Telmivas M 25mg Tablets

Telmivas M 25mg Tab contains a combination of two medicines for hypertension - Metoprolol and Telmisartan.

Dosage

Overdose

Symptoms of overdose may include low blood pressure, irregular heartbeat, heart failure, shock, loss of consciousness, coma, nausea, vomiting, bluish colour of the lips, tongue and skin, low levels of potassium or calcium in blood, dizziness and kidney failure. In case of an overdose, contact your doctor immediately or visit the nearest hospital.

Missed a Dose

If you missed a dose of this medicine, take it as soon as you remember. If it's time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose of this medicine to compensate for the missed one.

Mode of Action

How Does It Work?

• Metoprolol works by slowing the heart rate and relaxing blood vessels and reduces high blood pressure
• Angiotensin II is a substance produced in the body which causes the narrowing of blood vessels. It leads to an increase in blood pressure
• Telmisartan prevents the binding of Angiotensin II to its receptors and causes the blood vessels to relax and lowers the blood pressure

Directions for Use

• Take Telmivas M 25mg Tab as directed by your doctor
• Always take it at the same time every day
• Never change the dose or stop this medicine on your own

Precautions and Warnings

Pregnancy

Can I take Telmivas M 25mg Tab during pregnancy?

• Do not take this medicine if you are pregnant or if you are planning to have a baby
• This medicine may cause serious harm to your baby
• If you are on this medication and planning pregnancy, inform the same to your doctor, so that your prescription can be changed

Breast Feeding

Can I take Telmivas M 25mg Tab while breastfeeding?

This medicine passes into the mother’s milk. You should not take this medicine if you are breastfeeding. In case of breastfeeding, infant needs close monitoring for side effects like slowing of heart rate.

Driving

Can I drive if I have consumed Telmivas M 25mg Tab?

This medicine may affect your ability to drive or operate machines. Do not drive or operate machines if you experience dizziness, tiredness and drowsiness.

Alcohol

Can I consume alcohol with Telmivas M 25mg Tab?

Alcohol consumption, along with this medicine can lower your blood pressure and can increase side effects like sleepiness, dizziness or drowsiness, it is advised not to consume alcohol during the treatment.

Other General Warnings

Talk to your doctor if

• If you have asthma
• If you have diabetes, caution is required. Metoprolol may cause low blood sugar levels and also change the body’s response to low blood sugar. You may experience warning signs of low blood sugar such as an increase in heart rate, sweating, hunger pangs, headache, etc.
• If you have a tumour of adrenal gland tissue (Pheochromocytoma)
• If you have an overactive thyroid (a condition when the thyroid gland produces too much of the thyroxine hormone)
• If you are suffering from psoriasis
• If you have a circulation related problem in toes, arm, legs or fingers
• If you are suffering from a type of chest pain (Prinzmetal’s angina)
• If you recently had any heart attack, chest pain or heart surgery
• If you have kidney disease or have had a kidney transplant or liver disease
• If you are known to have narrowed or blockage of the blood vessels of one or both kidneys
• If you develop diarrhoea or vomiting, this dehydration can result in low blood pressure, have an adequate amount of water and fluids
• If you are suffering from low blood pressure (hypotension)
• If you have a high level of potassium in your blood
• If you are taking medicines like Ramipril and Lisinopril

Contraindications

• If you have any allergic reaction to this medicine or any of the ingredient of this medicine
• If you are suffering from heart problems like heart block, heart failure or sick sinus syndrome (abnormal heart rhythms)
• If you have a specific type of angina called Prinzmetal's angina
• If you have reduced blood supply to your limbs (peripheral arterial disease)
• If you have asthma or chronic obstructive pulmonary disease (COPD)
• If you are suffering from adrenal gland tumor (phaeochromocytoma)
• If you have a condition called metabolic acidosis (increased acidity in your body or are on medicines to treat irregular heart rhythm like disopyramide)
• If you have diabetes associated with frequent low blood sugar levels
• If you are suffering from low blood pressure (hypotension)
• If you are in the second or third trimester of pregnancy
• If you have blockage of any duct that carries bile from the liver to gallbladder (obstructive biliary disorders) or severe liver disease
• If you have diabetes and you are on Aliskiren, do not take this medicine

Side effects

• Low blood pressure or giddiness when you stand
• Tiredness
• Slow heart rate
• Dizziness
• Headache
• Nausea or vomiting
• Stomach pain
• Shortness of breath
• Flu-like symptoms
• Diarrhoea
• Conjunctivitis (inflammation of eye also known as pink eye)
• Palpitations (irregular heartbeats)
• Constipation
• Chest pain
• Dry Mouth
• Flatulence
• Joint pain
• Muscle spasm or pain
• Anxiety
• Skin disorders like rash

Interactions

Interactions with other medicines

• This medicine contains Metoprolol and Telmisartan, any interactions seen with these two components when taken alone may occur with this combination
• Do not take it with medicines like Amiodarone, Disopyramide or painkillers like Indomethacin, Sulindac, Diclofenac and Foctafenine as these can decrease the effect of this medicine
• If you have diabetes, dose adjustment may be needed as this medicine can cause a drop in blood glucose levels and close glucose monitoring is advised
• Medicines used to treat high blood pressure and benign prostatic hyperplasia (Prazosine, Tamsulosin, Terazosin and Doxazosin)
• If you have diabetes and you are on Aliskiren, do not take this medicine
• Caution is needed if you are taking Fluoxetine, Lithium, Paroxetine, Bupropion, Thioridazine (medicines for psychiatric illness), Diphenhydramine, Hydroxychloroquine and Mefloquine
• Medicines used to treat acidity or ulcers (antacids) like Cimetidine
• Medicines used to treat heart problems (Digoxin)
• Medicines used to treat depression and Parkinson’s disease (Monoamine Oxidase inhibitors)
• Medicines used to lower down the blood pressure (Clonidine, Guanfacine, Moxonidine, Methyldopa and Rilmenidine)
• Medicines used to treat migraine (Ergotamine) or Nitroglycerine
• General anaesthetics or local anesthetic (Lidocaine)
• Medicines that may increase blood potassium levels like salt containing potassium and potassium-sparing diuretics
• Blood thinners like Warfarin and Heparin
• Immunosuppressives (Cyclosporin or Tacrolimus)
• Medicines used to treat infections like Trimethoprim, Rifampicin or Terbinafine
• Medicines known as Diuretics (water pills) used to treat high blood pressure like Furosemide and Hydrochlorothiazide

Interactions with food items

It is advised to avoid high potassium-containing foods like spinach, broccoli and potatoes as Telmisartan is known to increase blood potassium levels.

Storage and disposal

• Store below 25°C
• Store it in original packing to protect it from light
• Try to keep out of the reach of children

Frequently Asked Questions (FAQs)

What special precautions should I follow?

If you experience any symptoms of dizziness, syncope, vision problems, sexual dysfunction, slowing of heart rate, etc., immediately report to your doctor. The doctor can adjust your dose depending on your blood pressure, heart rate, level of this medicine in your serum and other such important factors.

Are there any dietary restrictions I should follow as I have high blood pressure?

• Limit intake of salt in diet especially pickles and packaged foods like chips contain excess salt and should be avoided
• Have less amount of potassium-containing foods like spinach, broccoli or banana
• Limit meat intake in your diet
• Instead of having packaged snacks, prefer fresh cut fruits as they are rich in vitamins and fibre

What will be the consequences if I stop this medication on my own?

If you stop this medicine suddenly, you can suffer from chest pain, irregular heartbeat or heart attack. Your doctor might tell you to decrease the dose gradually. Don’t suddenly stop taking this medicine without talking to your doctor.