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Hypersensitivity to the active substances, or to any of the excipients.
Hypersensitivity to dihydropyridine derivatives.
Second and third trimesters of pregnancy.
Lactation.
Biliary obstructive disorders.
Severe hepatic impairment.
Severe hypotension.
Shock (including cardiogenic shock).
Obstruction of the outflow tract of the left ventricle (e.g. high grade aortic stenosis).
Haemodynamically unstable heart failure after acute myocardial infarction.
The concomitant use of TWYNSTA with aliskiren is contraindicated in patients with diabetes mellitus or renal impairment (GFR < 60 ml/min/1.73 m2).
In case of rare hereditary conditions that may be incompatible with an excipient of the product (see "Precautions") the use of the product is contraindicated.
