telma is ARB cardace is ace inhibitor, Avoid prescribing an angiotensin-converting enzyme (ACE) inhibitor and an angiotensin receptor blocker (ARB) for patients at high risk of vascular events or renal dysfunction. The combination does not reduce poor outcomes, and leads to more adverse drug-related events than an ACE inhibitor or ARB alone combination of these ( ace + arb) leads to renal dysfunction, increase of serum potassium, hypotension Ongoing Telmisartan Alone and in Combination With Ramipril Global Endpoint Trial (ONTARGET) found that dual RAS blockade was no more beneficial than monotherapy with an ACE inhibitor or an ARB in preventing serious outcomes in patients with known vascular disease or diabetes with end-organ damage. Furthermore, patients on dual RAS blockade had higher rates of renal insufficiency, hyperkalemia, and hypotension. side effect of cardace -Hypotension, renal impairment, angioedema, chronic cough, hyperkalemia. Nausea, vomiting, diarrhoea, dizziness, fatigue, headache, abdominal pain side effect of telma - back pains, inflammation of the sinuses, diarrhea, and infections of the respiratory tube,Headache, dizziness , renal dysfunction, hyperkalemia you should stop cardace and take telma-h instead of telma , add amtas 5 mg your bp will be controled