Telmed Act 40mg Tablet 10'S

Introduction About TELMED ACT 40MG TABLET

TELMED ACT 40MG TABLET is a combination of Chlorthalidone, Amlodipine and
Telmisartan which belongs to the group of medicines called Antihypertensives.
TELMED ACT 40MG TABLET is used to manage essential hypertension in adults.
Essential hypertension (primary hypertension) occurs when you have abnormally
high blood pressure that's not the result of a medical condition. It is
characterized by symptoms such as blurred vision, severe headache, chest pain,
dizziness, light-headedness and nose bleeds.

TELMED ACT 40MG TABLET is not recommended for use in patients having severe
liver, kidney and heart problems. Avoid eating or drinking grapefruit juice
while taking TELMED ACT 40MG TABLET as it may potentiate the risk of side
effects. Prior to management with TELMED ACT 40MG TABLET or during the course of
management, your doctor may want you to take several tests to understand your
health condition.

TELMED ACT 40MG TABLET is not recommended for use in pregnant and breastfeeding
woman. It is not recommended for use in children and adolescents (aged less than
18 years) and it should be used with caution in elderly patients (above 65 years
of age).

The common side effects of taking TELMED ACT 40MG TABLET are low blood pressure,
dizziness, loss of appetite, stomach upset and skin rashes. Consult your doctor
immediately if any of the side effect worsens.

Uses Of TELMED ACT 40MG TABLET

• Manage essential hypertension

How TELMED ACT 40MG TABLET Works

TELMED ACT 40MG TABLET helps to reduce high blood pressure, where amlodipine
works by relaxing the blood vessels and improving the flow of blood to the heart
muscles and chlorthalidone works by promoting the excretion of excess fluid and
certain electrolytes (such as sodium and chloride) from the body by increasing
the amount of urine produced by the kidneys. Telmisartan works by relaxing the
blood vessels by managing the binding of certain substance called angiotensin-II
(substance produced in the body which causes narrowing of blood vessels). All
these actions together effectively control high blood pressure.

How to use TELMED ACT 40MG TABLET

Take TELMED ACT 40MG TABLET as advised by your physician. Swallow the medicine
with a glass of water. Do not crush or chew the medicine. Your doctor will
decide the correct dose and duration of TELMED ACT 40MG TABLET for you depending
upon your age, body weight and disease condition.

Side Effects Of TELMED ACT 40MG TABLET

Common

• oedema (swelling due to fluid retention)
• low blood levels of potassium which can cause muscle weakness, muscle twitching
• low blood pressure
• low levels of sodium which can cause tiredness, confusion, muscle twitching
• fits or coma
• high blood sugar levels which can cause tiredness, weakness or feeling thirsty
• nettle like skin rash
• dizziness
• loss of appetite, stomach upset
• impotence in men

Uncommon

• urinary tract infections
• upper respiratory tract infections (signs include sore throat, inflamed sinuses, common cold)
• decreased red blood cells (anemia)
• difficulty falling asleep
• fainting
• head spinning sensation (vertigo)
• slow heart rate
• dizziness on standing up (orthostatic hypotension)
• shortness of breath, cough
• abdominal pain, diarrhoea, vomiting and bloating
• itching and increased sweating
• back pain, muscle cramps and muscle pain
• chest pain, feeling of weakness
• ringing in the ears
• sneezing/running nose caused by inflammation of the lining of the nose
• dry mouth
• hair loss, red patches on skin, skin discoloration
• difficulty in passing urine, increased urge to urinate at night, increased frequency of passing urine
• discomfort or enlargement of the breasts in men
• weight gain or decrease
• gout (pain and swelling in the joint)

Rare

• signs of increased calcium levels (agitation, sore eyes, abdominal pain)
• swelling of face or gums
• low blood sugar level in diabetic patients, worsening of diabetes
• signs of jaundice (yellowing of skin or eyes)
• increased skin sensitivity to sunlight
• impaired vision
• fast heartbeat
• altered taste sensation
• eczema, hives (urticaria)
• severe skin rash caused by drug, joint, tendon and extremities pain
• flulike illness such as fever, chills and throat pain
• signs of kidney problems (such as loss of appetite, decreased urinary output, fatigue)
• confusion and anxiety
• palpitations
• tingling and prickling sensation in arms, legs or feet

Stop taking TELMED ACT 40MG TABLET and contact your doctor immediately if you
experience any of the following side effects:

• signs of sepsis (rapid swelling of the skin and mucosa)
• sudden wheezing, chest pain, shortness of breath or difficulty in breathing
• swelling of eyelids, face or lips
• swelling of the tongue and throat which causes great difficulty breathing
• signs of stevens johnson syndrome, toxic epidermal necrolysis or other allergic reactions (severe skin reactions causing intense rash, hives, reddening of the skin over the whole body, severe itching, blistering, peeling and swelling of the skin, inflammation of mucous membranes)
• heart attack, abnormal heartbeat
• signs of inflamed pancreas (severe abdominal and back pain)
• severe muscles weakness

How To Manage Side Effects

!### Diarrhea

Drink lot of fluids such as water to keep yourself hydrated. Avoid eating
high-fat or spicy foods. Do not take any medicine on your own to manage diarrhea
without consulting your doctor.

!### Dizziness Or Drowsiness

Lie down until dizziness is gone, then get up slowly. Move slowly and carefully,
do not hurry. Get adequate rest. Drink plenty of water and other fluids. Consult
your doctor if the symptom gets worse.

!### Dry Mouth

Sip water regularly and other sugar free liquids. Do not use mouthwashes that
contain alcohol because they can make your mouth dry, use mouthwash that is used
only for dry mouth. Limit your caffeine intake. Avoid smoking or using tobacco
products. Consult your doctor if the symptom does not improve.

!### Loss Of Appetite

Eat when you feel hungry. Eat smaller meals frequently than usual. Snack only
when you're hungry. Eat a nutritious snack which is rich in calories and
protein, such as dried fruit and nuts. Consult your doctor if the symptom does
not improve.

!### Skin rash Or Itching

Try to avoid hot showers because it may cause skin irritation. Avoid frequent
contact and rubbing over the affected area. Use sunscreen and protective
clothing when going outdoors. Consult your doctor if the symptom does not
improve.

!### Stomach Pain

Try to rest and relax. Eat and drink slowly or try to have smaller meals more
frequently. Keep a heat pad on your stomach. If the symptom does not improve,
consult your doctor.

Warning & Precautions

!### Pregnancy

ContraindicatedTELMED ACT 40MG TABLET is not generally recommended for pregnant women as it may
cause serious harm to the baby. Consult your doctor before taking TELMED ACT
40MG TABLET.

!### Breastfeeding

ContraindicatedTELMED ACT 40MG TABLET is not recommended for use in breastfeeding women, as it
may pass through breast milk. Your doctor may choose another management
especially if you want to breast-feed when your baby is new-born or born
prematurely. Consult your doctor before taking TELMED ACT 40MG TABLET.

!### Driving and Using Machines

Use with CautionDo not drive or operate any machines if you feel dizziness, tiredness, headache
or feel sick after taking TELMED ACT 40MG TABLET.

!### Alcohol

Consult your doctorAvoid consum
risk of low blood pressure.

!### Kidney

Consult your doctorTELMED ACT 40MG TABLET is not recommended for use in patients with kidney stones
and it should be taken with caution in patients having kidney artery stenosis
(narrowing of blood vessels to one or both the kidneys) and kidney transplant.
Consult your doctor before taking TELMED ACT 40MG TABLET.

!### Liver

Consult your doctorTELMED ACT 40MG TABLET is not recommended for use in patients with severe liver
problems such as cholestasis or biliary obstruction (flow of bile from liver
stops or slows). It should be used with caution in patients having liver
disease. Consult your doctor before taking TELMED ACT 40MG TABLET.

!### Allergy

ContraindicatedTELMED ACT 40MG TABLET is not recommended for use if you are allergic to
Amlodipine, Chlorthalidone and Telmisartan.

!### Heart Disease

Consult your doctorTELMED ACT 40MG TABLET is not recommended for use in patients with cardiogenic
shock (when the heart is unable to supply enough blood to the vital organs of
the body), aortic stenosis (narrowed or blocked aortic valve), heart failure
after heart attack. It should be used with caution in patients having heart
trouble or low blood pressure (due to dehydration problems, low-salt intake,
diarrhoea, or vomiting). Before taking TELMED ACT 40MG TABLET consult with your
doctor.

!### Use In Pediatrics

ContraindicatedTELMED ACT 40MG TABLET is not recommended for use in children and adolescents
(under 18 years of age). Consult child’s doctor for advice

!### Use In Geriatrics

Use with CautionTELMED ACT 40MG TABLET should be used with caution in elderly patients (above 65
years of age). Consult your doctor before taking TELMED ACT 40MG TABLET

Others

TELMED ACT 40MG TABLET is not recommended for use if you:

• are not passing urine at all
• have low levels of potassium, sodium and calcium in the blood
• have gout
• have addison’s disease

Before taking TELMED ACT 40MG TABLET, inform your doctor if you have:

• raised aldosterone levels
• diabetes (high blood sugar)

Interactions

A. Drug-Drug interactions:

Before taking TELMED ACT 40MG TABLET, inform your doctor if you are taking any
of the following medicines:

• medicines used to lower the blood pressure (Ex. enalapril, lisinopril, ramipril, verapamil, diltiazem, aliskiren, bosentan, methyldopa and guanethidine)
• medicines that may increase blood potassium levels (Ex. amiloride, spironolactone)
• medicines used to manage pain and inflammation (Ex. aspirin, ibuprofen)
• heparin (used to manage blood clots)
• cyclosporin, tacrolimus, sirolimus, temsirolimus, and everolimus (used to manage organ rejection after transplant)
• medicines used to manage bacterial infections (Ex. clarithromycin, erythromycin, amphotericin, telithromycin, rifampicin, rifabutin and trimethoprim)
• furosemide, hydrochlorothiazide (used to manage oedema or high blood pressure)
• medicines used to suppress inflammation (Ex. prednisolone, betamethasone, dexamethasone and hydrocortisone)
• medicines used to manage depression (Ex. lithium, citalopram, fluoxetine, paroxetine, nefazodone and St. John’s wort (herbal medicine))
• itraconazole, ketoconazole (used to manage fungal infections)
• antiviral medicines used to manage HIV infections (Ex. ritonavir, indinavir, nelfinavir, nevirapine)
• simvastatin, colestyramine (used to manage high cholesterol)
• adrenocorticotropic hormone (ACTH) (used to manage ulcerative colitis, crohn’s disease)
• cyclophosphamide or methotrexate (used in cancer management)
• salbutamol or formoterol (used to manage asthma)
• carbenoxolone (used to manage stomach ulcers)
• insulin, chlorpropamide or glibenclamide (medicine used to manage diabetes)
• atropine (used to manage symptoms of low heart rate)
• amantadine (used to manage parkinson’s disease or viral infections)
• allopurinol (used to manage gout)
• calcium salts or vitamin D (used for vitamin deficiency)

B. Drug-Food interaction:

Avoid eating or drinking grapefruit juice while taking TELMED ACT 40MG TABLET as
it may potentiate the blood pressure lowering effect. Consult your doctor before
taking TELMED ACT 40MG TABLET.

Overdosage:

If you or anyone else accidentally takes too much of TELMED ACT 40MG TABLET,
consult your doctor immediately or visit the nearby hospital. Overdosage
symptoms of TELMED ACT 40MG TABLET are low blood pressure, fast or slow
heartbeat and dizziness.

Synopsis

Drug	:	Chlorthalidone, Amlodipine, Telmisartan
Pharmacological Category	:	Thiazide Diuretics, Calcium Channel Blockers, Angiotensin II receptor antagonist
Therapeutic Indication	:	Essential hypertension
Dosage Forms	:	Tablet

More Information

• Keep TELMED ACT 40MG TABLET out of reach of children
• Store TELMED ACT 40MG TABLET at room temperature

FAQs About TELMED ACT 40MG TABLET

Q: What is TELMED ACT 40MG TABLET and why is it given?

A: TELMED ACT 40MG TABLET is a combination of chlorthalidone, amlodipine and
telmisartan. It is used in the management of essential hypertension (blood
pressure that is not caused by any other condition) in adults.

Q: Is TELMED ACT 40MG TABLET safe to use in pregnant women?

A: TELMED ACT 40MG TABLET is not recommended in early pregnancy and must not be
taken when more than 3 months pregnant, as it may cause serious harm to the baby
if used after 3 months of pregnancy. Consult your doctor for advice before
taking TELMED ACT 40MG TABLET.

Q: Can TELMED ACT 40MG TABLET be used in patients with liver disease?

A: TELMED ACT 40MG TABLET is not recommended for use in patients with severe
liver problems such as cholestasis or biliary obstruction (flow of bile from
liver stops or slows). It should be used with caution in patients having liver
disease. Consult your doctor for advice before taking TELMED ACT 40MG TABLET.

Q:CanTELMED ACT 40MG TABLET be used in elderly patients?

A: TELMED ACT 40MG TABLET should be used with caution in elderly patients (above
65 years of age). Your doctor may adjust the dose with the lowest effective dose
depending upon vital organ functions such as kidney, liver and heart. Consult
your doctor before taking TELMED ACT 40MG TABLET.

Q:IsTELMED ACT 40MG TABLET safe to use in patients with kidney
problems?

A: TELMED ACT 40MG TABLET is not recommended for use in patients with kidney
stones and it should be used with caution in patients having kidney artery
stenosis (narrowing of blood vessels to one or both the kidneys) and with
surgical history of kidney transplant. Consult your doctor before taking TELMED
ACT 40MG TABLET.

Q:What to do If I forget to take a dose of TELMED ACT 40MG TABLET?

A: You should take TELMED ACT 40MG TABLET immediately when you remember. If it
is time for your next dose skip the missed dose and follow your regular dose
schedule. Do not double the dose of TELMED ACT 40MG TABLET to match up your
missed dose.

Useful Diagnostic Tests

• Serum electrolyte panel
• Liver function test
• Kidney function test