Telmivas-AM
Generic Name
Telmisartan 40 mg + Amlodipine 5 mg Tablet
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| telmivas am 5 mg tablet | ৳ 12.50 | ৳ 125.00 |
Description
Overview of the medicine
Telmivas-AM 5 mg Tablet is a combination medicine used to treat high blood pressure (hypertension). It contains Telmisartan, an Angiotensin Receptor Blocker (ARB), and Amlodipine, a Calcium Channel Blocker (CCB). This combination works by relaxing blood vessels, making it easier for the heart to pump blood, thereby lowering blood pressure effectively.
Uses & Indications
Dosage
Adults
The usual recommended dose is one tablet once daily. The dose should be individualized based on the patient's blood pressure response and tolerability. The combination of Telmisartan 40 mg and Amlodipine 5 mg is generally prescribed.
Elderly
No dosage adjustment is generally required for elderly patients, but caution is advised with increasing dosage.
Renal_impairment
No dosage adjustment is generally required for patients with mild to moderate renal impairment. For severe renal impairment, careful monitoring is advised.
How to Take
Take the tablet orally once daily with or without food. Swallow the tablet whole with a glass of water. It is recommended to take the medicine at the same time each day to maintain consistent blood levels.
Mechanism of Action
Telmisartan selectively blocks the angiotensin II AT1 receptor, preventing angiotensin II from binding to the receptor and thereby inhibiting its vasoconstrictive and aldosterone-secreting effects. Amlodipine is a dihydropyridine calcium channel blocker that inhibits the transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle. This leads to peripheral arterial vasodilation and reduction in peripheral vascular resistance, resulting in a reduction in blood pressure.
Pharmacokinetics
Onset
Amlodipine: Gradual onset, peak effect 6-12 hours. Telmisartan: Peak plasma concentrations within 0.5-1 hour, maximal reduction in blood pressure typically achieved after 4-8 weeks of therapy.
Excretion
Telmisartan: Excreted almost exclusively in feces. Amlodipine: Excreted primarily via urine (60% as inactive metabolites).
Half life
Telmisartan: Approximately 24 hours. Amlodipine: 30-50 hours.
Absorption
Telmisartan is rapidly absorbed (bioavailability 42-58%). Amlodipine is well absorbed after oral administration (bioavailability 64-90%).
Metabolism
Telmisartan: Metabolized by conjugation to its glucuronide. Amlodipine: Extensively metabolized in the liver to inactive metabolites.
Side Effects
Contraindications
- •Hypersensitivity to telmisartan, amlodipine, or any component of the formulation.
- •Second and third trimesters of pregnancy.
- •Biliary obstructive disorders.
- •Severe hepatic impairment.
- •Concomitant use with aliskiren in patients with diabetes or renal impairment (GFR < 60 mL/min/1.73 m²).
- •Cardiogenic shock, clinically significant aortic stenosis, unstable angina pectoris, severe hypotension.
Drug Interactions
Digoxin
Concomitant use with amlodipine may increase digoxin levels slightly, monitor digoxin levels.
Lithium
Increased serum lithium concentrations and toxicity have been reported with concomitant use of ACE inhibitors and ARBs. Monitor lithium levels during concomitant use.
CYP3A4 inducers (e.g., rifampicin)
May decrease amlodipine exposure, potentially leading to reduced efficacy. Monitor blood pressure.
Diuretics and other antihypertensive agents
May enhance the hypotensive effect.
NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
May reduce the antihypertensive effect of Telmisartan and increase the risk of renal impairment. Concurrent use requires careful monitoring of renal function.
CYP3A4 inhibitors (e.g., ketoconazole, ritonavir)
May increase amlodipine exposure, potentially leading to increased hypotensive effects. Monitor blood pressure and adjust amlodipine dose if necessary.
Potassium-sparing diuretics, potassium supplements, or other agents that may increase potassium levels (e.g., heparin)
May lead to hyperkalemia, especially in patients with renal impairment. Monitor serum potassium levels.
Storage
Store below 30°C in a dry place. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include marked hypotension and possibly reflex tachycardia. Management of overdose is symptomatic and supportive. If ingestion is recent, gastric lavage may be considered. Amlodipine is highly protein-bound, so dialysis is unlikely to be of benefit. Telmisartan is also highly protein-bound and not removed by hemodialysis. Intravenous fluids and vasopressors may be needed to restore blood pressure and support circulation.
Pregnancy & Lactation
Telmivas-AM 5 mg Tablet is contraindicated during the second and third trimesters of pregnancy due to the risk of fetal injury or death associated with telmisartan. It is also not recommended during the first trimester. It is unknown whether telmisartan or amlodipine are excreted in human milk. Due to the potential for adverse effects on the nursing infant, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from the date of manufacture, specific details on packaging.
Availability
Pharmacies, Hospitals
Approval Status
Approved
Patent Status
Off-patent
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Global Brand Names
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