Telnocal

This medicine is a fixed dose combination of Telmisartan and Amiodipine. Telmisartan is a non-peptide angiotensin receptor blocker (ARB). It is a specific angiotensin II antagonist and acts on the AT1 subtype. Angiotensin II is the principal pressor agent of the renin-angiotensin system. Its effects include vasoconstriction, stimulation of the synthesis and release of aldosterone, cardiac stimulation, and renal reabsorption of sodium, and together these lead to a rise in blood pressure (hypertension). Telmisartan selectively blocks angiotensin II from binding to the AT1 receptor in many tissues, such as vascular smooth muscle and the adrenal gland. This blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II. So Telmisartan dilates blood vessels and lowers blood pressure without affecting pulse rate. Its affinity for the AT1 receptor is much greater (>3,000 fold) than for the AT2 receptor, and it does not bind or block other hormone receptors or ion channels known to be important in cardiovascular regulation.

Amiodipine is a dihydropyridine calcium-channel blocker (CCB). It inhibits the transmembrane influx of calcium ion into vascular smooth muscle and cardiac muscle. Amiodipine is a peripheral arterial vasodilator that acts directly on vascular smooth muscle, which reduces peripheral vascular resistance and lowers blood pressure.

Pregnancy Categories C apply in the first trimester and D in the second and third trimesters. Nobody knows yet whether telmisartan and amiodipine pass into human breast milk. Because the nursing infant could be harmed, either stop nursing or stop the drug, after weighing how important the drug is to the mother.

Pediatric use: the safety and effectiveness of the Telmisartan & Amiodipine combination in pediatric patients have not been established. Geriatric use: starting treatment with the Telmisartan & Amiodipine combination is not recommended in patients who are 75 years old or above. Hepatic impairment: starting treatment with the Telmisartan & Amiodipine combination is also not recommended in hepatically impaired patients.

Telmisartan: Limited data are available on overdose in humans. The most likely effects of a telmisartan tablet overdose are hypotension, dizziness and tachycardia. Bradycardia could also occur because of parasympathetic (vagal) stimulation. If symptomatic hypotension develops, supportive treatment should be started. Telmisartan is not removed by hemodialysis.

Amiodipine: An overdose might be expected to cause excessive peripheral vasodilation with marked hypotension, and possibly reflex tachycardia. In a massive overdose, active cardiac and respiratory monitoring should be started. Blood pressure must be measured often. If hypotension occurs, cardiovascular support should begin, including elevation of the extremities and careful giving of fluids. If hypotension doesn't respond to these conservative measures, vasopressors (such as phenylephrine) should be considered, with attention to circulating volume and urine output. Amiodipine is not removed by hemodialysis.

Keep Amlodipine Besilate + Telmisartan below 30°C. Protect it from light and high humidity, and keep it out of the reach of children.