Telplus Trio Tablets (Telmisartan + Cilnidipine + Chlorthalidone)

• Composition :
  Each tablet contains Telmisartan IP 40 mg + Cilnidipine 10 mg + Chlorthalidone IP 6.25 mg
• Indications :
  For the treatment of uncontrolled hypertension with two drugs.
• Pharmacodynamics :
  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.Chlorthalidone is a benzothiadiazine (thiazide)-related diuretic with a long duration of action. It primarily acts on the distal renal tubule, inhibiting NaCl¯ reabsorption and promoting Ca++ reabsorption. Cilnidipine is a dihydropyridine calcium-channel blocker. It inhibits cellular influx of calcium, thus causing vasodilatation. It has greater selectivity for vascular smooth muscle
• Dosage and administration :
  One tablet once daily.
• Contraindications :
  contraindicated in patients with known hypersensitivity (e.g., anaphylaxis or angioedema) should not be prescribed in: Cardiogenic shock, Recent MI or acute unstable angina and Severe aortic stenosis, Anuria.
• Precautions and warnings :
  Telmisartan- Hyperkalemia, Symptomatic hypotension, Impaired Hepatic Function, Impaired Renal Function.Chlorthalidone- has been associated with electrolyte disturbances such as hypokalemia, hypomagnesemia, hyperglycemia and hyponatremiaCilnidipine- Hypotension, poor cardiac reserve, heart failure. Sudden withdrawal may exacerbate angina. Discontinue in patients who experience ischemic pain following administration.Avoid fetal or neonatal exposure. Hypotension: Correct any volume or salt depletion before initiatingtherapy. Observe for signs and symptoms of hypotension.Titrate slowly in patients with hepatic or severe renal impairment. Heart failure: Monitor for worsening.
• Use in pregnancy, lactation & pediatrics :
  Discontinue the tablet during pregnancy, it is not known whether TelplusTrio is excreted in milk, safety and effectiveness in children have not been established
• Drug interactions :
  Telmisartan- Monitoring of the serum digoxin and Lithium is recommended, its effect may be attenuated by NSAIDs including selective COX-2 inhibitor, concomitant use with ACE inhibitor is not recommended.Chlorthalidone-Adjust the dosage of insulin and oral anti-diabetic agents, bioavailability of thiazide-type diuretics ma increase,Concomitant treatment with cyclosporin may increase the risk of hyperuricemia, Concomitant administration of certain NSAIDs may reduce the diuretic and antihypertensive activity of chlorthalidone.Cilnidipine caninteract with aldesleukin, quinidine, phenytoin, rifampicin, erythromycin, other anti-hypertensive drugs and anti-psychotic drugs.
• Adverse reactions :
  The most common adverse events are back pain, sinusitis, diarrhea, dizziness, flushing, headache, hypotension, peripheral oedema, tachycardia, palpitations, GI disturbances, increased micturition frequency, lethargy, anorexia, gastric irritation.
• Therapy Area :
  Anti-Hypertensives