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INTRODUCTION
CILNIPRES T TABLET is a combination of Cilnidipine and Telmisartan which belongs to the group of medicines called Antihypertensive agents. It is used in adults to treat essential hypertension (high blood pressure). Hypertension is a condition in which the force of the blood against the blood vessel walls is too high which is characterized by symptoms such as headache, irregular heartbeat, vision changes, feeling of overtiredness, nausea, vomiting, confusion, anxiety and chest pain.
CILNIPRES T TABLET is not recommended for use in patients with severe liver impairment, advanced aortic stenosis (narrowing of the valve in the large blood vessel branching off the heart (aorta) and primary aldosteronism.
Before taking CILNIPRES T TABLET, inform your doctor if you have diabetes, peripheral edema, metabolic acidosis, cellular lysis (such as acute limb ischemia, rhabdomyolysis, extended trauma) and heart, liver or kidney problems.
CILNIPRES T TABLET is not recommended for use in pregnant and breast-feeding women. CILNIPRES T TABLET is not recommended for use in children and adolescents (aged below 18 years). It should be used with caution in elderly patients (aged 65 years and above).
The most common side effects of taking CILNIPRES T TABLET are dizziness, headache, flushing, and rash. Consult your doctor if any of the side effects worsen.
USES OF CILNIPRES T TABLET
Used in adults:
- To treat essential high blood pressure (hypertension)
HOW CILNIPRES T TABLET WORKS
CILNIPRES T TABLET helps to reduce high blood pressure, where cilnidipine blocks the incoming calcium and suppresses the contraction of blood vessels, thereby reduces the blood pressure. Telmisartan works by relaxing the blood vessels by preventing the binding of certain substance (angiotensin-II) resulting in low blood pressure.
DIRECTIONS FOR USE
Take CILNIPRES T TABLET as advised by your physician. Swallow CILNIPRES T TABLET with a glass of water. Do not crush or chew the medicine. Your doctor will decide the correct dose and duration for you depending upon your age, body weight and disease condition.
SIDE EFFECTS OF CILNIPRES T TABLET
COMMON
- dizziness, headache
- peripheral edema
- flushing
- rash
- gingival hyperplasia
UNCOMMON
- urinary tract infection including cystitis
- upper respiratory tract infection including pharyngitis and sinusitis
- anaemia
- hyperkalaemia (increased potassium levels in the blood)
- insomnia, depression
- sudden temporary loss of consciousness
- vertigo (spinning sensation of the head)
- slow heart rate
- low blood pressure
- orthostatic hypotension (low blood pressure while standing up from sitting or lying position)
- shortness of breath
- cough
- abdominal pain, diarrhoea
- flatulence, vomiting
- indigestion
- itching, excess sweating
- back or muscle pain, muscle spasms
- renal impairment including acute renal failure
RARE
- low blood sugar levels (in diabetic patients)
- anxiety
- sleepiness
- fast heart rate
- dry mouth, stomach discomfort, altered taste sensation
- angioedema
- eczema, erythema, urticaria, drug eruption
- joint or tendon pain, pain in extremity
- influenza-like illness
- toxic skin eruption
- sepsis
Stop taking CILNIPRES T TABLET and contact your doctor immediately if you experience any of the following side effects:
- anaphylactic reaction
- angioedema (swelling underneath the skin)
- acute renal failure
HOW TO MANAGE SIDE EFFECTS
Stomach pain:
Rest and relax. Eat and drink slowly or try to have smaller and frequent meals. Keep a heat pad on your stomach. Do not self-treat on your own and consult your doctor if the symptom did not improve on its own.
Diarrhea:
Drink lots of fluids, such as water or fruit juices to keep yourself hydrated. Avoid taking any medicine on your own for treating diarrhea. Consult your doctor if the symptom did not improve.
Headache:
Drink ample amount of water and avoid skipping meals. Get adequate rest. Try to be relaxed and stress free. Apply pain relieving balm on your forehead if necessary. Consult your doctor if the symptom does not improve.
Dizziness:
Try to rest and relax. Get enough sleep. Avoid driving or operating any tools or machines while you are feeling dizzy. Do not consume alcohol as it can aggravate your dizziness. Consult your doctor if the symptom did not improve.
WARNING & PRECAUTIONS
PREGNANCY
CILNIPRES T TABLET is not recommended for use in pregnant women. Consult your doctor for advice.
BREASTFEEDING
CILNIPRES T TABLET is not recommended for use in breast-feeding women. Consult your doctor for advice.
DRIVING AND USING MACHINES
Do not drive or handle any machines if you experience dizziness after taking CILNIPRES T TABLET.
ALCOHOL
Avoid consumption of alcohol while taking CILNIPRES T TABLET as it may cause low blood pressure while standing up from sitting or lying position (orthostatic hypotension).
KIDNEY
CILNIPRES T TABLET should be used with caution in patients with chronic renal insufficiency. It should be used with caution in patients with impaired kidney function, bilateral renal artery stenosis or stenosis of the artery to a single functioning kidney. Consult your doctor before taking CILNIPRES T TABLET.
LIVER
CILNIPRES T TABLET is not recommended for use in patients with severe liver impairment, cholestasis, biliary obstructive disorders. It should be used with caution in patients with mild to moderate liver impairment and elevated liver enzymes. Consult your doctor before taking CILNIPRES T TABLET.
ALLERGY
Do not take CILNIPRES T TABLET if you are allergic to Telmisartan, Cilnidipine or calcium channel antagonists such as amlodipine, nifedipine.
HEART DISEASE
CILNIPRES T TABLET is not recommended for use in patients with advanced aortic stenosis (narrowing of the valve in the large blood vessel branching off the heart (aorta)). It should be used with caution in patients with aortic or mitral stenosis, obstructive hypertrophic cardiomyopathy (condition in which the heart muscle becomes abnormally thick), angina (chest pain), ischaemic cardiopathy or ischaemic cardiovascular disease and congestive heart failure. Consult your doctor before taking CILNIPRES T TABLET.
OTHERS
CILNIPRES T TABLET is not recommended for use if you:
- primary aldosteronism
Before taking CILNIPRES T TABLET, inform your doctor if you:
- volume and/or sodium depletion by diuretic therapy, dietary salt restriction, diarrhoea or vomiting
- diabetes
- peripheral edema
- metabolic acidosis, cellular lysis (such as acute limb ischemia, rhabdomyolysis, extended trauma)
Use in paediatrics:
CILNIPRES T TABLET is not recommended for use in children and adolescents (aged below 18 years). Consult your child’s doctor for advice.
Use in geriatrics:
CILNIPRES T TABLET should be used with caution in elderly patients (aged 65 years and above). Consult your doctor before taking CILNIPRES T TABLET.
INTERACTIONS
A. Drug-Drug interactions:
Before taking CILNIPRES T TABLET inform your doctor, if you are taking or receiving any of these medicines:
- angiotensin-converting enzyme (ACE) inhibitors (Ex. enalapril, lisinopril) angiotensin-II receptor antagonists drugs (Ex. losartan, irbesartan), diuretics (Ex. chlorthalidone, torsemide) and aliskiren (used to treat high blood pressure)
- anti-psychotic drugs such as risperidone, quetiapine (used to treat mental health conditions such as schizophrenia)
- digoxin, quinidine (used to treat heart problems)
- lithium, antidepressants such as paroxetine, fluoxetine (used to treat depression)
- non-steroidal anti-inflammatory drugs such as aspirin or ibuprofen including selective COX-2 inhibitors such as celecoxib (used to treat pain)
- cyclosporin, tacrolimus (used to prevent organ rejection after transplant)
- potassium supplements, salt substitutes and potassium-sparing medicines (Ex. spironolactone) (used to treat fluid retention without potassium loss in the urine)
- aldesleukin (used to treat kidney cancer)
- trimethoprim, rifampicin, erythromycin (used to treat bacterial infection)
- baclofen (used to treat relax muscles)
- amifostine (used to protect the kidney from harmful effects of chemotherapy)
- heparin (used to prevent or treat blood clots)
- phenytoin, barbiturates such as phenobarbital, pentobarbital (used to treat seizures)
- narcotics such as morphine (used to treat severe pain)
Overdosage:
If you or anyone else accidentally take too much of CILNIPRES T TABLET, consult your doctor immediately or visit the nearby hospital. Overdosage symptoms of CILNIPRES T TABLET are low blood pressure, fast or slow heart rate, dizziness, increase in serum creatinine, acute renal failure, excessive peripheral vasodilatation.
SYNOPSIS
| Drug | : | Cilnidipine, Telmisartan |
| Pharmacological Category | : | Calcium channel blockers; Angiotensin II receptor antagonists |
| Therapeutic Indication | : | Hypertension (high blood pressure) |
| Dosage Forms | : | Tablet |
MORE INFORMATION
- Keep CILNIPRES T TABLET out of reach of children
- Store at room temperature
FAQs ABOUT CILNIPRES T TABLET
What to do if I miss to take a dose of CILNIPRES T TABLET?
You should take CILNIPRES T 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 to match up your missed dose.
For how long should I take CILNIPRES T TABLET?
You should continue taking CILNIPRES T TABLET unless your doctor tells you to stop the medicine. Blood pressure medicines will be usually taken for lifetime to prevent complications due to high blood pressure. Your doctor may change treatment with other hypertensive drug, if you do not attain effective therapeutic outcome with CILNIPRES T TABLET.
Can CILNIPRES T TABLET be taken during pregnancy?
CILNIPRES T TABLET is not recommended for use in pregnant women. If you think you may be pregnant or planning to get pregnant, consult your doctor before taking this medicine. Inform your doctor immediately if you get pregnant during treatment with CILNIPRES T TABLET.
Can CILNIPRES T TABLET be used in elderly patients?
Yes, CILNIPRES T TABLET should be used with caution in elderly patients (above 65 years of age). Your doctor may initiate the treatment with the lowest effective dose which may prevent the risk of increased side effects. Consult your doctor before taking CILNIPRES T TABLET.
Is CILNIPRES T TABLET safe to use in patients with kidney problems?
CILNIPRES T TABLET should be used with caution in patients with chronic renal insufficiency. It should be used with caution in patients with impaired kidney function, bilateral renal artery stenosis or stenosis of the artery to a single functioning kidney. Consult your doctor before taking CILNIPRES T TABLET.
REFERENCES
1. KD. Tripathi. Antianginal and other Anti-ischaemic Drugs & Drugs Affecting Renin Angiotensin System. Eighth edition. June 2018. Page – 596 & 536.
2. C Venkata S Ram, Baby Shalini Muppalla, Sarvepalli Vijaya Parthasaradhi, Gajjela Praveen Kumar, Saumitra Ray, Uday Jadhav, J P S Sawhney, Govindan Unni, Nagaraj Desai, Members of the TelCom Study Group. Achieving the Latest American Heart Association and American College of Cardiology Therapeutic Goals for Hypertension With Combination Therapy and Its Effects on Blood Pressure and Central Hemodynamic Parameters. NIH National Library of Medicine. National Centre for Biotechnology Information. Pubmed.gov. April 2022. [Accessed on October 21st 2022] https://pubmed.ncbi.nlm.nih.gov/35063267/
3. Torrent Pharmaceuticals Ltd. Telsar N (Telmisartan and Cilnidipine Tablets). [Revised in April 2020] [Accessed on October 21st 2022] https://www.torrentian.com/pisheet/Upload/PI_Sheet/2909.pdf
4. Leogenic healthcare. CiniLeo T 10/40 (Cilnidipine and Telmisartan Tablets). [Accessed on October 21st 2022] https://www.leogenic.com/cinileo-t-10-40-cilnidipine-and-telmisartan-tablet/
5. Pure & Cure Healthcare Pvt. Ltd. Cilacar T (Cilnidipine and Telmisartan Tablets). January 2020. [Accessed on October 21st 2022] https://medicaldialogues.in/uploads/2020/05/20/file_upload-129071.pdf
USEFUL DIAGNOSTIC TESTS
- Kidney Function Test
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