Amlodipine+Telmisartan+Chlorthalidone / Chlortalidone

When should one not use Amlodipine+Telmisartan+Chlorthalidone / Chlortalidone

• If you are allergic to amlodipine, chlorthalidone, telmisartan, or any of the other ingredients of Amlodipine+Telmisartan+Chlorthalidone / Chlortalidone.
• If you are allergic to other medicines of the dihydropyridine type (one type of calcium channel blocker) or other sulfonamide-derived medicines. If you are not sure what these medicines are, please confirm with your doctor.
• If you are more than 3 months pregnant.
• If you have severe liver or kidney problems.
• If your kidneys fail to produce urine (anuria).
• If you have biliary blockage (problems with the drainage of bile from the liver and gallbladder).
• If you have narrowing of the aortic heart valve (aortic stenosis) or cardiogenic shock (a condition where your heart is unable to supply enough blood to the body).
• If you have heart failure after a heart attack.
• If you have diabetes or kidney problems and you are treated with a blood pressure lowering medicine containing aliskiren.

Common side effects of this drug are:

• Swelling of legs and feet
• Nausea
• Vomiting
• Headache
• Dizziness

Other General Warnings

• You have a kidney disorder or have had a kidney transplant.
• You have a history of allergy or bronchial asthma.
• You have narrowing of the blood vessels to one or both kidneys (renal artery stenosis).
• You have liver or heart disease.
• You have raised aldosterone levels.
• You have low blood pressure.
• You are dehydrated or have salt deficiency due to the use of diuretics, a low-salt diet, diarrhoea, or vomiting.
• You have increased potassium levels in your blood.
• You have diabetes or narrowing of the aorta (aortic stenosis).
• You have heart-associated chest pain also at rest or with minimal effort (unstable angina pectoris).
• You have had a heart attack within the last four weeks.
• You are taking medicines called ACE inhibitors like enalapril, lisinopril, and ramipril or aliskiren (used to treat high blood pressure), and you have diabetes-related kidney problems.
• You are elderly.
• You are scheduled for surgery or anaesthesia.

How Does It Work?

• Amlodipine+Telmisartan+Chlorthalidone / Chlortalidone contains a combination of amlodipine, chlorthalidone, and telmisartan as active substances.
• Telmisartan is an angiotensin-II receptor antagonist. Angiotensin II is a chemical produced in the body which causes blood vessels to narrow, thus increasing blood pressure. Telmisartan works by blocking the effect of angiotensin II and thereby lowering blood pressure.
• Amlodipine is a calcium channel blocker that stops calcium from moving into the blood vessel wall. This prevents the blood vessels from tightening and increasing blood pressure.
• Chlorthalidone prevents the reabsorption of sodium and chloride by blocking the sodium/chloride symporter. This reduces the plasma and extracellular fluid volume which thereby lowers the blood pressure.

Interactions with other medicines

• Some medicines can affect the way Amlodipine+Telmisartan+Chlorthalidone / Chlortalidone works, or this medicine itself can reduce the effectiveness of other medicines taken at the same time.
• Inform your doctor about all the medicines, supplements, or herbals you are currently taking or might take to avoid any possible interaction.
• Particular care should be taken if you are taking lithium-containing medicines (used to treat some types of depression), medicines that may increase blood potassium levels such as salt substitutes containing potassium, potassium-sparing diuretics, angiotensin II receptor antagonists, ACE-inhibitors or aliskiren (used to lower high blood pressure), non steroidal anti-inflammatory medicines like acetylsalicylic acid or ibuprofen (used to reduce pain, swelling, and inflammation), heparin (used to thin the blood), immunosuppressives like cyclosporine or tacrolimus (used to prevent organ rejection after a transplant), trimethoprim, erythromycin (used to treat bacterial infections), rifampicin (used to treat tuberculosis), St. John's wort (used to treat depression), dantrolene (infusion for severe body temperature abnormalities), medicines used for HIV/AIDS like ritonavir, for treatment of fungal infections (like ketoconazole), diltiazem (used to treat heart-related chest pain), simvastatin (used to treat increased levels of cholesterol), tubocurarine (used to cause muscle relaxation), norepinephrine (for controlling blood pressure in certain conditions), and digoxin (used for treating heart failure).
• Insulin requirements in diabetic patients may be increased, decreased, or unchanged, or a higher dosage of oral anti-diabetic medicines may be required when used together with Amlodipine+Telmisartan+Chlorthalidone / Chlortalidone.

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