fast heartbeat)
• anxiety
• chest pain
• confusion
• difficulty moving how and when you want
• dizziness
• enlarged breasts (men)
• Low Blood Pressure (e.g., dizziness, fainting, dizziness when standing up)
• migraine
• ringing in the ears
• shortness of breath
• signs of Anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
• signs of clotting problems (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don't stop bleeding)
• signs of infection (symptoms may include Fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness)
• skin rash, Hives
• symptoms of Depression (e.g., feeling sad, weight changes, sleep changes, hopelessness, guilt, loss of interest in activities)
• symptoms of high blood sugar (e.g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odour)
• symptoms of kidney problems (e.g., difficulty urinating, producing little or no urine, swelling of ankles or feet)
• symptoms of liver problems (e.g., nausea, abdominal pain, tiredness, loss of appetite, feeling unwell, yellowing of the skin or eyes)
• symptoms of low blood sugar (e.g., cold sweat, cool pale skin, headache, fast heartbeat, weakness)
• symptoms of too much potassium in the body (e.g., muscle fatigue, weakness, difficulty moving, abnormal heart rhythms, nausea)
• symptoms of a urinary tract infection (e.g. pain when urinating, urinating more often than usual, low back or flank pain)
• tingling or prickling sensations in the hands and feet
• symptoms of muscle breakdown (e.g., unexplained muscle tenderness, cramps or wasting, dark brown urine)
• Vertigo (feeling of spinning)
• vision changes

Stop taking the medication and seek immediate medical attention if any of the following occur:

• inflammation of blood vessels (e.g., fever, red raised spots caused by bleeding under the skin, aching muscles and joints, headache)
• signs of pancreatitis (e.g., abdominal pain on the upper left side, back pain, nausea, fever, chills, rapid heartbeat, swollen abdomen)
• signs of a severe skin reaction such as blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort
• symptoms of a heart attack (e.g., chest pain, pressure or heaviness; nausea; shortness of breath; cool, clammy skin; anxiety)
• symptoms of a Anaphylaxis (severe allergic reaction) (e.g., hives; difficulty breathing; swelling of the mouth, tongue, face, or throat)
• symptoms of sepsis (blood infection; e.g., chills, confusion, fever or low body temperature, irregular heartbeat, shakiness)
• unexpected muscle stiffness, difficulty moving or unwanted movements (e.g., eye rolling, drooling)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Twynsta.

Personalized PocketPacks

We sort your medication into clearly labeled, individual packs so you can be sure you're taking the right dose at the right time.

40 mg/5 mg
Each oval-shaped, biconvex, uncoated, bilayer tablet with one layer white-to-off-white and the other layer blue, marked with the company logo and "A1" contains 40 mg telmisartan and 5 mg amlodipine. Nonmedicinal ingredients: colloidal anhydrous silica, FD&C Blue No. 1 Aluminum Lake (E 133), ferric oxide black (E172), ferric oxide yellow (E172), magnesium stearate, maize starch, meglumine, microcrystalline cellulose, povidone K25, pregelatinized starch, sodium hydroxide, and sorbitol (E420).

40 mg/10 mg
Each oval-shaped, biconvex, uncoated, bilayer tablet with one layer white-to-off-white and the other layer blue, marked with the company logo and "A2" contains 40 mg telmisartan and 10 mg amlodipine. Nonmedicinal ingredients: colloidal anhydrous silica, FD&C Blue No. 1 Aluminum Lake (E 133), ferric oxide black (E172), ferric oxide yellow (E172), magnesium stearate, maize starch, meglumine, microcrystalline cellulose, povidone K25, pregelatinized starch, sodium hydroxide, and sorbitol (E420).

80 mg/5 mg
Each oval-shaped, biconvex, uncoated, bilayer tablet with one layer white-to-off-white and the other layer blue, marked with the company logo and "A3" contains 80 mg telmisartan and 5 mg amlodipine. Nonmedicinal ingredients: colloidal anhydrous silica, FD&C Blue No. 1 Aluminum Lake (E 133), ferric oxide black (E172), ferric oxide yellow (E172), magnesium stearate, maize starch, meglumine, microcrystalline cellulose, povidone K25, pregelatinized starch, sodium hydroxide, and sorbitol (E420).

80 mg/10 mg
Each oval-shaped, biconvex, uncoated, bilayer tablet with one layer white-to-off-white and the other layer blue, marked with the company logo and "A4" contains 80 mg telmisartan and 10 mg amlodipine. Nonmedicinal ingredients: colloidal anhydrous silica, FD&C Blue No. 1 Aluminum Lake (E 133), ferric oxide black (E172), ferric oxide yellow (E172), magnesium stearate, maize starch, meglumine, microcrystalline cellulose, povidone K25, pregelatinized starch, sodium hydroxide, and sorbitol (E420).

Do not take Twynsta if you:

• are allergic to amlodipine, telmisartan, or any ingredients of the medication
• are allergic to similar medications (e.g., calcium channel blockers, ARBs)
• are breast-feeding
• are pregnant
• have Diabetes or Kidney Disease and are taking the medication Aliskiren
• have had angioedema (a serious allergic reaction which causes the area around the throat and tongue to swell) after taking any other ARBs (e.g., Candesartan, Losartan) or angiotensin-converting-enzyme inhibitors (ACEIs)
• have a rare hereditary condition of fructose intolerance (Twynsta contains sorbitol)
• have biliary obstruction (problems with the draining of bile from the liver and gall bladder)
• have severely decreased liver function
• have severely reduced blood pressure
• have low heart output because of a serious heart problem
• have unstable heart failure as a result of a Heart Attack

Discreet Packaging

Your privacy is important. That's why we send your medication inside a plain delivery box so no one will know what's inside.

There may be an interaction between amlodipine - telmisartan and any of the following:

• alcohol
• Aldesleukin
• aliskiren
• alpha-agonists (e.g., Clonidine, methyldopa)
• alpha-blockers (e.g., Alfuzosin, Doxazosin, Tamsulosin)
• amifostine
• Amiodarone
• amphetamines (e.g., Dextroamphetamine, Lisdexamfetamine)
• angiotensin-converting-enzyme inhibitors (ACEIs; Captopril, Enalapril, Ramipril)
• other angiotensin receptor blockers (ARBs; e.g., candesartan, Irbesartan, losartan)
• Apalutamide
• Apomorphine
• Aprepitant
• "azole" antifungal medications (e.g., fluconazole, itraconazole, ketoconazole, Voriconazole)
• barbiturates (e.g., butalbital, pentobarbital, Phenobarbital)
• beta-adrenergic blockers (e.g., Atenolol, Propranolol, Sotalol)
• Bosentan
• brimonidine
• Bromocriptine
• other calcium channel blockers (e.g., Diltiazem, Nifedipine, Verapamil)
• calcium supplements (e.g., calcium carbonate, calcium citrate)
• certain anti-psychotics (e.g., Clozapine, Olanzapine, Quetiapine, Risperidone)
• Clopidogrel
• Cobicistat
• conivaptan
• Cyclosporine
• Dantrolene
• Deferasirox
• dexmethylphenidate
• Digoxin
• diuretics (water pills; e.g., Furosemide, Hydrochlorothiazide, triamterene)
• Dronedarone
• drospirenone
• Duloxetine
• Enzalutamide
• Eplerenone
• Everolimus
• Flibanserin
• grapefruit juice
• Guanfacine
• Heparin
• HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., efavirenz, etravirine, nevirapine)
• HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
• levodopa
• lithium
• Lomitapide
• Lovastatin
• low-molecular-weight heparins (e.g., Dalteparin, Enoxaparin, Tinzaparin)
• lumacaftor and Ivacaftor
• macrolide antibiotics (e.g., clarithromycin, erythromycin, telithromycin)
• magnesium supplements
• medications that increase the level of potassium in the blood (e.g., Spironolactone, Amiloride, triamterene, or salt substitutes that contain potassium)
• melatonin
• Methylphenidate
• mifepristone
• Minoxidil
• Mitotane
• Modafinil
• Morphine
• nitrates (e.g., Nitroglycerin, isosorbide dinitrate, isosorbide mononitrate)
• nonsteroidal anti-inflammatory medications (NSAIDs; e.g., Asa, Naproxen, Diclofenac)
• Obinutuzumab
• opioid pain medications (e.g., Codeine, morphine, Oxycodone)
• Paclitaxel
• Pentoxifylline
• phosphodiesterase-5 inhibitors (e.g., Sildenafil, Tadalafil, Vardenafil)
• Pimozide
• potassium supplements
• Pramipexole
• protein kinase inhibitors (e.g., Ceritinib, Crizotinib, Dabrafenib, Dasatinib, imatinib, Nilotinib, Ribociclib)
• quinidine
• Rasagiline
• rifabutin
• rifampin
• Riociguat
• Ropinirole
• Rotigotine
• sacubitril
• St. John's wort
• Sarilumab
• seizure medications (e.g., Carbamazepine, Eslicarbazepine, phenobarbital, Phenytoin, primidone)
• Selegiline
• siltuximab
• Simvastatin
• Sirolimus
• sodium phosphate
• Tacrolimus
• Temsirolimus
• Tizanidine
• Tocilizumab
• Tolvaptan
• Triazolam
• Trimethoprim
• Yohimbine
• Warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Twynsta. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

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.

Automatic Refills

We manage your refills and get in touch with your doctors for prescription renewals so that you always have the medication you need.