Amlodipine / Indapamide / Telmisartan

Amlodipine, indapamide, and telmisartan are three blood pressure medicines combined into a single tablet. Here is what the combination is approved for:

• Widaplik (telmisartan/amlodipine/indapamide) is indicated for the treatment of high blood pressure (hypertension) in adults
• Widaplik may be used as initial therapy — meaning right from the start — in adults who are expected to need more than one drug to reach their blood pressure goal
• Lowering blood pressure with Widaplik reduces the risk of fatal and nonfatal cardiovascular events, primarily stroke and heart attack

Widaplik's three ingredients each target a different mechanism that drives high blood pressure. Telmisartan (an ARB — angiotensin II receptor blocker) blocks a hormone called angiotensin II that causes blood vessels to tighten, so blood vessels stay relaxed and pressure falls. Amlodipine (a calcium channel blocker) stops calcium from entering the muscle cells of blood vessel walls, which keeps them from contracting — widening the vessels further. Indapamide (a thiazide-like diuretic) tells the kidneys to excrete more sodium and water, reducing blood volume and taking pressure off the vessel walls. Because all three work at different sites and through different pathways, they complement each other for a stronger, more sustained effect than any one alone could provide.

Widaplik tablets are taken by mouth once daily, with or without food. The tablets must be swallowed whole — do not cut, crush, or chew them. Dosage is started at a lower strength and may be increased after 2 weeks if blood pressure is not yet at goal. Older adults (65 and older) are generally started on the lowest available strength. Always follow your prescriber's specific instructions; do not adjust your dose on your own.

• Take at the same time each day to keep levels steady
• Food does not significantly affect the overall amount of medicine absorbed
• If you miss a dose, take it as soon as you remember — unless it's almost time for your next dose, in which case skip the missed one

The most commonly reported side effect with Widaplik is a drop in blood pressure that you can feel. Other effects to be aware of include:

• Symptomatic hypotension (dizziness, lightheadedness from low blood pressure)
• Low sodium levels (hyponatremia) — may cause fatigue, confusion, or muscle weakness
• Low potassium levels (hypokalemia) — may cause muscle cramps or weakness
• Headache
• Peripheral edema (swelling in legs or ankles)

More serious reactions — including a sudden drop in blood pressure, kidney problems, significant changes in electrolytes, eye pain with vision changes, or worsening chest pain — require prompt medical attention. Stop Widaplik and call your doctor immediately if you become pregnant.

• Fetal toxicity (the most critical warning): Widaplik can cause serious injury or death to an unborn baby. Stop taking it as soon as pregnancy is detected and contact your prescriber immediately.
• Low blood pressure (hypotension): Risk is higher if you are dehydrated, have low sodium, or have significant narrowing in the heart's arteries. Worsening chest pain or a heart attack can occur, especially when starting the drug or increasing the dose.
• Electrolyte imbalances: The diuretic component can lower sodium, potassium, and magnesium, and can raise blood sugar — while the telmisartan component can raise potassium. Regular lab monitoring is important.
• Kidney function: This medicine can reduce kidney function, especially in people with heart failure or existing kidney disease. Kidney tests should be monitored regularly.
• Acute angle-closure glaucoma (sudden eye pressure rise): Rare but serious — seek urgent eye care if you develop sudden eye pain or rapid vision changes, especially within the first few weeks of starting Widaplik.
• Gout: The diuretic component can raise uric acid levels, potentially triggering gout attacks.
• Liver disease: All three ingredients are cleared by the liver; start at the lowest dose and monitor carefully. Diuretics can also provoke hepatic coma in people with severe liver problems.

Widaplik can interact with several common medicines and substances — always tell your prescriber and pharmacist everything you take:

• Aliskiren: Must not be combined in people with diabetes; should be avoided in those with kidney disease — risk of serious kidney problems, low blood pressure, and dangerous potassium levels
• NSAIDs (ibuprofen, naproxen, etc.): Can blunt the blood pressure-lowering effect and increase kidney risk
• Other RAAS inhibitors (ACE inhibitors, other ARBs): Combining rarely adds benefit and increases risks of kidney damage, high potassium, and low blood pressure
• Simvastatin: Amlodipine can raise simvastatin blood levels; the simvastatin dose should not exceed 20 mg daily when taken with Widaplik
• Sildenafil: Both lower blood pressure independently, which can cause an additive drop
• Potassium-raising agents (potassium supplements, potassium-sparing diuretics, potassium-containing salt substitutes): Can push potassium to dangerous levels when combined with telmisartan
• Cholestyramine or colestipol (cholesterol-lowering resins): May reduce absorption of the diuretic component
• Lithium: Diuretics and ARBs can raise lithium levels, increasing the risk of lithium toxicity

Not a complete list. The label covers the interactions the manufacturer studied or reported, and our own interaction database does not cover every medicine either. Bring your full medication list, including vitamins and herbal products, to your pharmacist.

• Pregnancy: Do not take Widaplik if you are pregnant or planning to become pregnant — it can cause serious fetal harm or death
• Breastfeeding: Breastfeeding is not recommended while taking Widaplik due to the potential for serious harm to the infant
• Allergy: Do not take if you are allergic to telmisartan, amlodipine, indapamide, sulfonamide-type drugs, or any ingredient in the tablet
• No urine output (anuria): Do not take Widaplik if your kidneys are producing no urine
• Diabetes: Widaplik cannot be combined with aliskiren; blood sugar may also be affected by the diuretic component — monitor closely
• Kidney disease: Use with caution; kidney function should be monitored regularly
• Liver disease: Start at the lowest dose and titrate slowly; severe liver disease can increase drug exposure significantly
• Older adults (65+): Start at the lowest dose — elderly people (especially women) are at higher risk for low sodium and low potassium; amlodipine is also cleared more slowly in older patients
• Children: Safety and effectiveness of Widaplik in patients under 18 have not been established
• Dehydration or low salt: Correct any fluid or salt imbalances before starting Widaplik to reduce the risk of low blood pressure

Taking too much Widaplik is most likely to cause a significant drop in blood pressure, dizziness, and a rapid heartbeat — and in severe cases, shock. Too much of the diuretic component can also cause nausea, vomiting, and dangerous shifts in electrolytes. If an overdose is suspected, seek emergency medical care immediately. Neither telmisartan nor amlodipine is effectively removed by hemodialysis (dialysis).

All three components of Widaplik lower blood pressure by reducing resistance in the blood vessels, but each does so through a different mechanism. Telmisartan significantly blunts the blood vessel-tightening effect of angiotensin II throughout the day with a single dose. Amlodipine produces gradual, sustained widening of peripheral arteries without significantly changing heart rate, and its effect persists for at least 24 hours with once-daily dosing. Indapamide reduces blood volume by promoting sodium and water excretion and may also have a direct vessel-widening effect. Together, they produce complementary reductions in blood pressure without the metabolic disruptions (such as changes in cholesterol, triglycerides, or blood glucose) sometimes seen with other antihypertensive classes.

After a single oral dose of Widaplik, telmisartan reaches peak blood levels in roughly 1–2 hours, amlodipine peaks around 7–8 hours, and indapamide peaks within about 1 hour. Food does not meaningfully affect overall absorption of any component, though it slightly slows the rate of absorption. Telmisartan is eliminated almost entirely unchanged through bile into the stool, while amlodipine is extensively broken down by the liver with metabolites excreted mainly in urine — it has a long half-life of 30 to 50 hours, so it takes about 7–8 days to reach stable blood levels. Indapamide is also heavily metabolized, with a whole-blood half-life of about 14 hours. In people with liver disease, drug levels of all three components can be meaningfully higher, which is why lower starting doses are recommended.

Store at 20°C to 25°C (68°F to 77°F); excursions permitted between 15°C and 30°C (59°F and 86°F) . Protect from moisture and light. Store and dispense the product in the original container.