Telmisartan-AmlodipineSkip to the navigation
Common brand names:Twynsta
Summary of Interactions with Vitamins, Herbs, & Foods
Replenish Depleted Nutrients
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Potential Negative Interaction
Angiotensin receptor blocker drugs such as telmisartan have caused significant increases in blood potassium levels.1 Potassium supplements, potassium-containing salt substitutes (No Salt, Morton Salt Substitute, and others), and even high-potassium foods (including Noni juice) should be avoided by those taking telmisartan, unless directed otherwise by their doctor.
Amlodipine has been shown to raise blood levels of DHEA-sulfate in insulin-resistant, obese men with high blood pressure.3
Ingestion of grapefruit juice has been shown to increase the absorption of felodipine (a drug similar in structure and action to that of amlodipine) and to increase the adverse effects of the medication in patients with hypertension. Until more is known, it seems that grapefruit juice should not be ingested by people taking amlodipine or similar drugs.4 The same effects might be seen from eating grapefruit as from drinking its juice.
As pleurisy root and other plants in the Aesclepius genus contain cardiac glycosides, it is best to avoid use of pleurisy root with heart medications such as calcium channel blockers.5The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Pomegranate juice has been shown to inhibit the same enzyme that is inhibited by grapefruit juice.6 , 7 The degree of inhibition is about the same for each of these juices. Therefore, it would be reasonable to expect that pomegranate juice might interact with amlodipine in the same way that grapefruit juice does.The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
1. Park IW, Sheen SS, Yoon D, et al et al. Onset time of hyperkalaemia after angiotensin receptor blocker initiation: when should we start serum potassium monitoring? J Clin Pharm Ther 2014;39:61–8
2. Park IW, Sheen SS, Yoon D, et al et al. Onset time of hyperkalaemia after angiotensin receptor blocker initiation: when should we start serum potassium monitoring? J Clin Pharm Ther 2014;39:61–8
3. Beer NA, Jakubowicz DJ, Beer RM, Nestler JE. The calcium channel blocker amlodipine raises serum dehydroepiandrosterone sulfate and androstenedione, but lowers serum cortisol, in insulin-resistant obese and hypertensive men. J Clin Endocrinol Metab 1993;76:1464-9.
4. Bailey DG, Arnold MO, Strong HA, Munoz C, Spence JD, et al. Effect of grapefruit juice and naringin on nisoldipine pharmacokinetics. Clin Pharmacol Ther 1993;54:589-94.
5. Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-Care Professionals. London: Pharmaceutical Press, 1996, 213-4.
6. Sorokin AV, Duncan B, Panetta R, Thompson PD. Rhabdomyolysis associated with pomegranate juice consumption. Am J Cardiol 2006;98:705-6.
7. Summers KM. Potential drug-food interactions with pomegranate juice. Ann Pharmacother 2006;40:1472-3.
Last Review: 04-29-2014
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