Telma-LN 40 from Glenmark combines Telmisartan 40 mg with Cilnidipine 10 mg. The LN in the name is a clue to the pharmacology: cilnidipine blocks both L-type and N-type calcium channels. Conventional calcium blockers such as amlodipine hit only L-type channels, which relaxes arteries but leaves the sympathetic nervous system unopposed – hence the reflex racing heart and, in a substantial minority of patients, ankle swelling bad enough that they stop taking it. The N-type channels sit on sympathetic nerve endings, so blocking them calms that reflex too. Telma is Glenmark’s long-established telmisartan brand, and this is its cilnidipine pairing. Strip of 15 tablets. Schedule H prescription medicine.

Key Features

• Telmisartan 40 mg + Cilnidipine 10 mg
• LN = L-type and N-type calcium channel blockade
• Calms the sympathetic reflex that causes racing heart with other calcium blockers
• Markedly less ankle swelling than amlodipine combinations
• Strip of 15 tablets from Glenmark Pharmaceuticals Ltd.

Composition

• Telmisartan – 40 mg
• Cilnidipine – 10 mg
• Per tablet, as printed on the pack

Composition as printed on the pack. Refer to the package insert for the complete list of excipients.

Uses & Benefits

• Lowers blood pressure more than either drug alone
• Two complementary mechanisms in one daily tablet
• Useful when a single medicine has not reached target pressure
• Reduces the long-term risk of stroke, heart attack and heart failure
• Fewer tablets to remember over years of treatment
• No dry cough, unlike ACE inhibitor combinations

Directions for Use

• Take one tablet once daily, exactly as prescribed, at the same time each day
• Swallow the tablet whole with water; may be taken with or without food
• Keep taking it even when you feel well – high blood pressure usually has no symptoms
• Do not take potassium supplements or potassium-based salt substitutes unless your doctor says so
• Do not stop or change the dose on your own; pressure rebounds when treatment stops

Precautions

• Stop immediately and contact your doctor if you become pregnant. The pack warns that telmisartan can cause injury and even death to the developing baby when used in the second and third trimesters
• Seek emergency care for swelling of the face, lips, tongue or throat
• Blood tests for kidney function and electrolytes are done before and during treatment
• Ankle swelling is much less likely than with amlodipine, but report it if it occurs
• Tell your doctor about kidney disease, renal artery narrowing, liver disease, or if you take NSAIDs or lithium
• Do not combine with an ACE inhibitor or aliskiren unless a specialist directs it

Storage

• Store below 30°C, protected from light and moisture
• Keep tablets in the original blister until use
• Keep out of reach of children

Disclaimer

Schedule H prescription drug – not to be sold by retail without the prescription of a Registered Medical Practitioner. This information is for general awareness and is not a substitute for professional medical advice, diagnosis or treatment. Telmisartan must be stopped as soon as pregnancy is detected; blood pressure treatment must be reviewed regularly by your doctor.

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