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What should I discuss with my healthcare provider before taking amlodipine and telmisartan (Twynsta)?

You should not use this medication if you are allergic to amlodipine (Norvasc) or telmisartan (Micardis).

To make sure you can safely take amlodipine and telmisartan, tell your doctor if you have any of these other conditions:

• kidney disease (or if you are on dialysis);
• liver disease;
• congestive heart failure, coronary artery disease;
• an electrolyte imbalance;
• low blood pressure;
• if you are vomiting or having diarrhea; or
• if you have recently had a heart attack.

FDA pregnancy category D. Do not use amlodipine and telmisartan if you are pregnant. Stop using this medication and tell your doctor right away if you become pregnant. Telmisartan can cause injury or death to the unborn baby if you take the medicine during your second or third trimester. Use effective birth control while taking amlodipine and telmisartan.

It is not known whether amlodipine and telmisartan passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take amlodipine and telmisartan (Twynsta)?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results.

Take this medication with a full glass (8 ounces) of water.

You may take this medication with or without food.

Conditions that may cause very low blood pressure include: vomiting, diarrhea, heavy sweating, heart disease, dialysis, a low salt diet, or taking diuretics (water pills). Follow your doctor's instructions about the type and amount of liquids you should drink while taking amlodipine and telmisartan. Tell your doctor if you have a prolonged illness that causes diarrhea or vomiting.

Your blood pressure will need to be checked often. Your heart, liver, and kidney function may also need to be tested. Visit your doctor regularly.

Keep using this medication even if you feel fine. High blood pressure often has no symptoms.

Store at room temperature away from moisture and heat.

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