valsartan + hydrochlorothiazide




Concise Prescribing Info
Per 80 mg/12.5 mg FC tab Valsartan 80 mg, hydrochlorothiazide 12.5 mg. Per 160 mg/12.5 mg FC tab Valsartan 160 mg, hydrochlorothiazide 12.5 mg
Essential HTN in adults not adequately controlled on monotherapy.
Dosage/Direction for Use
1 tab once daily. If BP remains uncontrolled, dose may be increased by increasing either 1 of the components to a max dose of valsartan/hydrochlorothiazide 320 mg/25 mg.
May be taken with or without food.
Hypersensitivity. Anuria. Pregnancy.
Special Precautions
Symptomatic hypotension in Na- &/or vol-depleted patients. Renal artery stenosis, renal (GFR <30 mL/min) & hepatic impairment. Patients who develop angioedema or are experiencing angioedema; discontinue immediately & do not readminister. Biliary obstructive disorders & cholestasis or SLE. Hypokalemia (may favor the onset of digitalis-induced cardiac arrhythmias), hyponatremia, hypercalcemia, symptomatic hyperuricemia. Disturbance of serum electrolyte balance, glucose tolerance & cholesterol, triglycerides & uric acid serum levels. Acute angle-closure glaucoma; history of allergy or asthma. Severe CHF, heart failure/post-MI. Heart failure, severe chronic heart failure or other conditions w/ simulation of renin-angiotensin-aldosterone-system. May impair ability to drive or operate machinery. Women of childbearing potential. Lactation. Childn <18 yr.
Adverse Reactions
Increased blood lipids. Hypomagnesemia, hyperuricemia; urticaria, other forms of rash; decreased appetite, mild nausea & vomiting; orthostatic hypotension which may be aggravated by alcohol, anesth or sedatives; impotence.
Drug Interactions
Valsartan: K supplements, K-sparing diuretics, salt substitutes containing K or other drugs altering K levels (eg, heparin). Attenuation of antihypertensive effect w/ NSAIDs. Increased systemic exposure w/ inhibitors of uptake transporter OATP1B1 (rifampin, ciclosporin) or efflux transporter MRP2 (ritonavir). Hydrochlorothiazide: Reversible increases in serum lithium & toxicity. Potentiates action of other antihypertensives (eg, guanethidine, methyldopa, β-blockers, vasodilators, Ca channel blockers, ACE inhibitors, angiotensin receptor blockers & direct renin inhibitors) & skeletal muscle relaxants (eg, curare derivatives). Increased hypokalemic effect w/ kaliuretic diuretics, corticosteroids, ACTH, amphotericin, carbenoxolone, penicillin G, salicylic acid derivatives or antiarrhythmics. Hyponatremic effect may be intensified w/ antidepressants, antipsychotics, antiepileptics. May alter glucose tolerance w/ insulin & oral antidiabetic agents. Risk of thiazide-induced hypokalemia or hypomagnesemia w/ digitalis glycosides. Diuretic & antihypertensive activity may be weakened w/ NSAIDs (eg, salicylic acid derivative, indomethacin) & selective COX-2 inhibitors. May increase incidence of hypersensitivity reactions to allopurinol & risk of adverse effects caused by amantadine; reduce renal excretion of cytotoxic agents & enhance their myelosuppressive effects eg, cyclophosphamide, methotrexate. Bioavailability may be increased by anticholinergics (eg, atropine, biperiden) or decreased by prokinetic drugs (eg, cisapride). Decreased absorption by cholestyramine or colestipol. Serum Ca elevation may be potentiated w/ vit D or Ca salts. Increased risk of hyperuricemia & gout-type complications w/ ciclosporin. Risk of hypercalcemia w/ Ca salts; hemolytic anemia w/ methyldopa. May enhance hyperglycemic effect of diazoxide. Orthostatic hypotension may be potentiated w/ alcohol, barbiturates or narcotics. May reduce response to pressor amines (eg, noradrenaline).
MIMS Class
Angiotensin II Antagonists / Diuretics
ATC Classification
C09DA03 - valsartan and diuretics ; Belongs to the class of angiotensin II receptor blockers (ARBs) in combination with diuretics. Used in the treatment of cardiovascular disease.
Co-Tareg 160 mg/12.5 mg film-coated tab
Co-Tareg 80 mg/12.5 mg film-coated tab
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