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Tems A is a fixed-dose combination of Telmisartan and Amiodipine.
- Telmisartan is an angiotensin II receptor blocker (ARB) that selectively blocks the AT1 receptor, preventing the vasoconstrictor and aldosterone-secreting effects of angiotensin II. This leads to blood vessel dilation and reduced blood pressure without affecting pulse rate.
- Amlodipine is a calcium-channel blocker (CCB) that inhibits calcium influx into vascular smooth muscle and cardiac muscle, leading to reduced peripheral vascular resistance and lower blood pressure.
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✅ Description:
Relevant Products / প্রাসঙ্গিক পণ্য
✔️ Dosage & Administration:
- Initial Therapy: Typically, start with 40/5 mg once daily if blood pressure control with a single agent is unlikely. For larger blood pressure reductions, 80/5 mg once daily may be used. Not recommended for patients 75 years or older or those with hepatic impairment.
- Add-on Therapy: For patients inadequately controlled on Amiodipine or Telmisartan alone, this combination can be added.
- Replacement Therapy: For patients already taking separate Telmisartan and Amlodipine tablets, this combination may be used in place of those. The dose may be adjusted after at least 2 weeks, with a maximum of 80/10 mg once daily.
- Pediatric use: Safety and efficacy have not been established.
- Geriatric use: Not recommended for patients ≥75 years old.
- Hepatic impairment: Not recommended for those with hepatic impairment.
✔️ Side Effects:
Common side effects include dizziness, peripheral edema, headache, fatigue, abdominal pain, nausea, diarrhea, pruritus, erectile dysfunction, chest pain, and bradycardia.
✔️ Interaction
- No clinically significant interactions with acetaminophen, amiodipine, glyburide, simvastatin, hydrochlorothiazide, warfarin, or ibuprofen.
- Telmisartan does not significantly affect cytochrome P450 enzymes.
- Amlodipine has no clinically relevant effects when taken with cimetidine, grapefruit juice, or sildenafil and is safe with a variety of other medications including thiazide diuretics and beta-blockers.
✔️ Contraindications:
- Known hypersensitivity to any of its components.
- Pregnancy and lactation.
- Severe hepatic impairment, biliary obstructive disorders, hypotension, cardiogenic shock, and left ventricle outflow tract obstruction.
✔️ Pregnancy & Lactation:
- Category C in the first trimester and Category D in the second and third trimesters.
- The safety of this combination during breastfeeding is not known. Discontinue breastfeeding or the drug after considering its importance to the mother.
✔️ Precautions & Warnings:
- Avoid fetal or neonatal exposure.
- Correct volume or salt depletion before initiating therapy.
- Monitor for worsening heart failure.
- Do not combine with ACE inhibitors and angiotensin receptor blockers.
- Monitor for myocardial infarction risk in patients with severe coronary artery disease.
✔️ Overdose Effects:
- Telmisartan: May cause hypotension, dizziness, and tachycardia. Treat with supportive care.
- Amlodipine: Overdose may lead to excessive vasodilation, hypotension, and reflex tachycardia. Cardiovascular support and vasopressors may be required.
✔️ Storage:
Store below 30°C, and protect from light and humidity. Keep out of reach of children.
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