📋 Indications & Clinical Dosage
*Hypertension not adequately controlled by telmisartan alone:*
Adults: 1 tab daily using the strength as clinically appropriate. Children: Not recommended.
⛔ Contraindications
Cardiogenic shock, aortic stenosis, unstable angina, hypersensitivity to dihydropyridines, cholestasis & biliary obstructive disorders, severe hepatic impairment, refractory hypokalaemia, hypercalcaemia.
⚠️ Precautions & Warnings
Patients who are vol-&/or Nadepleted by vigorous diuretic therapy, dietary salt restriction, within one month of MI, impaired hepatic function, hypertensive crisis, bilateral renal artery stenosis or stenosis of the artery to single functioning kidney, mild to moderate renal impairment, diarrhoea or vomiting, severe CHF, primary aldosteronism, aortic or mitral stenosis, obstructive hypertrophic cardio-myopathy, may impair glucose tolerance, hereditary fructose intolerance, ischaemic cardiopathy or CV disease. Monitor serum K in patients at risk of hyperkalaemia.
🔄 Drug Interactions
Monitor digoxin & lithium levels during concomitant use, other kaliuretic diuretics, laxatives, corticosteroids, ACTH, amphotericin, carbenoxolone, penicillin-G potassium, salicylic acid & derivatives.
⚠️ Adverse Reactions / Side Effects
Headache, oedema, fatigue, nausea, flushing and dizziness, rash, gingival hyperplasia, alopecia, pruritus, angioedema, palpitations, dyspnoea, abdominal pain, back pain, dyspepsia, muscle cramps, asthenia, somnolence, altered bowel habit, diarrhoea, myalgia, arthralgia, peripheral neuropathy, pancreatitis, mood changes, dry mouth, increased micturition, hyperglycaemia, impotence, sweating, syncope, thrombocytopenia, vasculitis, visual disturbances, sinusitis, pharyngitis, influenza-like symptoms, pain, chest pain
🤰 Pregnancy & Lactation Safety
Lactation / Breastfeeding:
Not recommended.
📚 Official Regulatory & Clinical References
- Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
- World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
- Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.