Telmisartan 40 Mg + Cilnidipine 10 Mg + Metoprolol Succinate (er) 23.75 Mg

It is typically taken orally once daily with food Swallow the tablet or extended-release tablet whole with a full glass of water. Do not crush, break, or chew it.

Store the medication at room temperature, away from moisture and heat. Keep it out of reach of children.

"Common side effects : Dizziness or lightheadedness, Fatigue or weakness, Headache, Edema (fluid retention), Hypotension (low blood pressure), Bradycardia (slow heart rate), Gastrointestinal disturbances such as nausea or diarrea.

Evidence and/or expert consensus has demonstrated harmful infant effects when used during breastfeeding. Avoid use of this drug during pregnancy and prescribe an alternative. Evidence has demonstrated fetal abnormalities or risks when used during pregnancy.

This medication combination should be used with caution in patients with impaired liver or kidney function. Patients should be monitored regularly for signs of hypotension, especially when initiating therapy or adjusting the dosage. Abrupt discontinuation of beta-blockers like metoprolol may exacerbate angina or precipitate myocardial infarction, so dosage should be gradually tapered if discontinuation is necessary. Metoprolol may cause changes in blood sugar levels. Also, this medicine may cover up the symptoms of low blood sugar (including fast heartbeat) and increase the risk for serious or prolonged hypoglycemia (low blood sugar). Check with your doctor if you notice a change in your normal symptoms. Dizziness, lightheadedness, or even fainting may occur when you get up suddenly from a lying or sitting position. Getting up slowly may help lessen this problem. Also, lying down for a while may relieve the dizziness or lightheadedness.

Product Information: MICARDIS(R) oral tablets, telmisartan oral tablets. Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, CT, 2009 Product Information: Telmisartan. Boehringer Ingelheim, US, 98. Product Information: Lopressor(R) oral tablets, metoprolol tartrate oral tablets. Validus Pharmaceuticals, LLC (per FDA), Parsippany, NJ, 2013. https://www.centaurpharma.com/downloads/CENTAPRES.pdf https://hypertension.ca/

Telmisartan: Telmisartan is an angiotensin II receptor blocker (ARB) that selectively blocks the binding of angiotensin II to its receptors, leading to vasodilation and lowering of blood pressure. Cilnidipine: Cilnidipine is a calcium channel blocker (CCB) with dual blocking activity on L-type and N-type calcium channels, resulting in vasodilation and reduction of blood pressure. Metoprolol Succinate: Metoprolol is a beta-blocker that competitively blocks beta-adrenergic receptors, thereby reducing heart rate, cardiac output, and blood pressure.

Cardiovascular Agent