Nioben (Telmisartan, Amlodipine Besilate)

Telmisartan and Amlodipine Besilate, the active ingredients in Nioben, are an angiotensin II receptor blocker and a calcium channel blocker presented as oral tablets for adult use. They treat hypertension in patients requiring combined blood pressure control.

GNH USA supplies Nioben as a licensed, GDP-compliant international pharmaceutical supplier serving hospitals, pharmacies and clinics worldwide.

Nioben combines telmisartan and amlodipine besilate to manage hypertension, a condition involving elevated arterial pressure.

- Essential hypertension: lowers blood pressure in patients with primary hypertension. - Stage 2 hypertension: provides additional BP reduction when single‑agent therapy is inadequate. - Hypertension with cardiovascular risk factors: helps achieve target BP in patients who also have diabetes or dyslipidemia.

Common Side Effects: - Dizziness: sensation of light‑headedness, especially after standing. - Headache: mild to moderate pain often reported during initiation. - Peripheral edema: swelling of ankles or feet due to fluid accumulation. - Flushing: transient warmth and redness of the skin. - Fatigue: feeling unusually tired or weak. - Palpitations: awareness of heartbeats.

Serious or Rare Side Effects: - Angioedema: rapid swelling of face, lips, tongue, or throat requiring emergency care. - Severe hypotension: markedly low blood pressure causing fainting or shock. - Hepatic dysfunction: abnormal liver enzymes or jaundice. - Myocardial infarction: chest pain indicative of a heart attack. - Arrhythmia: irregular heart rhythm that may be life‑threatening. - Severe allergic reaction: rash, itching, or difficulty breathing.

Before initiating therapy, consider the following precautions: - Renal impairment: monitor kidney function and serum creatinine. - Hepatic impairment: use with caution; assess liver enzymes periodically. - Electrolyte imbalance: check potassium levels, especially if used with diuretics. - Pregnancy: avoid unless clearly necessary, as safety data are limited. - Concomitant strong CYP3A4 inhibitors: may increase amlodipine exposure, requiring dose review. - Store at ambient temperature: keep in the original pack, protect from moisture and direct sunlight.

Nioben may interact with several medicines; review the following categories:

Major Interactions (Avoid): - Potassium‑sparing diuretics: increased risk of hyperkalemia. - ACE inhibitors or other ARBs: additive renal effects and possible hypotension. - Strong CYP3A4 inhibitors (e.g., clarithromycin, itraconazole): elevate amlodipine plasma levels.

Moderate Interactions (Monitor Closely): - NSAIDs: may blunt antihypertensive response. - Thiazide diuretics: enhanced hypotensive effect. - Lithium: potential increase in lithium concentrations. - Beta‑blockers: additive blood pressure lowering; monitor heart rate.