Amlodipine is a calcium channel blocker that relaxes (widens) blood vessels and improves blood flow.

Telmisartan is an angiotensin II receptor antagonist that keeps blood vessels from narrowing, which lowers blood pressure and improves blood flow.

Amlodipine and telmisartan is a combination medicine used to treat high blood pressure (hypertension). Lowering blood pressure may lower your risk of a stroke or heart attack.

Amlodipine and telmisartan may also be used for purposes not listed in this medication guide.

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

If you have diabetes, do not use amlodipine and telmisartan together with any medication that contains aliskiren (a blood pressure medicine).

You may also need to avoid taking amlodipine and telmisartan with aliskiren if you have kidney disease.

Tell your doctor if you have ever had:

• kidney disease (or if you are on dialysis);
• liver disease;
• heart disease;
• an electrolyte imbalance (such as low levels of potassium or magnesium in your blood); or
• if you are on a low-salt diet.

Do not use if you are pregnant, and tell your doctor right away if you become pregnant. Amlodipine and telmisartan can cause injury or death to the unborn baby if you take the medicine during your second or third trimester.

You should not breast-feed while you are using this medicine.

This medicine is not approved for use by anyone younger than 18 years old.

Use Twynsta (Oral) exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

In rare cases, this medicine can cause a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, or dark colored urine.

Call your doctor at once if you have:

• a light-headed feeling, like you might pass out;
• shortness of breath (even with mild exertion), swelling, rapid weight gain;
• new or worsened chest pain;
• pounding heartbeats or fluttering in your chest;
• tremors, muscle stiffness or twitching; or
• high potassium--nausea, slow or unusual heart rate, weakness, loss of movement.

Common side effects may include:

• swelling in your hands or feet;
• fast or pounding heartbeats;
• dizziness, drowsiness;
• flushing (warmth, redness, or tingly feeling);
• back pain; or
• nausea, diarrhea, stomach pain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Do not use potassium supplements or salt substitutes, unless your doctor has told you to.