The Medical Letter on Drugs and Therapeutics
A Third Amlodipine/ARB Combination (Twynsta) for Hypertension
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The FDA has approved Twynsta (Boehringer Ingelheim), a fixed-dose combination of the calcium-channel blocker (CCB) amlodipine and the angiotensin receptor blocker (ARB) telmisartan, for treatment of hypertension.1

CALCIUM-CHANNEL BLOCKERS — CCBs cause vasodilation, which decreases peripheral resistance and lowers blood pressure (BP). In black patients, they are more effective as monotherapy than angiotensin-converting enzyme (ACE) inhibitors or ARBs. Dizziness, headache and peripheral edema are their most frequent adverse effects.

ANGIOTENSIN RECEPTOR BLOCKERS — ARBs are probably the best tolerated antihypertensive drugs.They are less likely to cause the cough associated with ACE inhibitors. Whether they provide the same cardiac protection as ACE inhibitors is unclear. Some patients who have had angioedema with an ACE inhibitor have also developed it with an ARB. All ... more      

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Title: A Third Amlodipine ARB Combination (Twynsta) for Hypertension
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