Telpro-Max
Generic Name
telpro-max-5-mg-tablet
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| telpro max 5 mg tablet | ৳ 20.00 | ৳ 200.00 |
Description
Overview of the medicine
Telpro-Max 5 mg tablet is a combination medication containing Telmisartan (an ARB) and Amlodipine (a CCB). It is primarily used to treat high blood pressure (hypertension) when monotherapy is not sufficient. It helps relax blood vessels, allowing blood to flow more easily.
Uses & Indications
Dosage
Adults
One tablet (Telmisartan 40 mg / Amlodipine 5 mg) once daily, or as directed by physician. Dosage may be adjusted based on individual response and tolerability.
Elderly
No specific dosage adjustment is generally required, but caution is advised. A lower starting dose may be considered.
Renal_impairment
No initial dosage adjustment for mild to moderate renal impairment. Use with caution in severe cases and monitor renal function.
How to Take
Take the tablet orally with or without food, usually at the same time each day. Swallow whole with a glass of water.
Mechanism of Action
Telmisartan works by blocking the action of angiotensin II, a substance that narrows blood vessels, thereby relaxing blood vessels and lowering blood pressure. Amlodipine is a dihydropyridine calcium channel blocker that inhibits the influx of calcium ions into vascular smooth muscle and cardiac muscle, resulting in vasodilation and reduction in peripheral vascular resistance.
Pharmacokinetics
Onset
Antihypertensive effect within 24 hours (for Amlodipine peak effect 6-12 hours).
Excretion
Telmisartan: Primarily eliminated in feces via biliary excretion. Amlodipine: Excreted primarily via urine (60% as metabolites).
Half life
Telmisartan: ~24 hours. Amlodipine: ~30-50 hours.
Absorption
Telmisartan: Rapidly absorbed, bioavailability 42-58%. Amlodipine: Well absorbed, bioavailability 64-90%, peak plasma concentrations 6-12 hours.
Metabolism
Telmisartan: Conjugated to inactive acylglucuronide. Amlodipine: Extensively metabolized in the liver to inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to Telmisartan, Amlodipine, or any component of the formulation
- Pregnancy (second and third trimesters)
- Severe hepatic impairment
- Bile duct obstruction
- Cardiogenic shock
- Obstructive outflow tract disease (e.g., severe aortic stenosis)
- Hemodynamically unstable heart failure after acute myocardial infarction
- Concomitant use with aliskiren in patients with diabetes or renal impairment (GFR < 60 mL/min/1.73 m²)
Drug Interactions
Lithium
Increased serum lithium concentrations and toxicity. Monitor lithium levels.
Simvastatin
Coadministration with Amlodipine may increase systemic exposure to simvastatin. Limit simvastatin dose to 20 mg daily.
NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
May reduce the antihypertensive effect and increase the risk of renal function deterioration. Monitor blood pressure and renal function.
CYP3A4 inhibitors (e.g., ketoconazole, erythromycin)
May increase Amlodipine exposure. Monitor for increased side effects.
Potassium-sparing diuretics, potassium supplements, or other agents that increase potassium levels
May lead to hyperkalemia. Monitor serum potassium.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include marked hypotension, dizziness, reflex tachycardia, and possibly shock. Management involves supportive care, including fluid replacement and vasopressors if necessary. Amlodipine is not dialyzable.
Pregnancy & Lactation
Pregnancy: Contraindicated in the second and third trimesters due to fetal toxicity (black box warning). Discontinue if pregnancy is detected. Lactation: Not recommended. It is unknown if Telmisartan or Amlodipine is excreted in human milk, but serious adverse effects on the breastfed infant are possible.
Side Effects
Contraindications
- Hypersensitivity to Telmisartan, Amlodipine, or any component of the formulation
- Pregnancy (second and third trimesters)
- Severe hepatic impairment
- Bile duct obstruction
- Cardiogenic shock
- Obstructive outflow tract disease (e.g., severe aortic stenosis)
- Hemodynamically unstable heart failure after acute myocardial infarction
- Concomitant use with aliskiren in patients with diabetes or renal impairment (GFR < 60 mL/min/1.73 m²)
Drug Interactions
Lithium
Increased serum lithium concentrations and toxicity. Monitor lithium levels.
Simvastatin
Coadministration with Amlodipine may increase systemic exposure to simvastatin. Limit simvastatin dose to 20 mg daily.
NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
May reduce the antihypertensive effect and increase the risk of renal function deterioration. Monitor blood pressure and renal function.
CYP3A4 inhibitors (e.g., ketoconazole, erythromycin)
May increase Amlodipine exposure. Monitor for increased side effects.
Potassium-sparing diuretics, potassium supplements, or other agents that increase potassium levels
May lead to hyperkalemia. Monitor serum potassium.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include marked hypotension, dizziness, reflex tachycardia, and possibly shock. Management involves supportive care, including fluid replacement and vasopressors if necessary. Amlodipine is not dialyzable.
Pregnancy & Lactation
Pregnancy: Contraindicated in the second and third trimesters due to fetal toxicity (black box warning). Discontinue if pregnancy is detected. Lactation: Not recommended. It is unknown if Telmisartan or Amlodipine is excreted in human milk, but serious adverse effects on the breastfed infant are possible.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Pharmacies and Hospitals
Approval Status
Approved by regulatory authorities
Patent Status
Generic available
Clinical Trials
Several clinical trials have demonstrated the efficacy and safety of Telmisartan/Amlodipine combinations in reducing blood pressure and cardiovascular risk. Notable studies include the COACH, TEAM, and TRANSCEND trials which studied components and their combinations.
Lab Monitoring
- Serum potassium levels (especially in renal impairment or with potassium-sparing agents)
- Renal function (BUN, creatinine) periodically
- Liver function tests periodically (rarely, elevations can occur)
- Blood pressure monitoring regularly
Doctor Notes
- Emphasize patient compliance given the asymptomatic nature of hypertension.
- Counsel patients on lifestyle modifications.
- Regular monitoring of blood pressure, renal function, and serum potassium is important.
Patient Guidelines
- Take this medication regularly as prescribed, even if you feel well.
- Do not stop taking the medication without consulting your doctor.
- Inform your doctor about all other medications you are taking, including over-the-counter drugs and herbal supplements.
- Avoid grapefruit and grapefruit juice while on this medication.
- Monitor your blood pressure at home if advised by your doctor.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is close to the time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose to catch up.
Driving Precautions
May cause dizziness, fatigue, or drowsiness. Exercise caution when driving or operating machinery until you know how the medication affects you.
Lifestyle Advice
- Adopt a healthy diet low in sodium and saturated fats.
- Engage in regular physical activity as advised by your doctor.
- Maintain a healthy weight.
- Limit alcohol consumption.
- Quit smoking.
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