Twincal

Twincal Uses, Dosage, Side Effects, Food Interaction and all others data.

Twincal acts on the L-type calcium channels of blood vessels by blocking the incoming calcium and suppressing the contraction of blood vessels, thereby reducing blood pressure. Twincal also works on the N-type calcium channel located at the end of the sympathetic nerve, inhibiting the emission of norepinephrine and suppressing the increase in stress blood pressure.

Administration of cilnidipine has been shown to present an antisympathetic profile in vitro and in vivo. It decreases blood pressure safely and effectively without excessive blood pressure reduction or tachycardia.

Trade Name Twincal
Generic Cilnidipine
Cilnidipine Other Names Cilnidipine
Type Tablet
Formula C27H28N2O7
Weight Average: 492.528
Monoisotopic: 492.18965125
Protein binding

Cilnidipine presents a very high protein binding that represents to even 98% of the administered dose.

Groups Investigational
Therapeutic Class Calcium-channel blockers
Manufacturer Zydus Cadila Healthcare Ltd
Available Country India
Last Updated: September 19, 2023 at 7:00 am
Twincal
Twincal

Uses

Twincal is used for the management of hypertension for end-organ protection. It is reported to be useful in elderly patients and in those with diabetes and albuminuria. Twincal has been increasingly used in patients with chronic kidney disease.

Hypertension is the term used to describe the presence of high blood pressure. The blood pressure is generated by the force of the blood pumped from the heart against the blood vessels. Thus hypertension is caused when there is too much pressure on the blood vessels and this effect can damage the blood vessel

Twincal is also used to associated treatment for these conditions: High Blood Pressure (Hypertension)

How Twincal works

Twincal acts on the L-type calcium channels of blood vessels by blocking the incoming calcium and suppressing the contraction of blood vessels, thereby reducing blood pressure. Twincal also works on the N-type calcium channel located at the end of the sympathetic nerve, inhibiting the emission of norepinephrine and suppressing the increase in stress blood pressure.

Dosage

Twincal dosage

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

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.

Toxicity

The percentage of reports of cilnidipine that express drug toxicity reported as side effects are 5.26%.

Precaution

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

Interaction

Other antihypertensives; aldesleukin; antipsychotics that cause hypotension; may modify insulin and glucose responses; quinidine; carbamazepine; phenytoin; rifampicin; cimetidine; erythromycin.

Volume of Distribution

Drugs on the group of dihydropyridines such as cilnidipine tend to have a large volume of distribution.

Elimination Route

Twincal presents a very rapid absorption with a maximum peaked concentration after 2 hours. Its distribution tends to be higher in the liver as well as in kidneys, plasma and other tissues. Twincal does not present a high accumulation in the tissue after repeated oral administration.

Twincal is reported to present very low bioavailability determined to be approximately 13%. This low bioavailability is suggested to be due to its low aqueous solubility and high permeability. Hence, efforts have been made in order to find an innovative formulation that can significantly improve the bioavailability of this drug. One of these formulations corresponds to the generation of polymeric nanoparticles which enhance the bioavailability by 2.5-3-fold.

Half Life

The half-life of the hypotensive effect for cilnidipine is of about 20.4 min.

Elimination Route

Twincal gets eliminated through the urine in a proportion of 20% of the administered dose and 80% is eliminated by the feces.

Pregnancy & Breastfeeding use

No specific information about USFDA pregnancy category. Caution should be exercised during Twincal use in pregnancy. Nursing mothers should consult a physician before taking Twincal.

Contraindication

Cardiogenic shock; recent MI or acute unstable angina; severe aortic stenosis.

Innovators Monograph

You find simplified version here Twincal

Twincal contains Cilnidipine see full prescribing information from innovator Twincal Monograph, Twincal MSDS, Twincal FDA label

FAQ

What is the use of Twincal?

Twincal used to treat high blood pressure (hypertension). It belongs to a class of medicines known as a calcium channel blocker which helps to lower blood pressure. This helps prevent heart attacks and strokes. It may also be prescribed to prevent angina (heart-related chest pain). Twincal is approved for use in Japan, China, India, Nepal, Korea, and some European countries to treat hypertension.

Is Twincal safe?

It has been reported that once-daily administration of cilnidipine resulted in a safe and more effective BP decrease in essential hypertension without excessive BP reduction or reflex tachycardia than similar administration than once-daily administration of nifedipine (14) or nisoldipine (15).

How does Twincal work?

Twincal work by decreases blood pressure. Due to its blocking action at the N-type and L-type calcium channel, cilnidipine dilates both arterioles and venules, reducing the pressure in the capillary bed.

What are the common side effects of Twincal?

The side effects could be severe dizziness, fast heartbeat, and swelling of face, lips, tongue, eyelids, hands and feet.

Is Twincal safe during pregnancy?

Twincal is not rendered 'safe' for use during pregnancy. Hence, it should not usually be used during pregnancy because other relatively safer alternatives to control blood pressure are available.

Is Twincal safe during breastfeeding?

Twincal passes into breast milk in amounts that are probably too small to be harmful to a nursing infant. It's generally considered safe to breastfeed while taking Twincal. No adverse effects have been reported in breastfed babies.

Can I drink alcohol with Twincal ?

Twincal may cause a decrease in blood pressure so avoid alcohol while using this medicine.

Can I drive after taking Twincal?

Consumption of Twincal may cause dizziness. Avoid activities like driving while on this medication.

When should be taken of Twincal?

Twincal Tablet can be taken anytime of the day. Usually, it is advised to be taken in the morning, but your doctor may advise to take it in the evening as well. You should take it at the same time each day so that you remember to take it and consistent levels of medicine are maintained in the body.

How Twincal should be taken?

Twincal comes in the form of a tablet and to be taken orally either once daily or as directed by the physician.

Can I take Twincal on an empty stomach?

This Twincal can be taken either before or after meals.

How long does Twincal take to work?

Twincal starts to work on the day you start taking it, but it may take a couple of weeks fully take effect. If you're taking nifedipine for high blood pressure, you may not have any symptoms. In this case, you may not feel any different when you take it.

How long does Twincal stay in my system?

The elimination half-life of Twincal is approximately two hours.

Can I take Twincal for a long time?

Usually, treatment with Twincal is long term, even for the rest of your life.

Who should not take Twincal?

You should not use Twincal if you have severe coronary artery disease, or if you have had a heart attack within the past 2 weeks.

What happen If I stop taking Twincal?

Talk to your doctor if you want to stop taking Twincal. Stopping Twincal may cause your blood pressure to rise – and this may increase your risk of heart attack and stroke. If you're bothered by side effects, your doctor may be able to prescribe you a different medicine.

What happen If I overdose on Twincal?

Taking too much of this drug may cause severe side effects such as very low blood pressure (hypotension), a dangerously slow heart rate (bradycardia), heart failure, trouble breathing, extreme tiredness, dizziness, or very low blood sugar that could even lead to a coma. If you take too much nebivolol, call your doctor or go to the nearest hospital emergency department right away.

What happen If I missed Twincal?

If you forget to take your dose, take it as soon as you remember, unless you remember just a few hours before the time for your next dose. Then only take one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

Can Twincal affects my heart ?

Twincal may inhibit increases in heart rate and QT interval. Twincal may have beneficial effects in reducing cardiovascular events, resulting from increased sympathetic nerve activity and lethal arrhythmias in hemodialysis patients.

Can Twincal affect my kidneys?

Twincal effectively reduces the low- grade albuminuria in hypertensive CKD patient but main adverse effect of this drug induces the ankle edema, pedal edema, and peripheral edema.

*** Taking medicines without doctor's advice can cause long-term problems.
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