DOSAGE: Adults: TWYNSTA should be taken once daily.
Replacement therapy: Patients receiving telmisartan and amlodipine from separate tablets can instead receive TWYNSTA containing the same component doses in one tablet once daily, e.g. to enhance convenience or compliance.
Add on therapy: TWYNSTA may be administered in patients whose blood pressure is not adequately controlled with amlodipine or telmisartan alone.
Patients treated with 10 mg amlodipine who experience any dose limiting adverse reactions such as oedema, may be switched to TWYNSTA 40/5mg once daily, reducing the dose of amlodipine without reducing the overall expected antihypertensive response.
Initial therapy: A patient may be initiated on TWYNSTA if it is unlikely that control of blood pressure would be achieved with a single agent. The usual starting dose of TWYNSTA is 40/5 mg once daily. Patients requiring larger blood pressure reductions may be started on TWYNSTA 80/5 mg once daily.
If additional blood pressure lowering is needed after at least 2 weeks of therapy, the dose may be titrated up to a maximum of 80/10 mg once daily.
TWYNSTA can be administered with other antihypertensive drugs.
Special populations: Renal impairment: No posology adjustment is required for patients with renal impairment, including those on haemodialysis. Amlodipine and telmisartan are not dialyzable.
Hepatic impairment: In patients with mild to moderate hepatic impairment TWYNSTA should be administered with caution. For telmisartan the posology should not exceed 40 mg once daily.
Elderly Patients: No dose adjustment is necessary for elderly patients.
Normal amlodipine dosage regimens are recommended in the elderly, but increase of dosage should take place with care (see Precautions, and Pharmacology: Pharmacokinetics under Actions).
Paediatric population: TWYNSTA is not recommended for use in patients aged below 18 years due to a lack of data on safety and efficacy.
Method of Administration: Tablet for Oral administration.
TWYNSTA may be taken with or without food.