Duoval/Duoval Max Dosage/Direction for Use

The recommended starting dosage of valsartan is 80 mg once daily when used as monotherapy in patients who are not volume depleted. Patients requiring greater reduction may be increased to a dose of 160 mg daily. The antihypertensive effect is substantially present within 2 weeks and maximal reduction is generally attained after 4 weeks. If an additional antihypertensive effect is required over the starting dose range, the dose may be increased to a maximum of 320 mg or a diuretic may be added. Addition of a diuretic has a greater effect than dose increases beyond 80 mg. Care should be exercised with dosing of (Valsartan + hydrochlorothiazide) Duoval in patients with hepatic or severe renal impairment. Valsartan + hydrochlorothiazide may be administered with other antihypertensive agents. Valsartan + hydrochlorothiazide may be administered with or without food. Hydrochlorothiazide is effective in a dose of 12.5 to 25 mg once daily, and can be given a dose of 12.5 mg to 25 mg as (Valsartan and hydrochlorothiazide) Duoval. To minimize dose-independent adverse effects, it is usually appropriate to begin combination therapy only after a patient has failed to achieve the desired effect with monotherapy. The adverse effects of valsartan are generally rare and apparently independent of dose; those of hydrochlorothiazide are a mixture of dose-dependent phenomena (primarily hypokalemia) and dose-independent phenomena (e.g. pancreatitis, Stevens-Johnson Syndrome), the former much more common than the latter. Therapy with any combination of valsartan and hydrochlorothiazide will be associated with both sets of adverse effects.
Heart failure: The recommended starting dosage of (Valsartan + hydrochlorothiazide) Duoval is 40 mg twice daily. Up titration to 80 mg and 160 mg twice daily should be done to the highest dose, as tolerated by the patients, consideration should be given to reducing the dose of concomitant diuretics. The maximum daily dose administered in clinical trials is 320 mg in divided doses. Concomitant use with an ACE inhibitor and beta blockers is not recommended. Or as prescribed by the physician.