Blood Pressure Goal

Achieving blood pressure goal with TWYNSTA—A fixed-dose ARB/CCB combining telmisartan and amlodipine for the treatment of hypertension

Team Up with TWYNSTA & Help Patients Reach Blood Pressure Target1

An 8-week, multicenter, randomized, double-blind, placebo-controlled study in patients with mild to severe hypertension (defined as mean seated cuff DBP ≥95 and ≤119 mmHg) compared Twynsta® (telmisartan/amlodipine) tablets with respective monotherapies. 1,2

Significant BP reductions achieved with TWYNSTA2

All 4 dosage strengths of TWYNSTA demonstrated significant reductions in cuff DBP and SBP compared with respective individual monotherapies (N=1461).2

Review efficacy data

Ambulatory blood pressure monitoring (ABPM) performed in a subset of patients confirmed results seen
with in-clinic BP reductions (n=562)2


Review ABPM data


TWYNSTA achieves greater BP control than amlodipine monotherapy3

All 4 dosage strengths of TWYNSTA® (telmisartan/amlodipine) tablets demonstrated significant reductions in cuff DBP and SBP compared with amlodipine.3


*BP control defined as BP <140/90 mmHg.
SBP response defined as SBP <140 mmHg or ≥15 mm Hg reduction.
DBP control defined as DBP <90 mmHg.



Indication

TWYNSTA is indicated for the treatment of hypertension, alone or with other antihypertensive agents. It may also be used as initial therapy in patients who are likely to need multiple drugs to achieve their blood pressure goals.

Base the choice of TWYNSTA tablets as initial therapy for hypertension on an assessment of potential benefits and risks, including whether the patient is likely to tolerate the starting dose of TWYNSTA tablets.

Consider the patient's baseline blood pressure, the target goal, and the incremental likelihood of achieving goal with a combination, compared with monotherapy, when deciding whether to use TWYNSTA tablets as initial therapy.

References

1. Data on file. Study 1235.1. Boehringer Ingelheim Pharmaceuticals, Inc.
2. Twynsta PI. Ridgefield, CT: Boehringer Ingelheim Pharmaceuticals, Inc.; 2009.
3. Littlejohn, TW. J Clin Hypertens. 2009;11:207-213.

The concomitant use of telmisartan and amlodipine has been evaluated for safety in more than 3700 patients with hypertension.

Review TWYNSTA safety data

Visit the MICARDIS for Healthcare Professionals Web site to access tools and resources designed to help you create individualized treatment plans for your hypertensive patients.

Go to www.MicardisPro.com

INDICATION

Twynsta® (telmisartan/amlodipine) tablets is an angiotensin II receptor blocker (ARB) and a dihydropyridine calcium channel blocker (DHP-CCB) combination product indicated for the treatment of hypertension, alone or with other antihypertensive agents. It may also be used as initial therapy in patients who are likely to need multiple drugs to achieve their blood pressure goals.

Base the choice of TWYNSTA tablets as initial therapy for hypertension on an assessment of potential benefits and risks including whether the patient is likely to tolerate the starting dose of TWYNSTA tablets. Consider the patient's baseline blood pressure, the target goal, and the incremental likelihood of achieving goal with a combination compared with monotherapy when deciding whether to use TWYNSTA tablets as initial therapy.

IMPORTANT SAFETY INFORMATION

WARNING: AVOID USE IN PREGNANCY See full prescribing information for complete boxed warning. When pregnancy is detected, discontinue TWYNSTA as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and even death to the developing fetus.

TWYNSTA is contraindicated in patients with known hypersensitivity (e.g., anaphylaxis or angioedema) to telmisartan or amlodipine or any other components of this product.

Symptomatic hypotension may occur in patients with an activated renin-angiotensin system. Correct volume and/or salt depletion in patients before initiating TWYNSTA or start treatment under close supervision with a reduced dose.

Patients taking TWYNSTA should be told not to use potassium supplements or salt substitutes that contain potassium without consulting their physician. Consider periodic determinations of serum electrolytes to detect possible electrolyte imbalances.

Titrate slowly in patients with hepatic or severe renal impairment and closely monitor. Initial therapy with TWYNSTA is not recommended in hepatically impaired patients.

In patients whose renal function may depend on the activity of the renin-angiotensin-aldosterone system such as patients with severe congestive heart failure or renal dysfunction, treatment with ACE inhibitors and an ARB such as TWYNSTA has been associated with oliguria and/or progressive azotemia and, rarely, with acute renal failure and/or death. In patients with renal artery stenosis, increases in serum creatinine or blood urea nitrogen may occur. When adding an ACE inhibitor to an ARB, monitor renal function closely. Use of TWYNSTA with ramipril is not recommended.

Uncommonly, patients starting or increasing their dose of a CCB have developed increased frequency, duration, or severity of angina or acute myocardial infarction.

Monitor patients with heart failure for worsening of their condition.

In clinical trials, the most common reasons for discontinuation of therapy with TWYNSTA were peripheral edema, dizziness, and hypotension. Adverse events that occurred at a ≥2% higher incidence with TWYNSTA than with placebo were peripheral edema, dizziness, and back pain.

Please see full Prescribing Information, including boxed WARNING, for TWYNSTA.



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