INTRODUCTION

TELISTA D is a combination of Indapamide and Telmisartan which belongs to the group of medicines called Thiazide diuretics and Angiotensin-II receptor blockers respectively. It is used in adults to manage hypertension. Hypertension (also known as high blood pressure) is a medical condition in which the force of the blood exerted against the walls of the artery remains very high, and as a result it may lead to severe damage to the blood vessels supplying several vital organs, like heart, kidney, or brain.

Telmisartan is an angiotensin II receptor blocker. It acts by relaxing the blood vessels supplying the vital organs. Indapamide is a thiazide-diuretic. It acts by increasing the removal of excess water and certain electrolytes (sodium and chloride) from the body in the form of urine. Collectively, they improve blood flow through the blood vessels and makes the heart to pump blood more smoothly with less pressure.

While undergoing therapy with TELISTA D your doctor will regularly monitor your blood pressure, kidney function, blood sugar levels, blood cholesterol levels, blood uric acid levels and electrolyte profile (sodium, potassium, and magnesium levels) to avoid the risk of unwanted side effects.

Before taking TELISTA D inform your doctor if you have diabetes, gout, or any muscle problems. You must also inform your doctor if you have any heart problems, low blood volume or are severely dehydrated due to excessive vomiting or diarrhea.

TELISTA D is not recommended for use in patients with severe kidney or liver problems. It is also not suitable for use in patients with low blood potassium levels and in pregnant or breastfeeding women as it may cause serious harm to the growing baby.

TELISTA D may make you feel dizzy while standing up suddenly or changing positions. Therefore, do not drive or operate any heavy tools or machines as a precaution. Also, avoid drinking alcohol as it might make you feel dizzier and drowsier.

The most common side effects of taking TELISTA D are dizziness, nausea, headache, back pain, muscle cramps and tiredness. Consult your doctor if any of these side effect worsens.

USES OF TELISTA D

• Manages hypertension (high blood pressure) in adults

HOW TELISTA D WORKS

TELISTA D effectively controls blood pressure. It contains two medicines namely, telmisartan and indapamide. Telmisartan blocks the actions of certain hormones (angiotensin-II) in the body that causes narrowing of blood vessels and increase in blood pressure.

Indapamide increases the excretion of excess fluid and certain electrolytes (sodium and chloride) from the body in the form of urine. Together, they reduce blood volume, relax blood vessels, and improve blood flow through the blood vessels which helps the heart to pump blood more efficiently with less pressure.

DIRECTIONS FOR USE

Take TELISTA D as directed by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine. TELISTA D can be taken with or without meals. Try to take TELISTA D at the same time each day.

Your doctor will decide the correct dose and duration of therapy for you depending upon your age, body weight and health condition. Continue to take TELISTA D for the stipulated duration instructed by your doctor without interruption to achieve better results.

SIDE EFFECTS OF TELISTA D

HOW TO MANAGE SIDE EFFECTS

Nausea and Vomiting:

Take TELISTA D with or just after a meal or a snack. Stick to simple meals. Avoid eating rich or spicy food. Consult your doctor if your nausea worsens.

Dizziness:

Try to rest and relax. Get enough sleep. Avoid driving or operating any tools or machines completely while you are feeling dizzy. Do not consume excessive alcohol, as it could aggravate your dizziness. Consult your doctor if your dizziness worsens.

Headache:

Rest and relax. Keep yourself hydrated by drinking plenty of fluids such as water or electrolytes. Applying a pain-relieving balm on your forehead can be beneficial. Do not consume excessive alcohol, as it could aggravate your headache. Consult your doctor if your headache worsens.

WARNING & PRECAUTIONS

INTERACTIONS

A. Drug-Drug Interaction:

Before taking TELISTA D inform your doctor if you are taking any of the following:

• other medicines used to manage elevated blood pressure (such as aliskiren, captopril, enalapril, lisinopril, losartan, valsartan)
• medicines used to manage angina or other heart problems (Ex. amlodipine, diltiazem, verapamil, amiodarone, and digoxin)
• lithium (a medicine used to manage depression)
• potassium supplements or potassium-sparing diuretics such as spironolactone, triamterene or amiloride (used to retain or increase potassium levels in the body)
• non-steroidal anti-inflammatory drugs (used for pain relief) such as indomethacin, celecoxib, ibuprofen, aspirin
• medicines to prevent graft rejection (Ex. cyclosporin, tacrolimus, sirolimus)
• diuretics (used to manage edema and hypertension) such as furosemide
• heparin (a medicine used to prevent blood clots)
• medicines used to manage abnormal heart rhythm (Ex. hydroquinidine, quinidine, amiodarone, sotalol, ibutilide, dofetilide or digitalis)
• bepridil (a medicine used to manage chest pain)
• stimulant laxatives (used to manage constipation) Ex. bisacodyl, sodium pico sulfate
• medicines used to manage mental disorders such as depression, psychosis or anxiety (Ex. pimozide, amisulpride, haloperidol)
• medicines used to manage bacterial infections (Ex. sparfloxacin, moxifloxacin, erythromycin)
• vincamine injection (a medicine used to manage memory loss)
• pentamidine (a medicine used to manage pneumonia)
• halofantrine (a medicine used to manage malaria)
• mizolastine (a medicine used to manage allergic reactions)
• amphotericin B injection (a medicine used to manage fungal infections)
• baclofen (a medicine used to manage muscle spasm)
• allopurinol (a medicine used to manage gout)
• metformin (a medicine used to manage diabetes mellitus)
• oral corticosteroids (used to manage inflammation) Ex. dexamethasone, prednisolone, budesonide, salbutamol
• iodinated contrast media (used for X-rays)
• calcium supplements or calcium containing medicines
• tacrolimus, ciclosporin (used to prevent graft rejection)
• tetracosactide (a medicine used to manage Crohn’s disease)
• colesevelam (a medicine used to manage high blood cholesterol levels)
• cisapride (a medicine used to enhance bowel movements)
• diphemanil (a medicine used to manage stomach problems)
• methadone (a medicine used to manage addiction)

Overdosage:

If you or anyone else accidentally took more TELISTA D, consult your doctor immediately or visit the nearby hospital straight away. Overdosage may cause side effects such as nausea, vomiting, dizziness, low blood pressure, cramps, changes in urine output, drowsiness, and confusion.

SYNOPSIS

MORE INFORMATION

• Keep TELISTA D out of reach of children
• Store TELISTA D at room temperature

FAQs ABOUT TELISTA D

What are the uses of TELISTA D?

TELISTA D is used to manage hypertension. It contains two medicines namely telmisartan and indapamide. Telmisartan acts by relaxing the blood vessels and indapamide acts by increasing the excretion of sodium and water from the body in the form of urine. Collectively, they relax blood vessels, improves blood flow, and reduces blood pressure.

What type of a medicine is TELISTA D?

TELISTA D is an antihypertensive medicine used to reduce elevated blood pressure. It is a combination of two medicines namely telmisartan and indapamide. Telmisartan is an angiotensin II receptor blocker and indapamide is a thiazide-diuretic. They both acts together in reducing blood pressure.

Can the use of TELISTA D cause kidney problems?

Yes. The use of TELISTA D may affect your kidney functions. It is strictly not recommended for use in patients with severe kidney problems. It should be used with caution in patients with other kidney problems (such as dialysis or any recent kidney transplant). Therefore, consult your doctor before taking TELISTA D as a precaution.

What happens when I stop taking TELISTA D?

Do not stop taking TELISTA D without consulting your doctor as your blood pressure may raise once again. Make sure to take TELISTA D for the stipulated duration recommended by your doctor to achieve maximum results.

What is the best time to take TELISTA D?

TELISTA D can be taken with or without meals. Your doctor will decide the best time for you to take TELISTA D based on your age, body weight and disease condition.

What to do if I forgot to take a dose of TELISTA D?

If you have missed a dose of TELISTA D, take it as soon as you remember. However, if it is time for the next dose of TELISTA D, skip the missed dose and take the next one regularly. Do not take a double dose of TELISTA D to compensate the missed ones.

What precautions should be followed while taking TELISTA D?

Before taking TELISTA D inform your doctor if you have diabetes, gout, or any muscle problems. You must also inform your doctor if you have any severe liver, kidney or heart problems, low blood pressure or are severely dehydrated. Stop taking TELISTA D and consult your doctor immediately if you become pregnant. Avoid driving or handling heavy tools or machines, as TELISTA D may cause excessive dizziness or drowsiness. Regularly visit your doctor and take all the necessary blood test recommended by your doctor without fail.

Can TELISTA D causes electrolyte imbalance?

Yes. TELISTA D may the levels of certain electrolytes (sodium or potassium) in the body. To avoid this, your doctor will closely monitor the electrolytes levels in the blood periodically. However, if you experience any unusual symptoms such as chest pain, muscle weakness, irregular heartbeat, confusion, drowsiness, nausea, or vomiting, consult your doctor for advice.

Can I consume alcohol while taking TELISTA D?

Avoid consumption of alcohol while taking TELISTA D as it might make you feel dizzier and drowsier.

What happens if I accidentally take more TELISTA D?

If you or anyone else accidentally took more TELISTA D, consult your doctor immediately. Overdosage may cause side effects such as nausea, vomiting, dizziness, low blood pressure, cramps, changes in urine output, drowsiness, and confusion.

Can I take TELISTA D daily?

Take TELISTA D as advised by your physician. Your doctor will evaluate your health condition and suggests whether can you take TELISTA D every day or not.

Is TELISTA D safe to use in diabetic patients?

TELISTA D may alter the blood sugar levels in your body. Therefore, it is necessary to inform your doctor if you have diabetes before taking TELISTA D as a precaution. Your doctor will closely monitor you blood sugar levels to avoid the risk of side effects. Also, inform your doctor if you experience any unusual tiredness, hunger or thirst while undergoing therapy with TELISTA D.

What are the side effects of TELISTA D?

The most common side effects of taking TELISTA D are dizziness, nausea, headache, back pain, muscle cramps and tiredness. Consult your doctor if any of these side effect worsens.

Can I stop taking TELISTA D once my symptoms subside?

No. Do not stop taking TELISTA D without consulting your doctor. As hypertension is a chronic condition, long term management may be necessary to control its symptoms. Therefore, take TELISTA D as advised by your doctor for the stipulated duration. Premature discontinuation of therapy may increase your blood pressure once again.

Can the use of TELISTA D affect the liver?

Yes. TELISTA D may affect the way your liver work. It can elevate the levels of certain liver enzymes in your body. Therefore, it is strictly not recommended for use in patients with severe liver diseases. It should be used with caution in patients with other minor liver problems. Consult your doctor before taking it.

Can TELISTA D be taken during pregnancy?

TELISTA D is not recommended for use in pregnant women as it may cause serious harm to the growing foetus. Therefore, inform your doctor before taking TELISTA D if you are pregnant, think you may be pregnant or planning to have a baby. If you become pregnant while undergoing therapy with TELISTA D, stop taking it and consult your doctor immediately.

REFERENCES

1. KD. Tripathi. Antihypertensive Drugs & Drugs affecting renin angiotensin system and plasma kinins. Essentials of medical pharmacology. Seventh edition. 2013. Page – 561 & 507.

2. Jie Peng, Yingxin Zhao, Hua Zhang, Zhendong Liu, Zhihao Wang, Mengxiong Tang, Ming Zhong, Fanghong Lu, Wei Zhang. Prevention of metabolic disorders with telmisartan and indapamide in a Chinese population with high-normal blood pressure. NIH National Library of Medicine, National center for biotechnology information. Pubmed.gov. February 2015. [Accessed on 11th April 2022] https://pubmed.ncbi.nlm.nih.gov/25273554/

3. Servier (Ireland) Industries Ltd. Electronic Medicines Compendium (EMC). [Revised in October 2021] [Accessed on 13th July 2022] https://www.medicines.org.uk/emc/files/pil.1152.pdf

4. Actavis Ltd. Health Products Regulatory Authority (HPRA). [Revised in July 2021] [Accessed on 9th April 2022] http://www.hpra.ie/img/uploaded/swedocuments/8c0fc811-cf88-4bd5-818e-609e07fe1190.pdf

5. Telmisartan 40/80 mg + Indapamide SR 1.5/1.5 mg tablet. Central Drugs Standard Control Organization. [Revised in April 2010]. [Accessed on 13th July 2022] https://cdscoonline.gov.in/CDSCO/Drugs

USEFUL DIAGNOSTIC TESTS

• Kidney Function Test