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Arbitel Trio Tablets (Telmisartan + Cilnidipine and Metoprolol Succinate)

  • Each tablet contains Telmisartan40mg + Cilnidipine10mg and Metoprolol Succinate 25/50mg.
  • Indicated for the treatment of uncontrolled essential Hypertension with two drugs
  • Telmisartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor in many tissues, such as vascular smooth muscle and the adrenal gland. Telmisartan has much greater affinity for the AT1 receptor than for the AT2 receptor.MetoprololSuccinate is a beta1-selective (cardioselective) adrenergic receptor blocking agent. Hypertension: 1) competitive antagonism of catecholamines at peripheral (especially cardiac) adrenergic neuron sites, leading to decreased cardiac output; 2) a central effect leading to reduced sympathetic outflow to the periphery; and 3) suppression of renin activity. Cilnidipine is a dihydropyridine calcium-channel blocker. It inhibits cellular influx of calcium, thus causing vasodilatation. It has greater selectivity for vascular smooth muscle.
  • One tablet once a day
  • In patients with known hypersensitivity to ArbitelTrio or any other component of this product.In severe bradycardia, second or third degree heart block,cardiogenic shock, decompensated cardiac failure, sick sinussyndrome,Severe hepatic impairment.
  • Telmisartan-Hyperkalemia,Symptomatic hypotension, Impaired Hepatic Function, Impaired Renal Function.Metoprolol Succinate-InBronchospastic Disease, Avoid beta blockers, May mask tachycardia occurringwith hypoglycemia, hepatic impairment, Thyrotoxicosis, Anaphylactic Reactions, Peripheral Vascular Disease, Calcium Channel Blocker.Cilnidipine- Hypotension, poor cardiac reserve, heart failure. Sudden withdrawal may exacerbate angina. Discontinue in patients who experience ischemic pain following administration.
  • Discontinue the tablet during pregnancy,safety and effectiveness in lactation and pediatric patients have not been established.
  • Telmisartan-Monitoring of the serum digoxin and Lithium is recommended, its effect may be attenuated by NSAIDs including selective COX-2 inhibitor, concomitant use withACE inhibitor is not recommended. Metoprolol Succinate –It is recommended to monitor Catecholamine-depleting drugs, CYP2D6 Inhibitors, clonidine. Diltiazem and verapamil on concomitant use with beta blockers can increase the risk of bradycardia.Cilnidipine can interact with aldesleukin, quinidine, phenytoin, rifampicin, erythromycin, other anti-hypertensive drugs and anti-psychotic drugs.
  • Adverse reactions: Telmisartan- The most common adverse are back pain, sinusitis, and diarrhea. Metoprolol Succinate- Most common adverse reactions are tiredness, dizziness, shortness of breath, bradycardia, hypotension. Cilnidipine- Dizziness, Flushing, Headache, Hypotension.
  • Anti-Hypertensives