CILIDIN-T
Composition Cilnidipine 10mg And Telmisartan 40mg tablets
Indication Uncontrolled Hypertension
Mechanism of Action

Cilnidipine is a dihydropyridine calcium-channel blocker. It inhibits cellular influx of calcium, thus causing vasodilatation. It has greater selectivity for vascular smooth muscle. It has little or no action at the SA or AV nodes and -ve inotropic activity is rarely seen at therapeutic doses.

Telmisartan : is a nonpeptide AT1 angiotensin II receptor antagonist. It exerts antihypertensive activity by preventing angiotensin II from binding to AT1 receptors thus inhibiting the vasoconstricting and aldosterone-secreting effects of angiotensin II.

Pharmacokinetic's

Rapid absorption. Cmax within 2 h. Highest level in the liver and also distribution in the kidneys, plasma, and other tissues. No tissue showed a particularly high accumulation of the drug following repeated oral administrations. Protein binding 98% The percentage urinary excretion of Cilnidipine following an oral dose is about 36%

Telmisartan : Onset: 1-2 hr.

Duration: Up to 24 hr.

Absorption: Rapidly absorbed from the GI tract. Food may slightly decrease the bioavailability. Absolute bioavailability: Dose-dependent (approx 42% after 40-mg dose; 58% after 160-mg dose). Time to peak plasma concentration: Approx 0.5-1 hr.

Distribution: Volume of distribution: 500 L. Plasma protein binding: >99%.

Metabolism: Undergoes conjugation w/ glucuronic acid to form inactive metabolites.

Excretion: Via faeces (97%, as unchanged drug). Terminal elimination half-life: Approx 24 hr.

Side effects

Dizziness; flushing; headache; hypotension; peripheral oedema; tachycardia; palpitations; GI disturbances; increased micturition frequency; lethargy; eye pain; depression; ischaemic chest pain; cerebral or myocardial ischaemia; transient blindness; rashes; fever; abnormal liver function; gingival hyperplasia; myalgia; tremor; impotence.

Telmisartan : Dizziness, fatigue, headache, sinusitis, upper resp tract infection, pharyngitis, UTI, back pain, myalgia, diarrhoea, abdominal pain, dyspepsia, nausea.

Potentially Fatal: Intermittent claudication and skin ulcer.

Precaution

Cilnidipine:

Hypotension, poor cardiac reserve, heart failure. Sudden withdrawal may exacerbate angina. Discontinue in patients who experience ischemic pain following administration. Pregnancy, lactation.

Telmisartan :Volume- or salt-depleted patients including patients on prolonged diuretic therapy. Patients w/ renal artery stenosis, aortic or mitral stenosis, obstructive biliary disease. Renal and mild to moderate hepatic impairment. Lactation. Monitoring Parameters Monitor BP, electrolytes and serum creatinine levels.

Dosage

Cilnidipine:

Hypertension

Adult: 5-10 mg once daily, increase to 20 mg once daily if necessary.

Telmisartan :Adult: PO HTN Initial: 40 mg once daily, may be adjusted to 20-80 mg once daily. CV risk reduction 80 mg once daily.