Amlodipine and Valsartan

Amlodipine and Valsartan Brand Name– Exforge

What is Amlodipine and Valsartan

Amlodipine and Valsartan (Exforge) is a combination product for treating hypertension.

The combination product is used once a patient has been titrated with individual components.

Amlodipine is a calcium-channel blocker. It is a potent vasodilator and has the longest half-life of the calcium-channel blocker group, thus allowing for once-daily dosing.

Valsartan is a specific angiotensin II antagonist which selectively and competitively blocks the AT-1 receptor, which mediates the vasopressor and aldosterone effects of angiotensin II.

Compared to losartan, valsartan has a similar efficacy and safety profile, but does not have an active metabolite or possess uricosuric effects.

Because valsartan does not inhibit angiotensin converting enzyme (ACE), it does not result in bradykinin accumulation which is theorized to cause the cough and angioedema associated with ACE inhibitors.

However, angioedema has been rarely associated with valsartan or other angiotensin II antagonists.

Because AT-1 receptors are nearly saturated at the starting dose for most angiotensin II antagonists, the antihypertensive dose-response curve of these drugs are nonlinear, with proportionally small decreases in blood pressure attained with increased dosage.

Amlodipine and Valsartan was approved June 20, 2007.

Indications

  • hypertension

Side Effects

  1. abdominal pain
  2. alopecia
  3. angina
  4. angioedema
  5. anorexia
  6. anxiety
  7. arthralgia
  8. asthenia
  9. atrial fibrillation
  10. azotemia
  11. back pain
  12. blurred vision
  13. bradycardia
  14. bullous rash
  15. carpal tunnel syndrome
  16. chest pain (unspecified)
  17. colitis
  18. conjunctivitis
  19. constipation
  20. cough
  21. depression
  22. diabetes mellitus
  23. diaphoresis
  24. diarrhea
  25. diplopia
  26. dizziness
  27. drowsiness
  28. dyspepsia
  29. dysphagia
  30. dysphonia
  31. dyspnea
  32. edema
  33. elevated hepatic enzymes
  34. epistaxis
  35. erythema
  36. erythema multiforme
  37. fatigue
  38. fever
  39. flatulence
  40. flushing
  41. gastritis
  42. gingival hyperplasia
  43. gout
  44. gynecomastia
  45. headache
  46. heart failure
  47. hematuria
  48. hemorrhoids
  49. hepatitis
  50. hot flashes
  51. hypercholesterolemia
  52. hyperglycemia
  53. hyperhidrosis
  54. hyperkalemia
  55. hypoesthesia
  56. hypotension
  57. impotence (erectile dysfunction)
  58. increased urinary frequency
  59. insomnia
  60. jaundice
  61. leukopenia
  62. lymphadenopathy
  63. maculopapular rash
  64. malaise
  65. musculoskeletal pain
  66. myalgia
  67. nasal congestion
  68. nausea
  69. nephrolithiasis
  70. neutropenia
  71. nocturia
  72. orthostatic hypotension
  73. otalgia
  74. palpitations
  75. pancreatitis
  76. paresthesias
  77. peripheral edema
  78. peripheral neuropathy
  79. peripheral vasodilation
  80. pruritus
  81. purpura
  82. rash
  83. rhabdomyolysis
  84. sinus tachycardia
  85. sinusitis
  86. syncope
  87. teratogenesis
  88. thrombocytopenia
  89. tinnitus
  90. tremor
  91. urticaria
  92. vasculitis
  93. ventricular tachycardia
  94. vertigo
  95. visual impairment
  96. vomiting
  97. weight gain
  98. weight loss
  99. xerostomia

Monitoring Parameters

  • blood pressure
  • heart rate
  • LFTs
  • serum creatinine/BUN
  • serum potassium

Contraindications

  • ACE-inhibitor induced angioedema
  • acute myocardial infarction
  • angioedema
  • aortic stenosis
  • Black patients
  • bradycardia
  • breast-feeding
  • cardiogenic shock
  • coronary artery disease
  • dihydropyridine hypersensitivity
  • geriatric
  • heart failure
  • hepatic disease
  • hyperkalemia
  • hypotension
  • hypovolemia
  • pregnancy
  • renal artery stenosis
  • renal impairment
  • surgery
  • ventricular dysfunction

Interactions

  • Acarbose
  • Acebutolol
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Pseudoephedrine
  • Acetaminophen; Tramadol
  • Acrivastine; Pseudoephedrine
  • Aldesleukin, IL-2
  • Alemtuzumab
  • Alfentanil
  • Aliskiren
  • Aliskiren; Amlodipine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Aliskiren; Valsartan
  • Alogliptin; Metformin
  • Alpha-glucosidase Inhibitors
  • Alprostadil
  • Amifostine
  • Amiloride
  • Amiloride; Hydrochlorothiazide, HCTZ
  • Aminolevulinic Acid
  • Amiodarone
  • Amlodipine; Celecoxib
  • Amobarbital
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Amphetamine; Dextroamphetamine Salts
  • Amprenavir
  • Amyl Nitrite
  • Angiotensin II
  • Angiotensin-converting enzyme inhibitors
  • Apalutamide
  • Apomorphine
  • Apraclonidine
  • Aprepitant, Fosaprepitant
  • Aripiprazole
  • Armodafinil
  • Asenapine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Oxycodone
  • Atazanavir
  • Atazanavir; Cobicistat
  • Atenolol
  • Atenolol; Chlorthalidone
  • Avanafil
  • Baclofen
  • Barbiturates
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Bendroflumethiazide; Nadolol
  • Benzhydrocodone; Acetaminophen
  • Benzonatate
  • Benzphetamine
  • Beta-blockers
  • Betaxolol
  • Bexarotene
  • Bisoprolol
  • Bisoprolol; Hydrochlorothiazide, HCTZ
  • Boceprevir
  • Bortezomib
  • Bosentan
  • Brexpiprazole
  • Brimonidine; Timolol
  • Brompheniramine; Carbetapentane; Phenylephrine
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Brompheniramine; Pseudoephedrine
  • Bupivacaine; Lidocaine
  • Cabergoline
  • Caffeine; Ergotamine
  • Calcium Phosphate, Supersaturated
  • Canagliflozin; Metformin
  • Carbamazepine
  • Carbetapentane; Chlorpheniramine; Phenylephrine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carbetapentane; Guaifenesin; Phenylephrine
  • Carbetapentane; Phenylephrine
  • Carbetapentane; Phenylephrine; Pyrilamine
  • Carbetapentane; Pseudoephedrine
  • Carbidopa; Levodopa
  • Carbidopa; Levodopa; Entacapone
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbinoxamine; Phenylephrine
  • Carbinoxamine; Pseudoephedrine
  • Cariprazine
  • Carteolol
  • Carvedilol
  • Celecoxib
  • Cenobamate
  • Ceritinib
  • Cetirizine; Pseudoephedrine
  • Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
  • Chlophedianol; Guaifenesin; Phenylephrine
  • Chloramphenicol
  • Chloroprocaine
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpheniramine; Pseudoephedrine
  • Ciprofloxacin
  • Cisapride
  • Clarithromycin
  • Clobazam
  • Clofarabine
  • Clopidogrel
  • Clozapine
  • Co-Enzyme Q10, Ubiquinone
  • Cobicistat
  • Cocaine
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Colchicine
  • Colchicine; Probenecid
  • Conivaptan
  • Crizotinib
  • Cyclosporine
  • Dabrafenib
  • Daclatasvir
  • Danazol
  • Dantrolene
  • Dapagliflozin; Metformin
  • Darunavir
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Deferasirox
  • Delavirdine
  • Desloratadine; Pseudoephedrine
  • Dexamethasone
  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dexmedetomidine
  • Dexmethylphenidate
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Guaifenesin; Phenylephrine
  • Dextromethorphan; Guaifenesin; Pseudoephedrine
  • Dextromethorphan; Quinidine
  • Diazoxide
  • Diclofenac
  • Diclofenac; Misoprostol
  • Diethylpropion
  • Diflunisal
  • Digoxin
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Dihydroergotamine
  • Diltiazem
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Diphenhydramine; Phenylephrine
  • Dofetilide
  • Dorzolamide; Timolol
  • Dronabinol
  • Dronedarone
  • Drospirenone
  • Drospirenone; Estradiol
  • Drospirenone; Ethinyl Estradiol
  • Drospirenone; Ethinyl Estradiol; Levomefolate
  • Duloxetine
  • Dutasteride; Tamsulosin
  • Duvelisib
  • Efavirenz
  • Efavirenz; Emtricitabine; Tenofovir
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Elagolix
  • Elagolix; Estradiol; Norethindrone acetate
  • Elbasvir; Grazoprevir
  • Elexacaftor; tezacaftor; ivacaftor
  • Eliglustat
  • Eltrombopag
  • Elvitegravir
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Empagliflozin
  • Empagliflozin; Linagliptin
  • Empagliflozin; Linagliptin; Metformin
  • Empagliflozin; Metformin
  • Enflurane
  • Enzalutamide
  • Ephedrine
  • Epirubicin
  • Eplerenone
  • Epoprostenol
  • Ergonovine
  • Ergotamine
  • Ertugliflozin; Metformin
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Eslicarbazepine
  • Esmolol
  • Esomeprazole; Naproxen
  • Estradiol
  • Estradiol Cypionate; Medroxyprogesterone
  • Ethinyl Estradiol
  • Ethinyl Estradiol; Desogestrel
  • Ethinyl Estradiol; Ethynodiol Diacetate
  • Ethinyl Estradiol; Etonogestrel
  • Ethinyl Estradiol; Levonorgestrel
  • Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
  • Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
  • Ethinyl Estradiol; Norelgestromin
  • Ethinyl Estradiol; Norethindrone
  • Ethinyl Estradiol; Norethindrone Acetate
  • Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
  • Ethinyl Estradiol; Norethindrone; Ferrous fumarate
  • Ethinyl Estradiol; Norgestimate
  • Ethinyl Estradiol; Norgestrel
  • Ethosuximide
  • Ethotoin
  • Etodolac
  • Etomidate
  • Etravirine
  • Everolimus
  • Ezetimibe; Simvastatin
  • Famotidine; Ibuprofen
  • Fedratinib
  • Fenofibric Acid
  • Fenoprofen
  • Fentanyl
  • Fexofenadine; Pseudoephedrine
  • Fish Oil, Omega-3 Fatty Acids (Dietary Supplements)
  • Fluconazole
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Flurbiprofen
  • Flutamide
  • Fluvoxamine
  • Fosamprenavir
  • Fosphenytoin
  • Fospropofol
  • Gemfibrozil
  • General anesthetics
  • Ginkgo, Ginkgo biloba
  • Ginseng, Panax ginseng
  • Glipizide; Metformin
  • Glyburide; Metformin
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Guaifenesin; Phenylephrine
  • Guaifenesin; Pseudoephedrine
  • Haloperidol
  • Halothane
  • Heparin
  • Homatropine; Hydrocodone
  • Hydantoins
  • Hydralazine; Isosorbide Dinitrate, ISDN
  • Hydrochlorothiazide, HCTZ; Metoprolol
  • Hydrochlorothiazide, HCTZ; Propranolol
  • Hydrochlorothiazide, HCTZ; Spironolactone
  • Hydrochlorothiazide, HCTZ; Triamterene
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Ibuprofen
  • Ibuprofen; Oxycodone
  • Ibuprofen; Pseudoephedrine
  • Idelalisib
  • Iloperidone
  • Iloprost
  • Imatinib
  • Incretin Mimetics
  • Indapamide
  • Indinavir
  • Indomethacin
  • Insulins
  • Intravenous Lipid Emulsions
  • Isavuconazonium
  • Isocarboxazid
  • Isoflurane
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Isoproterenol
  • Isosorbide Dinitrate, ISDN
  • Isosorbide Mononitrate
  • Itraconazole
  • Ketamine
  • Ketoconazole
  • Ketoprofen
  • Ketorolac
  • Labetalol
  • Lacosamide
  • Lanreotide
  • Lansoprazole; Naproxen
  • Lasmiditan
  • Lefamulin
  • Lesinurad
  • Lesinurad; Allopurinol
  • Letermovir
  • Levobetaxolol
  • Levobunolol
  • Levodopa
  • Lidocaine
  • Lidocaine; Prilocaine
  • Linagliptin; Metformin
  • Lisdexamfetamine
  • Lithium
  • Lomitapide
  • Loop diuretics
  • Loperamide
  • Loperamide; Simethicone
  • Lopinavir; Ritonavir
  • Loratadine; Pseudoephedrine
  • Lorlatinib
  • Lovastatin
  • Lovastatin; Niacin
  • Lumacaftor; Ivacaftor
  • Lumacaftor; Ivacaftor
  • Lurasidone
  • Magnesium Sulfate; Potassium Sulfate; Sodium Sulfate
  • Maraviroc
  • Meclofenamate Sodium
  • Mefenamic Acid
  • Meglitinides
  • Melatonin
  • Meloxicam
  • Mestranol; Norethindrone
  • Metformin
  • Metformin; Pioglitazone
  • Metformin; Repaglinide
  • Metformin; Rosiglitazone
  • Metformin; Saxagliptin
  • Metformin; Sitagliptin
  • Methadone
  • Methamphetamine
  • Methohexital
  • Methoxsalen
  • Methylergonovine
  • Methylphenidate
  • Methysergide
  • Metoprolol
  • Mifepristone
  • Miglitol
  • Milrinone
  • Mitotane
  • Modafinil
  • Nabumetone
  • Nadolol
  • Nafcillin
  • Naproxen
  • Naproxen; Pseudoephedrine
  • Naproxen; Sumatriptan
  • Nateglinide
  • Nebivolol
  • Nebivolol; Valsartan
  • Nefazodone
  • Nelfinavir
  • Nesiritide, BNP
  • Netupitant, Fosnetupitant; Palonosetron
  • Neuromuscular blockers
  • Nevirapine
  • Niacin, Niacinamide
  • Niacin; Simvastatin
  • Nilotinib
  • Nitrates
  • Nitroglycerin
  • Nitroprusside
  • Nonsteroidal antiinflammatory drugs
  • Obeticholic Acid
  • Octreotide
  • Olanzapine
  • Ombitasvir; Paritaprevir; Ritonavir
  • Omeprazole; Amoxicillin; Rifabutin
  • Oritavancin
  • Oxaprozin
  • Oxcarbazepine
  • Oxycodone
  • Oxymetazoline
  • Paliperidone
  • Pasireotide
  • Pazopanib
  • Penbutolol
  • Pentoxifylline
  • Perampanel
  • Phenelzine
  • Phentermine; Topiramate
  • Phenylephrine
  • Phenylephrine; Promethazine
  • Phenytoin
  • Photosensitizing agents (topical)
  • Pindolol
  • Piroxicam
  • Polyethylene Glycol; Electrolytes
  • Polyethylene Glycol; Electrolytes; Ascorbic Acid
  • Posaconazole
  • Potassium
  • Pramlintide
  • Prazosin
  • Procainamide
  • Procaine
  • Propofol
  • Propoxyphene
  • Propranolol
  • Protease inhibitors
  • Pseudoephedrine
  • Quinidine
  • Quinine
  • Rasagiline
  • Remifentanil
  • Repaglinide
  • Ribociclib
  • Ribociclib; Letrozole
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Risperidone
  • Ritonavir
  • Rofecoxib
  • Saquinavir
  • Segesterone Acetate; Ethinyl Estradiol
  • Selegiline
  • Sevoflurane
  • SGLT2 Inhibitors
  • Sildenafil
  • Silodosin
  • Simeprevir
  • Simvastatin
  • Simvastatin; Sitagliptin
  • Sincalide
  • Sirolimus
  • Sodium Phosphate Monobasic Monohydrate; Sodium Phosphate Dibasic Anhydrous
  • Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
  • Sofosbuvir; Velpatasvir
  • Sofosbuvir; Velpatasvir; Voxilaprevir
  • Sotalol
  • Spironolactone
  • St. John’s Wort, Hypericum perforatum
  • Sufentanil
  • Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
  • Sulfonylureas
  • Sulindac
  • Tacrolimus
  • Tamsulosin
  • Telaprevir
  • Telithromycin
  • Telotristat Ethyl
  • Temsirolimus
  • Tetrabenazine
  • Tetracaine
  • Thalidomide
  • Thiazolidinediones
  • Thiopental
  • Thiothixene
  • Timolol
  • Tipranavir
  • Tizanidine
  • Tolmetin
  • Tolvaptan
  • Topiramate
  • Tramadol
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  • Tranylcypromine
  • Trazodone
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  • Triamterene
  • Trimethoprim
  • Tucatinib
  • Valdecoxib
  • Valproic Acid, Divalproex Sodium
  • Vemurafenib
  • Verapamil
  • Verteporfin
  • Vinorelbine
  • Voriconazole
  • Yohimbine
  • Zafirlukast
  • Ziprasidone
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