Twinmax Tablets 40/5 Milligrams

Adult dose

The recommended dose of this medication is one tablet once daily, taken with water and irrespective of meals. It is advisable to take it at the same time each day (e.g., in the morning). For patients with renal impairment: No dosage adjustment is required for mild to moderate renal impairment; however, those with severe renal impairment should start with a lower dose and gradually increase. For patients with liver impairment: The daily dose of telmisartan for patients with mild or moderate liver impairment should not exceed 40 milligrams.

Child dose

The safety and efficacy of this medication in pediatric patients under 18 years have not been established, therefore its use is not recommended.

This medication can pose serious risks to the fetus during pregnancy, especially in the second and third trimesters, and should not be taken by women who are pregnant or might become pregnant. This medication should not be administered to patients with specific conditions, such as liver impairment, obstructive biliary disease, severe hypotension, serious heart conditions, diabetes, or moderate to severe kidney impairment. Patients with primary aldosteronism, aortic stenosis, hypertrophic obstructive cardiomyopathy, impaired liver function, gastrointestinal disease, renal artery hypertension, etc. should use this medication with caution, especially elderly patients or those with renal failure requiring dialysis. Common side effects such as dizziness or peripheral edema may occur while taking this medication, and serious side effects have been reported less frequently; hence, any unusual symptoms should be reported to a medical professional immediately. Taking this medication during pregnancy can lead to severe issues such as decreased fetal kidney function, reduction in amniotic fluid, and delayed skull ossification, thus it should be stopped immediately and alternative treatment should be initiated upon confirmation of pregnancy. It is also recommended that women who are breastfeeding do not take this medication and must consult a healthcare professional if they are nursing. The safety and efficacy of this medication have not been sufficiently established in children under 18 years, so it is not recommended for use in this population. Exceeding the prescribed dosage can result in hypotension, dizziness, and changes in heart rate; therefore, adhering to the recommended dosage is important, and any unusual symptoms should prompt an immediate visit to a medical facility. This medication may interact with other drugs, so it's essential to inform healthcare professionals regarding any other medications being taken, particularly potassium supplements, diuretics, lithium, digoxin, and grapefruit juice. Dizziness or drowsiness may occur when driving or operating machinery, so caution is advised. Store this medication out of reach of children, and it's important to keep it sealed after opening to maintain product quality.

Serious side effects

• Urticaria, severe swelling (angioedema), chest tightness, difficulty in breathing, cold sweat, pallor → severe allergic reaction
• Sepsis
• Hypersensitivity, anaphylactic reaction
• Angioedema (including fatal outcomes), toxic skin rash, drug rash, urticaria
• Angioedema, erythema multiforme, urticaria, exfoliative dermatitis, Stevens-Johnson syndrome, photosensitivity reaction
• Hepatitis, jaundice, increased liver enzymes
• Shortness of breath or difficulty breathing, asthma attack, cough with fever

Mild side effects

Dizziness, peripheral edema, fainting, drowsiness, headache, sensory disturbance, visual impairment, vertigo, tinnitus, palpitations, hypotension, orthostatic hypotension, cough, changes in bowel habits (including diarrhea and constipation), abdominal pain, dyspepsia, nausea, vomiting, dry mouth, itching, sweating, rash, hair loss, purpura, skin discoloration, eczema, erythema, joint swelling, muscle cramps, arthralgia, myalgia, low back pain, limb pain, erectile dysfunction, asthenia, fatigue, chest pain

This medication is sensitive to light and should be stored in a container that protects it from light. Additionally, it should be kept at room temperature, between 1 to 30 degrees Celsius, to preserve its effectiveness.

Appearance

White and light gray, double convex oval-shaped tablet

Package unit

30 tablets (10 tablets/PTP × 3)