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telmisartan + amlodipine (Micamlo BP / Onduarp / Micamlo AP)

✓ Approved

Astellas Pharma · AGTR1 · Small Molecule

What is telmisartan + amlodipine?

telmisartan + amlodipine is a small molecule developed by Astellas Pharma. It is approved for therapeutic indications via oral (po).

Drug Profile

Brand NamesMicamlo BP, Onduarp, Micamlo AP
CompanyAstellas Pharma
Drug ClassSmall Molecule
Molecular TargetAGTR1, CACNA1C
RouteOral (PO)
StatusApproved
Sources: ClinicalTrials.gov, Astellas Pharma

Mechanism of Action

Molecular Targets

telmisartan + amlodipine acts on 2 molecular targets:

AGTR1angiotensin II receptor type 1 (HAT1R, AT1)
CACNA1Ccalcium voltage-gated channel subunit alpha1 C (CACNL1A1, CACNA1C-IT2)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

telmisartan + amlodipine is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Vascular disordersHypertension✓ Approved

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PubMedBMC cancer2026-11-11

Combined morphology and distribution features for risk stratification in pathology-enriched BI-RADS 4A/4B microcalcifications.

Zhang Shiyi S, Dong Shiwen S, Chen Yongtian Y, Yu Yonglong Y et al.

Breast microcalcifications are a common indication for biopsy in breast cancer screening and often represent the earliest mammographic manifestation of malignancy. However, substantial heterogeneity within BI-RADS 4 A lesions presents challenges for clinical interpretation. This study aimed to evaluate the association of microcalcification morphology and distribution with pathological outcomes and to explore their potential role in characterizing heterogeneity within BI-RADS 4 A lesions. A total of 327 patients with 356 pathologically confirmed microcalcification-positive breast lesions detected on digital mammography were retrospectively analyzed on a lesion-based basis. Calcification morphology and distribution were classified according to the BI-RADS 5th Edition. Associations with pathological outcomes were assessed using chi-square or Fisher's exact tests. Multivariable logistic regression was performed to identify independent factors associated with malignancy. Receiver operating characteristic (ROC) curve analysis was used to evaluate diagnostic performance at BI-RADS thresholds ≥4 A and ≥4B. Among the 327 patients, 205 (62.7%) had malignant disease and 122 (37.3%) had benign disease. Fine pleomorphic (80.2%), amorphous (66.2%), and fine linear or branching (100%) morphologies, as well as clustered (71.2%), regional (96.6%), and linear (100%) distribution patterns, were significantly associated with malignancy (P < 0.001). Multivariable analysis demonstrated that morphology and distribution remained independently associated with malignancy. Among lesions initially categorized as BI-RADS 4 A in institutional practice (n = 58), substantial heterogeneity was observed. Lesions with high-risk morphology and distribution patterns were more frequently malignant, whereas punctate calcifications with scattered distribution showed a lower malignancy proportion. In this pathology-confirmed cohort, BI-RADS ≥4B showed higher specificity than BI-RADS ≥4 A, although this category-level finding should be interpreted descriptively. In this retrospective cohort of biopsied BI-RADS 4 A/4B microcalcification-positive lesions, combined morphology and distribution features provided supplementary information for imaging-pathology correlation and helped illustrate risk heterogeneity within institutionally assigned BI-RADS 4 A lesions. These findings should be interpreted as confirmatory observations within a selected biopsy cohort rather than population-level malignancy estimates, and they are not intended to replace established BI-RADS-based management principles. These findings should be interpreted with caution due to the pathology-enriched design and should not be considered population-level risk estimates. They may provide supplementary information for understanding lesion heterogeneity but are not intended to replace established BI-RADS-based clinical decision-making.

PMID 43009821
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PubMedNature communications2026-11-11

Signatures of bi-altermagnetism revealed by sublattice-specific circular dichroism in resonant inelastic X-ray scattering.

Channagowdra Ganesha G, Singh Amol A, Huang Hsiao-Yu HY, Furo Mizuki M et al.

An altermagnet is a recently identified class of magnets that exhibit a zero net magnetic moment but break symmetry under the combined operations of parity and time reversal. It typically consists of two magnetic sites of opposite spins related by rotation within the unit cell. Here, we use circular dichroism (CD) in resonant inelastic X-ray scattering (RIXS) to reveal symmetry signatures of a distinct form of altermagnetism, namely bi-altermagnetism, in the correlated insulator Fe2Mo3O8, which comprises two altermagnetic sublattices: one with alternating quasi-octahedral Fe environments and the other with alternating tetrahedral Fe environments. We experimentally revealed the emergence of CD in an achiral, zero-magnetization system, thereby probing mirror-symmetry breaking associated with altermagnetic order. Notably, the CD appeared at sublattice-specific excitations of the octahedral and tetrahedral sites, indicating symmetry breaking in both altermagnetic sublattices. Calculations based on a model with the bi-altermagnetic order along the c axis successfully reproduce the observed CD. Our findings support the realization of bi-altermagnetism in Fe2Mo3O8, and showcase the use of RIXS-CD as a probe of magnetic sublattices in systems with zero net magnetization.

PMID 43009465
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PubMedMedicine2026-11-11

Comparative effectiveness of novel laser-assisted technologies for treating peri-implantitis: A network meta-analysis of randomized controlled trials.

Wang Zhe Z, Wen Jing J, Li Haoyang H, Xu Jiaying J et al.

Peri-implantitis impairs dental implant survival. Though new laser-assisted therapies are promising, their relative efficacy remains unclear. This Bayesian network meta-analysis compared photodynamic therapy (PDT), diode laser (DL), erbium:YAG laser (Er:YAG), and conventional non-laser control (CON). Following PRISMA guidelines, we retrieved relevant randomized controlled trials from PubMed, Embase, Web of Science, MEDLINE, and China National Knowledge Infrastructure up to May 31, 2025. Primary outcomes included bleeding on probing (BOP), probing depth (PD), and plaque index; secondary outcomes covered clinical attachment level, crestal bone loss, gingival index, and bleeding index (BI). We calculated odds ratios and standardized mean differences with 95% credible intervals and P-values via Stata 14. Treatments were ranked using the surface under the cumulative ranking curve, combined with effect estimates and evidence quality for result interpretation. Thirty-three randomized controlled trials with 1825 participants were included. PDT ranked best overall, with significant improvements in PD, plaque index, crestal bone loss, gingival index, and BI versus CON. No therapy yielded significant differences in BOP and clinical attachment level. DL showed no clinical advantages over CON, while Er:YAG only improved BI significantly. Surface under the cumulative ranking curve rankings of DL and Er:YAG only indicated probability order, not definite therapeutic effects. PDT exerted the most stable short-term efficacy for peri-implantitis. DL and Er:YAG had limited valid benefits. Due to insufficient long-term data, the sustained effects of these treatments and their roles in preventing lesion recurrence and maintaining implant survival are still undetermined. A network meta-analysis of 33 RCTs found that photodynamic therapy (PDT) had the most consistent statistically supported benefits, with significant improvements versus CON in PD, PI, CBL, GI, and BI, but not in BOP or CAL. Although PDT also showed the most favorable SUCRA based ranking profile, SUCRA reflects ranking probability rather than effect magnitude, certainty of evidence, or definitive clinical superiority. DL did not show statistically significant superiority over CON, and Er:YAG showed a significant benefit versus CON only for BI. These findings support considering PDT as a minimally invasive adjunct to mechanical debridement when clinically appropriate, while emphasizing that treatment selection should be guided by statistically robust effects, CrI precision, patient-specific factors, and the limitations of the underlying evidence network. Importantly, the current evidence mainly reflects short term clinical response. Whether PDT provides sustained disease control, reduces recurrence, or improves long term implant survival remains to be confirmed in well powered trials with longer follow-up.

PMID 43012816
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PubMedRSC advances2026-11-11

One-dimensional Bi-Br pyrazinamide-based hybrid halide perovskite: crystal architecture, intermolecular interactions, and structure-optical properties relationship.

Alibi Amin A, Elleuch Nour N, Khdhiri Emna E, Shova Sergiu S et al.

A one-dimensional bismuth bromide organic-inorganic hybrid halide perovskite based on protonated pyrazinamide cations, (C5H6N3O)2·[BiBr5], is reported and comprehensively investigated. Single-crystal X-ray diffraction reveals a perovskite-related architecture built from corner-sharing [BiBr6] octahedra forming one-dimensional chains, stabilized by a dense network of N-H⋯Br and N-H⋯O hydrogen bonds together with significant π-π stacking interactions. Hirshfeld surface analysis quantitatively confirms the dominance of halogen-mediated hydrogen bonding in governing the supramolecular organization. Diffuse reflectance spectroscopy establishes the material as a direct-band-gap semiconductor with an optical gap of ∼2.8 eV, supported by a sharp absorption edge, low Urbach energy, and consistent threshold wavelength analysis. Photoluminescence measurements reveal a single intense phosphorescent emission centered at 540 nm, with CIE coordinates located in the yellowish-green region. Density functional theory calculations, including DOS, PDOS, ELF, LOL, and NCI-RDG analyses, provide microscopic insight into the electronic structure and intermolecular interactions, highlighting charge-transfer contributions from the inorganic sublattice to the organic moiety near the band edges. The combined results establish clear structure-property correlations in this lead-free Bi-based hybrid system and underline its relevance within the broader family of perovskite-inspired semiconductors.

PMID 43011874
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PubMedEuropean journal of case reports in internal medicine2026-11-11

Combined Calcium Channel Blocker And Angiotensin-Converting Enzyme Inhibitor Overdose.

Kahal Fares F, Guérard-Poirier Natasha N, Ji Cheng C, Gursahaney Ashvini A et al.

Combined overdoses of angiotensin-converting enzyme inhibitors and calcium channel blockers are rare but associated with more severe toxicity than either agent alone. A 48-year-old woman presented to the emergency department nine hours after intentionally ingesting 40 tablets of amlodipine (10 mg) and 40 tablets of ramipril (10 mg). On arrival, she was hypotensive and tachycardic. Initial management included fluids, intravenous calcium and insulin bolus followed by high-dose insulin euglycaemic therapy (HIET). Despite escalating vasopressor support, she developed mixed vasoplegic and cardiogenic shock complicated by acute kidney injury, fluid overload, respiratory failure and metabolic acidosis, necessitating intubation and continuous renal replacement therapy. Improvement in haemodynamics was only achieved by day 9. She was transferred from the intensive care unit (ICU) on day 20 with residual weakness from ICU-acquired myopathy and was ultimately discharged after 66 days, with a prolonged hospitalisation attributed to delirium and deconditioning. Severe combined angiotensin-converting enzyme inhibitors (ACEI) and calcium channel blockers (CCB) overdose may cause prolonged, refractory haemodynamic instability requiring extended high-dose insulin euglycaemic therapy (HIET), vasoactive support and fluid administration. Concentrated insulin, dextrose and vasopressor preparations may help mitigate fluid overload. Angiotensin II may be a potential treatment for refractory vasoplegia, although evidence and availability remain limited. Secondary complications can prolong recovery beyond the duration of drug toxicity. This case highlights the need for individualised, multidisciplinary management, early HIET, vasoactive support and fluid-sparing strategies in severe combined ACEI and CCB overdose. Management of severe combined calcium channel blocker and angiotensin-converting enzyme inhibitor overdose may require prolonged resuscitation with high-dose insulin euglycaemic therapy, vasoactive support and fluid administration. The cumulative fluid requirements of these therapies, combined with complications such as acute kidney injury, can contribute to severe fluid overload. The use of concentrated insulin, dextrose and vasopressor preparations may help limit the iatrogenic fluid accumulation.Clinicians should anticipate and proactively manage secondary complications, including acute kidney injury, volume overload, respiratory failure and infection, as these complications may independently prolong recovery beyond the expected duration of drug toxicity.Combined angiotensin-converting enzyme inhibitor and calcium channel blocker overdose lacks established management guidelines and requires individualised, multidisciplinary care based on clinical severity and response to therapy.

PMID 43012017
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PubMedEnvironmental science and pollution research international2026-11-11

Sustainable tetracycline transportation using greener PIM: nanoindentation, prolonged stability, and process kinetics modelling studies.

Oluwasola Ebenezer Idowu EI, Olusegun Sunday Joseph SJ, Felis Ewa E

The industrial application of Polymer Inclusion Membranes (PIMs) for pharmaceutical wastewater remediation is often limited by the extraction-stripping trade-off and carrier-mediated transport kinetics. To bypass these limitations, this study introduces a highly efficient, liquid-plasticizer-free, self-plasticizing bi-continuous network PIM system and employs a 1 M NaCl strip phase. This transition provides mobile chloride (Cl⁻) counter-ions that trigger an accelerated, continuous ion-exchange "hopping" mechanism, breaking the low transport efficiency ceilings typical of traditional receiving chemistries. Scanning electron microscopy and nanoindentation modeling confirm that this optimized engineered PIM created a vertically aligned finger-like matrix channel, induced a ~92% reduction in nanomechanical stiffness, and a ~39% increase in elastic recovery. Process kinetics modeling demonstrates a well-balanced mass transport regime, splitting the kinetic diffusion share (Dm = 48%) and thermodynamic sorption share (S = 52%) to drive a synchronized surge in the kinetic rate constant (k = 0.09169 h⁻1) and effective diffusivity (8.48 × 10⁻10 m2 s⁻1). As a result, the membrane exhibits 100% quantitative tetracycline extraction and an exceptional transport efficiency of ~99.5% at a peak initial flux (J0) of 3.98 × 10⁻10 mol · m⁻2 · s⁻1. Long-term process stability trials confirm matrix integrity and a sustained high-flux transport environment across the initial four phases, maintaining membrane structural integrity across 10 consecutive cycles totaling 450 h of continuous runtime without chemical regeneration. This offers a robust, eco-friendly framework that aligns with Global Sustainable Development Goal 6 (SDG 6).

PMID 43009700
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