Twynsta Warnings and Precautions
You may not be able to safely use Twynsta if you have certain problems with your heart, kidneys, or liver. Other warnings and precautions with Twynsta apply to women who are pregnant or breastfeeding. To help avoid complications, tell your healthcare provider about any other medical conditions you have or any other medications you are taking before starting treatment with this blood pressure medicine.
What Should I Tell My Healthcare Provider?You should talk with your healthcare provider prior to taking Twynsta® (telmisartan/amlodipine) 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
Make sure to tell your healthcare provider about all other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.
Specific Precautions and Warnings With TwynstaSome warnings and precautions to be aware of prior to taking this drug include the following:
- Twynsta 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 medication, lie down and contact your healthcare provider.
- Twynsta can increase blood potassium levels, and it can be dangerous if potassium levels become too high. People with kidney disease, heart failure, or who take potassium supplements are at an increased risk for this complication. Your healthcare provider should periodically check your potassium level during treatment with a simple blood test.
- In some cases, this drug 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 Twynsta. Contact your healthcare provider if you experience swelling in your hands, legs, ankles, or feet, or if you have unexplained weight gain, which can be signs of kidney problems.
- In rare cases, Twynsta 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 dose is increased.
- In general, calcium channel blockers (such as amlodipine, one of the components of Twynsta) should not be used by people who have congestive heart failure. Although amlodipine does not seem to cause problems in people with heart failure, if you do have it, your healthcare provider may choose to monitor you more closely.
- Twynsta can react with a number of other medications (see Twynsta Drug Interactions).
- 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 whether this drug passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to beginning treatment (see Twynsta and Breastfeeding).