Trade Names:Diovan HCT- Tablets hydrochlorothiazide 12.5 mg/valsartan 80 mg- Tablets hydrochlorothiazide 12.5 mg/valsartan 160 mg- Tablets hydrochlorothiazide 12.5 mg/valsartan 320 mg- Tablets hydrochlorothiazide 25 mg/valsartan 160 mg- Tablets hydrochlorothiazide 25 mg/valsartan 320 mg
Antagonizes the effect of angiotensin II (vasoconstriction and aldosterone secretion) by blocking the angiotensin II receptor (AT 1 receptor) in vascular smooth muscle and the adrenal gland, producing decreased BP.Hydrochlorothiazide
Increases chloride, sodium, and water excretion by interfering with transport of sodium ions across renal tubular epithelium.
Treatment of hypertension.
Hypersensitivity to any component of this product; anuria; hypersensitivity to sulfonamide-derived drugs.
PO Dosage must be individualized. The usual starting dosage is 160 mg/12.5 mg once daily. Increase after 1 to 2 wk to a max dosage of 320 mg/25 mg once daily.Renal Function Impairment (CrCl 30 mL/min or less)
Use is not recommended.Hepatic Function Impairment
Start with a low dose and titrate slowly.
Store at 59° to 86°F. Protect from moisture.
Increased electrolyte depletion, increasing the risk of hypokalemia.Alcohol, barbiturates, narcotics
Increased risk of orthostatic hypotension.Anticholinergic agents (eg, atropine, biperiden)
May increase bioavailability of thiazide-type diuretics.Antidiabetic agents (oral agents and insulin)
Dosage adjustment of antidiabetic agent may be necessary.Antihypertensive agent
Additive or potentiation of effects.Cholestyramine, colestipol resins
Impaired absorption of hydrochlorothiazide.Cyclosporine
Concomitant use may increase risk of hyperuricemia and gout-type complications.Digoxin
Thiazide-induced electrolyte disturbances may predispose to digitalis-induced arrhythmias.Lithium
Plasma concentrations may be elevated by valsartan, increasing the pharmacologic and toxic effects of lithium.Methyldopa
Reports of hemolytic anemia occurring with concomitant use.Nondepolarizing skeletal muscle relaxants (eg, tubocurarine)
Increased effect of the muscle relaxant.Nonsteroidal anti-inflammatory agents
The diuretic, natriuretic, and antihypertensive effects of loop, potassium-sparing, and thiazide diuretics may be reduced.Potassium supplements
May lead to increases in serum potassium. Monitor potassium levels and renal function regularly.Pressor amines (eg, norepinephrine)
Decreased responsiveness to the pressor amine.Vitamin D/calcium salts
May potentiate rise in serum calcium.
May decrease serum protein-bound iodine levels without signs of thyroid disturbances. May cause diagnostic interference of serum electrolyte levels, blood and urine glucose levels, serum bilirubin levels, and serum uric acid levels.
Hypotension (1%); palpitations, syncope, tachycardia.
Dizziness (6%); anxiety, asthenia, decreased libido, depression, fatigue, increased appetite, insomnia, paresthesia, somnolence.
Flushing, hyperhidrosis, pruritus, rash, sunburn.
Sinus congestion, nasal congestion, nasopharyngitis (2%); abnormal vision, epistaxis, pharyngolaryngeal pain, pharyngitis, sinusitis, tinnitus, vertigo.
Abdominal pain, constipation, diarrhea, dry mouth, dyspepsia, flatulence, gastritis, nausea, vomiting.
Dysuria, erectile dysfunction, pollakiuria, UTI.
Elevated liver enzymes.
Dehydration, gout, peripheral edema.
Arthralgia, back pain, muscle cramps, muscle weakness, myalgia, pain in extremity.
Bronchospasm, bronchitis, cough, dyspnea, upper respiratory tract infection.
Increased BUN (15%); increased creatinine (2%); anaphylaxis, asthenia, chest pain, influenza, pyrexia, viral infection.
When used in pregnancy, drugs that act directly on the renin-angiotensin system can cause injury, and even death to the developing fetus. When pregnancy is detected, discontinue therapy as soon as possible.
Monitor BP and electrolytes at regular intervals.
Category D .
Excreted in breast milk.
Safety and efficacy not established.
May occur in patients with or without history of allergy or bronchial asthma; cross-sensitivity with sulfonamides may also occur.
Decreases in renal function may occur in patients whose renal function is dependent on the renin-angiotensin system; patients with renal artery stenosis may experience acute renal failure. Use caution in treating patients whose renal function may depend on the activity of renin-angiotensin-aldosterone system (eg, severe CHF). In addition, hydrochlorothiazide may precipitate azotemia, and cumulative effects of the drug may develop in patients with renal function impairment.
Use with caution. Minor alterations of fluid and electrolyte balance may precipitate hepatic coma.
May occur, or acute gout may be precipitated in thiazide therapy.
Symptomatic hypotension may occur after initiation of valsartan therapy in patients who are intravascularly volume depleted (eg, those treated with diuretics). Correct these conditions prior to administration of valsartan or start treatment under close medical supervision. Light-headedness can occur, especially during the first days of therapy.
Increases in cholesterol and triglycerides may occur.
Exacerbation or activation may occur.
May increase the risk of decreased coronary perfusion when treated with vasodilators.
Bradycardia, circulatory collapse, depressed consciousness, dehydration, electrolyte depletion (eg, hypochloremia, hypokalemia, hyponatremia), hypotension, tachycardia, shock.
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