Exforge

Essential HTN. May be used as initial therapy in patients who are likely to need multiple drugs to achieve BP goals.

Adult Initially 5 mg/80 mg once daily, can be increased after 1-2 wk to a max of 10 mg/320 mg once daily.

May be taken with or without food: Take w/ some water.

Hypersensitivity. Concomitant use w/ aliskiren in patients w/ type 2 diabetes. Pregnancy.

Risk of symptomatic hypotension in patients w/ activated renin-angiotensin system (eg, salt- &/or vol-depleted patients). Correction of salt &/or vol depletion prior to administration of therapy or close medical supervision at start of treatment is recommended. Not recommended as initial therapy in patients w/ intravascular vol depletion. Reports of angioedema w/ valsartan; discontinue immediately if patient develops angioedema. Include assessment of renal function in the evaluation of patients w/ heart failure or post-MI. Risk of worsening angina pectoris & acute MI after starting or increasing dose of amlodipine in patients w/ severe obstructive CAD. Caution in patients w/ serious CHF (NYHA class III-IV); aortic or mitral valve stenosis or obstructive hypertrophic cardiomyopathy; unilateral or bilateral renal artery stenosis or stenosis to solitary kidney; severe renal impairment (CrCl <10 mL/min); hepatic impairment or biliary obstructive disorders. Dual blockade of renin-angiotensin system (RAS) when ARB (including valsartan) is co-administered w/ other agents blocking the RAS eg, ACE inhibitors or aliskiren. Caution & w/ frequent monitoring of K when concomitantly used w/ K supplements, K-sparing diuretics, salt substitutes containing K, or other drugs that may increase K levels (eg, heparin). No experience of safe use in patients who have had recent kidney transplantation. Closely observe infants whose mothers have taken ARB therapy in 1st trimester. Not advisable for lactating women. Not recommended for use in childn <18 yr.

Nasopharyngitis, flu; headache; edema (including peripheral, pitting, facial), hot flush, fatigue, flushing, asthenia.

Amlodipine: Increased exposure to simvastatin. Increased systemic exposure w/ diltiazem in elderly hypertensive patients. Increased plasma conc w/ strong CYP3A4 inhibitors (eg, ketoconazole, itraconazole, ritonavir). Monitor patients for adequate clinical effect when co-administered w/ CYP3A4 inducers. Valsartan: Increased incidence of hypotension, hyperkalemia & changes in renal function w/ other agents acting on RAS. Increased K levels w/ K supplements, K-sparing diuretics, salt substitutes containing K or other drugs that may increase K levels (eg, heparin). Attenuated antihypertensive effect w/ NSAIDs including selective COX-2 inhibitors. Increased risk of worsening renal function w/ NSAIDs in patients who are elderly, vol-depleted (including those on diuretic therapy), or have compromised renal function. Reversible increases in serum lithium conc & toxicity. Systemic exposure to valsartan may be increased w/ inhibitors of OATP1B1 (eg, rifampin, ciclosporin) or MRP2 (eg, ritonavir).

Angiotensin II Antagonists / Calcium Antagonists

C09DB01 - valsartan and amlodipine ; Belongs to the class of angiotensin II receptor blockers (ARBs) and calcium channel blockers. Used in the treatment of cardiovascular disease.

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