INTRODUCTION

TELISTA PLUS is a combination of Atorvastatin and Telmisartan which belongs to the group of medicines called HMG-CoA reductase inhibitors and Angiotensin-II receptor blockers respectively. It is used to manage hypertension (high blood pressure) and high blood cholesterol levels. It can also be used to reduce the risk of cardiovascular events such as heart attack or stroke in patients who are at risk of heart diseases.

Telmisartan is an angiotensin II receptor blocker. It reduces blood pressure by relaxing the blood vessels supplying the heart and other vital organs. Atorvastatin is an HMG-CoA reductase inhibitor. It reduces the bad cholesterol levels in the body by the blocking the actions of certain enzymes that are involved in the cholesterol production. Collectively they decrease blood pressure and blood lipid levels.

Before taking TELISTA PLUS inform your doctor if you have diabetes, thyroid problems, any family history of muscle disorders or problems in your kidney or heart. You must also inform your doctor if you are severely dehydrated or on a low-salt diet or taking antibiotics (such as fusidic acid) to manage any existing infections.

TELISTA PLUS is strictly not recommended for use in patients with severe liver problems, or an abnormally low blood pressure. It is also not suitable for use in pregnant or breastfeeding women as it may cause serious harm to the growing baby. Stop taking TELISTA PLUS and inform your doctor immediately if you become pregnant while undergoing therapy with TELISTA PLUS.

TELISTA PLUS 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.

TELISTA PLUS may alter your blood sugar levels and electrolyte levels. Therefore, your doctor will constantly monitor your blood sugar levels and kidney functions during therapy with TELISTA PLUS to avoid the risk of unwanted side effects.

The most common side effects of taking TELISTA PLUS are dizziness, headache, nausea, constipation, high blood potassium levels and high blood sugar levels. Consult your doctor if any of these side effect worsens. You must also inform your doctor if you experience severe muscle pain or cramps with fever and malaise after taking TELISTA PLUS.

USES OF TELISTA PLUS

It is used to:

• Manage high blood pressure
• Manage high cholesterol levels
• Prevent the risk of heart attack or stroke

HOW TELISTA PLUS WORKS

TELISTA PLUS effectively reduces high blood pressure and high blood cholesterol levels. It contains two medicines namely, telmisartan and atorvastatin. Telmisartan reduces blood pressure by blocking the actions of certain hormones (angiotensin-II) in the body that causes narrowing of blood vessels and increase in blood pressure.

Atorvastatin reduces the levels of bad cholesterol (LDL) and triglycerides in the body by the blocking the actions of certain enzymes (HMG-CoA reductase) that is involved in the cholesterol production. Collectively they decrease blood pressure, blood lipid levels, and reduces the risk of heart attack or stroke.

DIRECTIONS FOR USE

Take TELISTA PLUS as directed by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine. TELISTA PLUS can be taken with or without meals. Try to take TELISTA PLUS 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 PLUS for the stipulated duration instructed by your doctor without interruption to achieve better results.

SIDE EFFECTS OF TELISTA PLUS

HOW TO MANAGE SIDE EFFECTS

Nausea and Vomiting:

Take TELISTA PLUS 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 PLUS 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)
• other medicines used to reduce blood cholesterol levels (Ex. gemfibrozil, ezetimibe, colestipol)
• medicines used to manage angina or other heart problems (Ex. amlodipine, diltiazem, verapamil, amiodarone, and digoxin)
• lithium, St. John’s wort (medicines 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
• corticosteroids (used to manage pain and inflammation) Ex. prednisolone
• narcotics (used for pain relief) Ex. morphine, pethidine, fentanyl
• barbiturates (used to induce sleep) Ex. pentobarbital, phenobarbital
• antidepressants (used to manage depression) such as sertraline, fluoxetine, escitalopram, amitriptyline, nortriptyline, imipramine
• baclofen (a medicine used for relaxing muscles)
• amifostine (a kidney protectant used along with chemotherapeutic agents)
• medicines used to manage Hepatitis C infection (Ex. telaprevir, boceprevir and combination of elbasvir/grazoprevir)
• medicines used to manage fungal infection (Ex. ketoconazole, itraconazole, voriconazole, fluconazole, posaconazole)
• medicines used to manage bacterial infections (Ex. fusidic acid, erythromycin, clarithromycin, telithromycin, trimethoprim)
• medicines used to manage HIV infection (Ex. ritonavir, lopinavir, atazanavir, indinavir, darunavir)
• warfarin, heparin (used to prevent or manage blood clots)
• letermovir (a medicine used to manage cytomegalovirus)
• oral contraceptives (birth control pill) Ex. levonorgestrel, ethinylestradiol
• cimetidine (a medicine used to manage heartburn and stomach ulcers)
• colchicine (a medicine used to manage gout)
• antacids (used to neutralize stomach acid) Ex. aluminium hydroxide, milk of magnesia
• stiripentol (a medicine used to manage fits)

B. Drug-Food Interaction:

While taking TELISTA PLUS, avoid drinking grapefruit juice as it may interact with TELISTA PLUS and reduce its effectiveness.

Overdosage:

If you or anyone else accidentally take too much of this medicine, consult your doctor immediately. Overdosage may cause side effects such as low blood pressure, increased or decreased heartbeat, low blood pressure and dizziness.

SYNOPSIS

MORE INFORMATION

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

FAQs ABOUT TELISTA PLUS

Is TELISTA PLUS safe to use in diabetic patients?

TELISTA PLUS may alter the blood sugar levels in your body. Therefore, it is necessary to inform your doctor if you have diabetes before taking TELISTA PLUS 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 PLUS.

What precautions should be followed while taking TELISTA PLUS?

Before taking TELISTA PLUS inform your doctor if you have any kidney or heart problems. You must also inform your doctor if you have diabetes, family history of muscle problems or are severely dehydrated. Regularly visit your doctor and take all the necessary tests which your doctor recommends to you without fail. Consult your doctor before taking TELISTA PLUS if you have any severe liver or heart diseases (such as low blood pressure). If you are pregnant or become pregnant while taking TELISTA PLUS stop taking it immediately and consult your doctor.

Can TELISTA PLUS causes electrolyte imbalance?

Yes. TELISTA PLUS 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 PLUS?

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

What happens if I accidentally take more TELISTA PLUS?

If you or anyone else accidentally took more TELISTA PLUS, consult your doctor immediately. Overdosage may cause low blood pressure and abnormal heartbeat.

Can I take TELISTA PLUS daily?

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

Can I stop taking TELISTA PLUS if my blood pressure reduces?

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

What is TELISTA PLUS used for?

TELISTA PLUS is used to manage hypertension (high blood pressure) and high blood cholesterol levels. It can also be used to reduce the risk of cardiovascular events such as heart attack or stroke in patients who are at risk of heart diseases.

What are the side effects of TELISTA PLUS?

The most common side effects of taking TELISTA PLUS are dizziness, headache, nausea, constipation, high blood potassium levels and high blood sugar levels. Consult your doctor if any of these side effect worsens. You must also inform your doctor if you experience severe muscle pain or cramps with fever and malaise after taking TELISTA PLUS.

Can I stop taking TELISTA PLUS once my symptoms subside?

No. Do not stop taking TELISTA PLUS without consulting your doctor. As high blood pressure and high blood cholesterol levels are chronic conditions, long term management is necessary to control its symptoms. Therefore, take TELISTA PLUS as advised by your doctor for the stipulated duration. Premature discontinuation of therapy may cause the symptoms to reappear.

What should I do if I forget to take a dose of TELISTA PLUS?

If you forget to take a dose of TELISTA PLUS, take it as soon as you remember. However, if it is time to take the next dose, skip the missed dose of TELISTA PLUS and take the next one at the regular time. Do not take a double dose of TELISTA PLUS to compensate the missed dose.

Can the use of TELISTA PLUS affect the liver?

Yes. TELISTA PLUS 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. Therefore, consult your doctor before taking it.

Which medicines should I avoid while taking TELISTA PLUS?

While undergoing therapy with TELISTA PLUS, avoid concomitant use of antibiotics (erythromycin), antifungals (ketoconazole) and antiviral medicines (ritonavir) without consulting your doctor.

Can TELISTA PLUS cause muscle pain?

Yes. TELISTA PLUS may lead to abnormal muscle breakdown known as rhabdomyolysis which can be identified by symptoms such as muscle pain, tenderness or weakness, red-brown discoloration of urine and high fever. Consult your doctor immediately, if you experience any such symptoms.

What foods should I avoid while taking TELISTA PLUS?

While taking TELISTA PLUS avoid eating foods high in fat or cholesterols such as fried or processed foods, grapefruit juice, dairy products, and red meat which can lead to poor therapeutic outcome in manageing the disease.

For how long should I take TELISTA PLUS?

You should continue taking TELISTA PLUS unless your doctor tells you to stop the medicine. TELISTA PLUS will be usually taken for lifetime to prevent complications due to high blood pressure and high cholesterol levels. Therefore, consult your doctor for advice regarding the duration of therapy.

Can TELISTA PLUS be taken during pregnancy?

No. TELISTA PLUS is not recommended for use in pregnancy as it may cause serious   harm to the baby. Women of childbearing age should follow effective method of birth control to prevent pregnancy while taking TELISTA PLUS. In case of accidental pregnancy immediately, stop taking TELISTA PLUS and contact your doctor.

Is TELISTA PLUS safe to use in kidney disease?

TELISTA PLUS should be used with caution in patients with kidney diseases (such as those having renal artery stenosis, kidney transplant or in those undergoing haemodialysis). Your doctor will access your health condition and suggest a suitable dose for you. Therefore, it is important to inform your doctor if you have any kidney problems before taking TELISTA PLUS as a precaution.

REFERENCES

1. K.D. Tripathi. Drugs affecting renin angiotensin system and plasma kinins & Hypolipidaemic Drugs and Plasma Expanders. Essentials of medical pharmacology. Seventh edition. 2013. Page –507 & 637.

2. O M Bochar. Combined effect of appointment telmisartan and atorvastatin on hemodynamic indicators and the indicators of lipid profile in patients with arterial hypertension combined with obesity and steatohepatitis. NIH National Library of Medicine, National center for biotechnology information. Pubmed.gov. 2014. [Accessed on 13th July 2022] https://pubmed.ncbi.nlm.nih.gov/25796814/

3. Kevin A Bybee, John H Lee, James H O Keefe. Cumulative clinical trial data on atorvastatin for reducing cardiovascular events: the clinical impact of atorvastatin. NIH National Library of Medicine, National center for biotechnology information. Pubmed.gov. April 2008. [Accessed on 13th July 2022] https://pubmed.ncbi.nlm.nih.gov/18358084/

4. Boehringer Ingelheim Pharma GmbH & Co. KG. Electronic Medicines Compendium (EMC). [Revised in April 2021] [Accessed on 13th July 2022] https://www.medicines.org.uk/emc/files/pil.3165.pdf

5. Sun Pharmaceutical Industries Europe B.V. Electronic Medicines Compendium (EMC). [Revised in December 2021] [Accessed on 13th July 2022] https://www.medicines.org.uk/emc/files/pil.4339.pdf

6. Telmisartan 40mg + Atorvastatin (as calcium) 10mg Tablets. Central Drugs Standard Control Organization. [Revised in May 2008]. [Accessed on 13th July 2022] https://cdscoonline.gov.in/CDSCO/Drugs

USEFUL DIAGNOSTIC TESTS

• Kidney Function Test
• Lipid profile