AMTEL 5/40MG TABS 30S

Amtel 40/5mg is a fixed-dose combination antihypertensive containing telmisartan 40 mg and amlodipine 5 mg. This lower-strength combination is typically the preferred starting point when stepping up from monotherapy, or as the initial fixed-dose combination in patients with moderate hypertension.

Telmisartan provides 24-hour blood pressure control with once-daily dosing due to its exceptionally long half-life (~24 hours). It also confers additional organ-protective benefits in patients with diabetes and CKD by reducing proteinuria and slowing renal disease progression. Amlodipine at 5 mg provides meaningful vasodilation with a lower incidence of ankle oedema compared to the 10 mg dose.

Together, the complementary mechanisms produce synergistic blood pressure reduction while minimising dose-dependent side effects. This formulation is widely used across Kenya's public and private healthcare facilities for patients requiring dual antihypertensive therapy.

Approved Indications

•       Mild to moderate hypertension not controlled by monotherapy

•       Hypertension in patients with type 2 diabetes mellitus

•       Hypertension with CKD and proteinuria

•       Hypertension with stable coronary artery disease

•       First-step fixed-dose combination therapy in high-cardiovascular-risk hypertensive patients

•       Substitution therapy for patients stable on separate telmisartan 80 mg and amlodipine 5 mg

General Instructions

Take one tablet once daily, with or without food, at the same time each day. Swallow whole with water. Avoid grapefruit juice.

Dosage, Adults

One tablet (Telmisartan 40 mg + Amlodipine 5 mg) once daily. If blood pressure remains uncontrolled, the prescriber may switch to Amtel 80/10mg or 80/5mg.

Elderly Patients

No dose adjustment required for elderly patients, but initiate with caution and monitor for hypotension. 

Missed Dose

Take the missed dose on the same day as soon as remembered. Skip if the next day; never double dose.

Duration of Treatment

Long-term, usually lifelong treatment. Do not discontinue without medical advice.

Common Side Effects

•       Peripheral oedema (ankle swelling), less frequent than with 10 mg amlodipine

•       Dizziness and lightheadedness

•       Headache

•       Flushing (warm sensation in face/chest)

•       Fatigue

Less Common Side Effects

•       Nasopharyngitis (runny nose, sore throat)

•       Nausea and abdominal discomfort

•       Back pain

•       Hyperkalaemia in high-risk patients (diabetes, CKD)

•       Palpitations

Serious / Seek Immediate Medical Attention

•       Angioedema (face/lip/throat swelling), rare but life-threatening; stop medicine and seek emergency care immediately

•       Severe hypotension, especially in volume-depleted patients

•       Acute kidney injury in patients with renovascular disease

•       Identical precautions apply as for Amtel 80/10mg, but the 5 mg amlodipine component carries a lower risk of ankle oedema and flushing.

•       Confirm renal function and electrolytes before initiation in at-risk patients.

•       Volume depletion (e.g., from diuretic use or poor fluid intake) increases first-dose hypotension risk.

•       Telmisartan is not recommended during breastfeeding.

•       Caution in patients with obstructive biliary disorders or hepatic impairment; telmisartan undergoes hepatic elimination.

•       Avoid dual RAAS blockade with ACE inhibitors or aliskiren.

Always inform your pharmacist and prescriber about all medicines, supplements, and herbal remedies you are currently taking.

ACE inhibitors: Dual RAAS blockade, not recommended; increased risk of hypotension, hyperkalaemia, renal failure

Aliskiren: Contraindicated in diabetics and CKD patients

NSAIDs: Blunts antihypertensive effect; risk of renal impairment

Potassium-sparing diuretics/supplements: Hyperkalaemia risk

CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin): Increased amlodipine exposure

Simvastatin > 20 mg: Amlodipine inhibits simvastatin metabolism, keep simvastatin ≤ 20 mg/day

Grapefruit juice: Raises amlodipine levels, avoid

Lithium: Telmisartan may alter lithium levels, monitor

Store below 30°C in a cool, dry place away from direct sunlight. Keep in the original packaging until use. Keep out of reach of children. Do not use after the expiry date.

Prescription Only Medicine (POM) in Kenya. Pharmily dispenses on a valid prescription only.

Amtel 80/5mg is the preferred initial fixed-dose combination when a patient has failed monotherapy with either telmisartan or amlodipine. The 5 mg amlodipine dose is better tolerated (lower oedema incidence ~5–8%) than the 10 mg dose (~18–20%), making it the rational starting point.

Counsel patients that the ARB component (telmisartan) may cause a small rise in serum potassium; this is generally inconsequential in patients with normal renal function but warrants monitoring in those with CKD or diabetes.

Remind patients that blood pressure-lowering medicines do not cure hypertension; they control it. Regular follow-up monitoring (BP, U&E, creatinine) at 1-, 3-, and 6-months post-initiation is standard of care in Kenya.

Can I take Amtel 80/5mg if I have kidney disease?

A: Telmisartan is actually beneficial in hypertensive patients with CKD and diabetes, as it slows kidney damage. However, renal function and potassium must be monitored closely. In severe kidney disease (eGFR < 30 mL/min), use with caution under specialist supervision.

Is it safe to take Amtel 80/5mg with my diabetes medication?

A: Yes, generally. Telmisartan may slightly improve insulin sensitivity. However, monitor potassium levels, as both diabetes and ARBs can elevate them. Inform your doctor about all medicines, including insulin and oral hypoglycaemics.

Why does my doctor want me to take blood pressure medicine if I feel fine?

A: High blood pressure is called a "silent killer" because it causes no symptoms until it damages organs (heart, kidneys, brain, eyes). Taking your medicine consistently protects these organs even when you feel well.

Can I drink alcohol while taking Amtel 80/5mg?

A: Alcohol can lower blood pressure and increase the dizziness and lightheadedness caused by Amtel. Limit alcohol consumption and avoid drinking on an empty stomach.