Twynsta (Telmisartan and Amlodipine) - Oral


If taken during pregnancy, telmisartan and amlodipine can cause harm to a developing fetus. Stop taking this medication immediately if you become pregnant.

What Is Telmisartan/Amlodipine?

Telmisartan/amlodipine is a combination medication used alone or with other drugs to treat hypertension (high blood pressure). It contains two drugs in one tablet: telmisartan and amlodipine (as the besylate salt).

Both these drugs work in different ways to control your blood pressure. Telmisartan is an angiotensin II receptor antagonist. Angiotensin II is a hormone that causes blood vessels to narrow, resulting in hypertension. Telmisartan blocks the effect of angiotensin II to relax the blood vessels, lowering blood pressure.

Amlodipine is a calcium channel blocker. Amlodipine blocks the movement of calcium into the cells of the heart and blood vessels. As a result, it relaxes the blood vessels and increases the blood and oxygen supply to the heart while reducing its workload.

Combining these active ingredients allows the blood vessels to relax and widen to induce blood pressure-lowering effects.

This medication comes in tablet form to be taken by mouth. Your healthcare provider may prescribe these medications individually and then switch you to the combination pill.

Drug Facts

Generic Name: Telmisartan/amlodipine

Brand Name(s): Twynsta (discontinued)

Drug Availability: Prescription

Administration Route: Oral

Therapeutic Classification: Antihypertensive

Available Generically: Yes

Controlled Substance: N/A

Active Ingredient: Telmisartan and amlodipine

Dosage Form(s): Tablet

What Is Telmisartan/Amlodipine Used For?

Telmisartan/amlodipine is indicated to treat high blood pressure. It may also be used as initial therapy in individuals needing multiple drugs to control their hypertension.

Lowering high blood pressure helps reduce the risk of strokes, heart attacks, and kidney problems. Whether your healthcare provider prescribes one of these medications as monotherapy (single therapy) or a combination pill may depend on your baseline blood pressure, target goals, and response to treatment.

An illustration with drug information about twynsta (telmisartan/amlodipine)

Verywell / Dennis Madamba

How to Take Telmisartan/Amlodipine

Follow the directions on the prescription label. Your healthcare provider may change the dose based on your blood pressure and response to treatment.

Usually, you will be prescribed to take one tablet once daily with or without food. Take the tablet at the same time each day to prevent missed doses. Don't remove the tablets from the blister pack until you are ready to take them. Do not take more, less, or longer than prescribed.

You may have low blood pressure while on this medication. Tell your healthcare provider if you feel sick, are vomiting, have diarrhea, or are sweating more than usual. Monitor your blood pressure regularly. In addition to receiving blood pressure readings in a healthcare provider's office, you can check your blood pressure with home blood pressure monitoring.

Keep taking the medicine even if you feel well. You may need to be on this treatment long-term for optimal control.


Store the tablets at room temperature (68 F to 77 F) away from light and moisture. Do not store it in the bathroom. Keep all medications locked away and out of reach of children and pets.

Do not discard the unwanted medication by throwing it in a waste bin, flushing it down the toilet, or pouring it down the drain. The best way to discard medications is to ask your pharmacist or local law enforcement officials to find a nearby drug take-back program. If none are available, ask your pharmacist how to dispose of your medication at home.

How Long Does Telmisartan/Amlodipine Take to Work?

Studies have demonstrated a significant decrease in blood pressure from baseline at eight weeks after starting telmisartan/amlodipine therapy.

What Are the Side Effects of Telmisartan/Amlodipine?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the Food and Drug Administration (FDA) at or 1-800-FDA-1088.

Common Side Effects

Telmisartan/amlodipine may cause some side effects. The most common ones are:

  • Peripheral edema (swelling in the hands or feet)
  • Dizziness or drowsiness
  • Back pain
  • Gastrointestinal effects such as nausea, diarrhea, or stomach pain
  • Hypotension (low blood pressure)

These side effects usually go away on their own and do not require medical help. However, call your healthcare provider or pharmacist if any side effects do not go away or worsen.

Severe Side Effects

Call your healthcare provider if you have any of the following:

  • New or worsening chest pain
  • Angioedema (swelling of the face, arms, or legs)
  • Symptoms of hypotension (low blood pressure), such as dizziness, lightheadedness, nausea, heart palpitations, or fainting
  • Signs of hyperkalemia (high potassium), such as muscle weakness, tingling, paralysis, or decreased reflexes

In rare cases, this medication can cause a condition that leads to the breakdown of skeletal muscle tissue and kidney failure. Call your healthcare provider if you have unexplained muscle pain or tenderness, particularly if you also have a fever, unusual tiredness, or dark-colored urine.

Report Side Effects

Telmisartan/amlodipine may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Telmisartan/Amlodipine Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For high blood pressure:
      • Adults—At first, one tablet containing 40 milligrams (mg) of telmisartan and 5 mg of amlodipine once a day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 80 mg of telmisartan and 10 mg of amlodipine once a day.
      • Children—Use and dose must be determined by your doctor.


People older than 75 or those with liver impairment may require a different medication dosage. Your healthcare provider will advise you on whether you need a dosing modification.

Missed Dose

If you miss a dose, take it as soon as you can. If it is nearly time for the next dose, skip the missed one and take the following dose at its regular time. Never take a double dose to make up for the missed one.

Overdose: What Happens If I Take Too Much Telmisartan/Amlodipine?

Symptoms of a telmisartan/amlodipine overdose are:

  • Severe dizziness
  • Fainting
  • Fast heartbeat

What Happens If I Overdose on Telmisartan/Amlodipine?

If you think you or someone else may have overdosed on telmisartan/amlodipine, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking telmisartan/amlodipine, call 911 immediately.


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It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using this medicine, tell your doctor right away.

Dizziness, lightheadedness, or fainting may also occur, especially when you get up from a lying or sitting position or if you have been taking a diuretic (water pill). Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or not alert. If you feel dizzy, lie down so you do not faint. Then sit for a few moments before standing to prevent the dizziness from returning.

Check with your doctor right away if you become sick while taking this medicine, especially with severe or continuing nausea, vomiting, or diarrhea. These conditions may cause you to lose too much water and may lead to low blood pressure. You can also lose water by sweating, so drink plenty of water during exercise or in hot weather.

Hyperkalemia (high potassium in the blood) may occur in certain people receiving this medicine. Check with your doctor right away if you have the following symptoms: abdominal or stomach pain, confusion, difficulty with breathing, irregular heartbeat, nausea or vomiting, nervousness, numbness or tingling in the hands, feet, or lips, shortness of breath, or weakness or heaviness of the legs. Ask your doctor before you use medicines, supplements, or salt substitutes that contain potassium.

This medicine may worsen the symptoms of angina (chest pain) or increase risk of heart attack in certain patients with severe heart or blood vessel disease. Check with your doctor right away if you have chest pain that is worse than usual, trouble breathing, nausea or vomiting, pain or discomfort in your arms, jaw, back, or neck, feel faint, or you are sweating.

Do not take other medicines unless they have been discussed with your doctor. This especially includes nonprescription medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may increase your blood pressure.

What Are Reasons I Shouldn’t Take Telmisartan/Amlodipine?

You should not take telmisartan/amlodipine if you are:

  • Allergic to amlodipine, telmisartan, or any other component of the tablet
  • Pregnant or planning to become pregnant while on treatment: Telmisartan/amlodipine may be toxic to a developing fetus. Stop taking this medication if you become pregnant.

What Other Medications Interact With Telmisartan/Amlodipine?

Telmisartan/amlodipine may interact with certain other drugs. Before starting this medication, tell your healthcare provider about all other medications you currently take.

Telmisartan/amlodipine can interact with the following drugs:

This may not be a complete list of drug interactions. Consult your healthcare provider about prescription and over-the-counter (OTC) medicines, vitamins, and herbal products.

What Medications Are Similar?

Other combination drugs containing a calcium channel blocker and an angiotensin II receptor antagonist include:

  • Azor (amlodipine and olmesartan)
  • Exforge (amlodipine and valsartan)

These combination drugs are used to treat hypertension. Exforge is typically a second-line option if an individual has not achieved their targeted results with other drugs first.

Frequently Asked Questions

  • How does telmisartan/amlodipine work?

    High blood pressure causes harm to the body by increasing the workload of the heart and blood vessels. Telmisartan and amlodipine work together to relax and widen the blood vessels, which helps decrease blood pressure.

  • What is the best time to take telmisartan/amlodipine?

    Take your medication at the same time each day for better results.

  • What drugs should not be taken with telmisartan/amlodipine?

    Drugs that may interact with this medication include aliskiren, lithium, ramipril, NSAIDs, drugs that increase potassium levels in the blood, including ACE inhibitors, and others.

  • What are the side effects of telmisartan/amlodipine?

    Common side effects of taking telmisartan/amlodipine include:

    • Swelling of hands, ankles, and feet
    • Drowsiness
    • Back pain
    • Nausea
    • Diarrhea
    • Vomiting
  • Can I drink alcohol while taking telmisartan/amlodipine?

    Drinking alcohol while on telmisartan/amlodipine may increase the risk of certain side effects. You should limit liquor if you have a health condition like high blood pressure.

How Can I Stay Healthy While Taking Telmisartan/Amlodipine?

Combining multiple medications, like telmisartan/amlodipine, is becoming more prevalent for treating hypertension. The synergistic effects of telmisartan and amlodipine can help effectively control blood pressure if monotherapy doesn't work. However, there are ways you can increase the likelihood that your blood pressure treatments will be effective.

Healthy lifestyle changes are an important component of blood pressure management. Eat a balanced, blood pressure-lowering diet and exercise regularly if you are physically able to. Healthcare providers often recommend food plans like the Dietary Approaches to Stop Hypertension (DASH) diet.

Remember to drink enough water while exercising and in hot temperatures while taking this medication. Not drinking enough water can cause you to feel faint, lightheaded, or sick due to a sudden drop in blood pressure or decreased potassium levels. In general, drink at least eight 8-ounce glasses of water per day. Tell your healthcare provider if you feel lightheaded or dizzy after taking telmisartan/amlodipine or when your dose is increased.

Additionally, keep up with regular appointments for blood tests and monitor your blood pressure regularly. Your healthcare provider may occasionally do blood tests to check potassium levels and kidney function.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Billecke SS, Marcovitz PA. Long-term safety and efficacy of telmisartan/amlodipine single pill combination in the treatment of hypertension. Vasc Health Risk Manag. 2013;9:95-104. doi:10.2147/VHRM.S40963

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