INTRODUCTION

LNDIP TRIO TABLET is a combination of Chlorthalidone, Cilnidipine and Telmisartan which belongs to the group of medicines called Antihypertensive drugs. It is used to treat essential hypertension in adults. High blood pressure that is not caused by any other condition is called essential hypertension. Symptoms of essential hypertension include early morning headaches, nosebleeds, irregular heartbeat, vision changes, buzzing in the ears, fatigue (feeling overtiredness), nausea, vomiting, confusion, anxiety, chest pain and muscle tremors (shakiness).

LNDIP TRIO TABLET is not recommended for use in patients with liver, kidney and heart disease. LNDIP TRIO 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. LNDIP TRIO TABLET is not suitable for use by breastfeeding women. LNDIP TRIO TABLET is not recommended for use in children and adolescents (under 18 years of age). Consult your doctor before taking this medicine.

LNDIP TRIO TABLET and it should be used with caution in elderly patients. The most common side effects of taking LNDIP TRIO TABLET are dizziness, nausea, headache, constipation, fever and chills. Consult your doctor if the above-mentioned symptoms are not improving.

USES OF LNDIP TRIO TABLET

• Treats essential hypertension (high blood pressure) in adults
• Lowers the risk of stroke and heart attack

HOW LNDIP TRIO TABLET WORKS

LNDIP TRIO TABLET effectively reduces the blood pressure where Chlorthalidone acts by enhancing the excretion of sodium (which is necessary for constriction of blood vessels) and water from the body causing blood vessels to relax and Cilnidipine makes the blood vessels relax and thus lowers the blood pressure by blocking the calcium entry in blood vessels which is necessary for the smooth muscle contraction. Telmisartan acts by blocking the effects of Angiotensin II (a substance produced in your body which causes the narrowing of blood vessels).

DIRECTIONS FOR USE

Take LNDIP TRIO TABLET as advised by your physician. Swallow this medicine, do not crush or chew the medicine. The correct dosage and duration of medicine to be taken will be prescribed by your doctor depending on your age, body weight and disease condition.

SIDE EFFECTS OF LNDIP TRIO TABLET

HOW TO MANAGE SIDE EFFECTS

Vomiting:

Take this medicine with or just after meals. Stick to simple meals. Avoid eating oil-rich or spicy foods, sugary snacks and drinks. Avoid drinking too much liquid along with your meals, drink slowly in between meals. Consult your doctor if your symptom does not improve.

Diarrhea:

Drink lots of fluids, such as water or fruit juice to keep yourself hydrated. Do not consume any medicine on your own without consulting your doctor.

Stomach pain:

Try to rest and relax. Try to have smaller and more frequent meals. Keep a heating pad on your stomach. If the symptom does not improve, contact your doctor.

Dizziness:

When you feel dizzy, lie or sit down immediately. if you're experiencing a severe episode of vertigo, lie in a dark and quiet place with your eyes closed. Vehicle driving should be avoided if you experience frequent dizziness without warning. Talk to your doctor if the symptom worsens.

Skin rash:

Try to avoid hot showers because they may cause skin irritation. Avoid frequent contact and rubbing over the affected area. Use sunscreen and protective clothing when outdoors. If this symptom does not get better, speak to a doctor.

WARNING & PRECAUTIONS

INTERACTIONS

A. Drug-Drug interactions:

• digoxin (a medicine used to treat heart failure and abnormal heart rhythm)
• cimetidine (a medicine used for stomach ulcers)
• rifampicin (a medicine used to treat tuberculosis)
• itraconazole, miconazole (medicines used to treat fungal infections)
• angiotensin-converting enzyme inhibitors used to treat high blood pressure (Ex. enalapril, lisinopril, ramipril)
• aliskiren (a medicine used to treat high blood pressure)
• medicines containing lithium (used to treat some types of depression)
• medicines that may increase blood potassium levels such as salt substitutes containing potassium, potassium-sparing diuretics (Ex. amiloride, spironolactone)
• non-steroidal anti-inflammatory drugs - medicines used to treat pain and inflammation (Ex. aspirin, ibuprofen)
• heparin (a medicine used to prevent blood clots)
• immunosuppressive agents such as ciclosporin or tacrolimus (used to prevent organ rejection after transplant)
• antibiotic trimethoprim (a medicine used to treat and prevent urinary tract infections)
• diuretics such as furosemide, hydrochlorothiazide (used to treat oedema or high blood pressure)
• corticosteroids such as dexamethasone, hydrocortisone which are involved in stress, immune response
• baclofen (a medicine used for muscle spasms)
• amifostine (a medicine used in cancer chemotherapy)
• barbiturates (medicine that acts as a central nervous system depressant) such as phenobarbital, pentobarbital
• antidepressants such as citalopram, fluoxetine and paroxetine (a medicine used to treat depression)
• narcotics such as morphine and codeine (a medicine used to treat moderate to severe pain)

B. Drug - Food interaction:

Avoid drinking grapefruit juice while taking LNDIP TRIO TABLET as it may increase the levels of this medication in the body.

Overdosage:

If you or anyone else accidentally take too much of LNDIP TRIO TABLET, consult your doctor immediately or visit the nearby hospital as it may increase the risk of side effects. Signs and symptoms of overdosage include low blood pressure, dizziness, nausea, sleepiness, elevated creatinine levels, sudden kidney failure, electrolyte disturbances associated with cardiac arrhythmias (irregular heartbeat) and muscle stiffness.

SYNOPSIS

MORE INFORMATION

• Keep LNDIP TRIO TABLET out of reach from children
• Store at a temperature not exceeding 30°C

FAQs ABOUT LNDIP TRIO TABLET

What is LNDIP TRIO TABLET and why is it given?

LNDIP TRIO TABLET is used to treat essential hypertension (blood pressure not caused by any other condition called essential hypertension) in adults.

Is LNDIP TRIO TABLET safe for pregnant women?

LNDIP TRIO 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.

Can LNDIP TRIO TABLET cause anxiety?

Yes. LNDIP TRIO TABLET may make you feel anxious. However, it does not affect every individual. Try to rest and relax. Meditation and breathing exercises can work. If your symptom worsens, please consult your doctor.

Can LNDIP TRIO TABLET be given to children?

LNDIP TRIO TABLET is not recommended for use in children and adolescents (under 18 years of age). Consult your doctor before taking this medicine.

What precautions do I need to follow while taking LNDIP TRIO TABLET?

Patients taking LNDIP TRIO TABLET must inform their doctor about their pre-existing disease conditions like kidney, heart or liver problems. Consult your doctor immediately if you experience any unusual symptoms after taking LNDIP TRIO TABLET.

REFERENCES

1. KD Tripathi. Diuretics, Drugs Affecting Renin Angiotensin System. Essentials of medical pharmacology. Eighth edition. 2019. Page – 630-632, 535-538.

2. Connor C. Kerndt; Jayesh B. Patel. Chlorthalidone. National Library of Medicine, National center for biotechnology information. Revised in May 2022. [Accessed 8th May 2022] https://www.ncbi.nlm.nih.gov/books/NBK553174/#:~:text=Mechanism%20of%20Action,-Chlorthalidone%20exerts%20its&text=Chlorthalidone%20inhibits%20sodium%20reabsorption%20at,retains%20a%20higher%20sodium%20content.

3. A Prem Kumar, Anirudra Ghorai, Vasudev Kriplani, Rabindra Kumar Dash, J Aravinda, Paramesh Shamanna, TK Sabeer, Abdul Hannan and Santosh Revankar. Clinical data analysis of telmisartan for hypertension management in Indian population. NIH National Library of Medicine, National center for biotechnology information. PubMed Central June 2021. [Accessed 17th June 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8819792/

4. Prabhakar Adake, H.S. Somashekar, P. K. Mohammed Rafeeq, Dilshad Umar, Bahija Basheer and Kusai Baroudi. Comparison of amlodipine with cilnidipine on antihypertensive efficacy and incidence of pedal edema in mild to moderate hypertensive individuals: A prospective study. NIH National Library of Medicine, National center for biotechnology information. PubMed Central June 2015. [Accessed 17th June 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4397623/

5. J. B. Chemicals & pharmaceuticals ltd. [Revised in November 2021] [Accessed 8th May 2022] https://jbpharma.com/wp-content/uploads/2021/11/CILACAR-C-12.5_PI_India_November-2021.pdf

6. Accord Healthcare Ireland Limited. Health Products Regulatory Authority (HPRA). [Revised in July 2021] [Accessed 9h May 2022] http://www.hpra.ie/img/uploaded/swedocuments/8c0fc811-cf88-4bd5-818e-609e07fe1190.pdf

7. Hetero Labs Limited. U.S. Food & Drug Administration. [Revised in August 2015] [Accessed 9th May 202] https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/205901Orig1s000lbl.pdf

USEFUL DIAGNOSTIC TESTS

• Kidney function test
• Serum electrolyte test