Amlodipine Hydrochlorothiazide Valsartan

Amlodipine Hydrochlorothiazide Valsartan Brand Name– Exforge HCT

What is Amlodipine Hydrochlorothiazide Valsartan

Amlodipine Hydrochlorothiazide Valsartan is a triple combination product for the treatment of hypertension.

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 receptor antagonist (angiotensin II receptor blocker or ARB) that selectively and competitively blocks the AT-1 receptor, which mediates the vasopressor and aldosterone effects of angiotensin II.

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 ARBs. Hydrochlorothiazide (HCTZ) is a thiazide diuretic.

Unlike the loop diuretics, the efficacy of thiazide diuretics is diminished in patients with renal insufficiency.

Amlodipine Hydrochlorothiazide Valsartan (Exforge HCT) was initially approved by the FDA in April 2009.

Indications

• hypertension

Side Effects

1. abdominal pain
2. agranulocytosis
3. alopecia
4. angina
5. angioedema
6. anorexia
7. anxiety
8. aplastic anemia
9. appetite stimulation
10. arthralgia
11. asthenia
12. azotemia
13. back pain
14. blurred vision
15. bradycardia
16. bullous rash
17. carpal tunnel syndrome
18. chest pain (unspecified)
19. chills
20. cholestasis
21. constipation
22. cough
23. dehydration
24. depression
25. diabetes mellitus
26. diaphoresis
27. diarrhea
28. dizziness
29. drowsiness
30. dysgeusia
31. dyspepsia
32. dysphagia
33. dyspnea
34. dysuria
35. edema
36. elevated hepatic enzymes
37. erythema multiforme
38. exfoliative dermatitis
39. fatigue
40. gastritis
41. gingival hyperplasia
42. gout
43. gynecomastia
44. headache
45. hemolytic anemia
46. hemorrhoids
47. hepatitis
48. hyperbilirubinemia
49. hypercalcemia
50. hypercholesterolemia
51. hyperglycemia
52. hyperhidrosis
53. hyperkalemia
54. hyperlipidemia
55. hypertriglyceridemia
56. hyperuricemia
57. hypokalemia
58. hypomagnesemia
59. hyponatremia
60. hypotension
61. impotence (erectile dysfunction)
62. influenza
63. insomnia
64. jaundice
65. lethargy
66. leukopenia
67. malaise
68. musculoskeletal pain
69. myopia
70. nasal congestion
71. nausea
72. nephrolithiasis
73. neutropenia
74. night sweats
75. ocular hypertension
76. orthostatic hypotension
77. pancreatitis
78. pancytopenia
79. paresthesias
80. peripheral neuropathy
81. pharyngitis
82. photosensitivity
83. pruritus
84. purpura
85. rash
86. rhabdomyolysis
87. rhinitis
88. sinus tachycardia
89. Stevens-Johnson syndrome
90. syncope
91. teratogenesis
92. thrombocytopenia
93. tinnitus
94. toxic epidermal necrolysis
95. tremor
96. urticaria
97. vasculitis
98. vertigo
99. vomiting
100. weakness
101. xanthopsia
102. xerostomia

Monitoring Parameters

• blood glucose
• blood pressure
• heart rate
• LFTs
• serum bilirubin (total and direct)
• serum creatinine/BUN
• serum electrolytes
• serum uric acid

Contraindications

• ACE-inhibitor induced angioedema
• acute myocardial infarction
• angina
• angioedema
• anuria
• aortic stenosis
• asthma
• Black patients
• bradycardia
• breast-feeding
• cardiogenic shock
• cardiomyopathy
• coronary artery disease
• diabetes mellitus
• dihydropyridine hypersensitivity
• electrolyte imbalance
• geriatric
• gout
• heart failure
• hepatic disease
• hypercalcemia
• hyperglycemia
• hyperkalemia
• hyperuricemia
• hypokalemia
• hypomagnesemia
• hyponatremia
• hypotension
• hypovolemia
• mitral stenosis
• orthostatic hypotension
• pancreatitis
• penicillin hypersensitivity
• pregnancy
• renal artery stenosis
• renal impairment
• sulfonamide hypersensitivity
• sunlight (UV) exposure
• surgery
• sympathectomy
• syncope
• systemic lupus erythematosus (SLE)
• thiazide diuretic hypersensitivity
• 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; Pentazocine
• Acetaminophen; Propoxyphene
• Acetaminophen; Pseudoephedrine
• Acetaminophen; Tramadol
• Acetazolamide
• Acetohexamide
• Aclidinium; Formoterol
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• Albiglutide
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• Alfentanil
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• Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
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• Aliskiren; Valsartan
• Allopurinol
• Alogliptin
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• Alpha-glucosidase Inhibitors
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• Aminolevulinic Acid
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• Vemurafenib
• Venlafaxine
• Verapamil
• Verteporfin
• Vilazodone
• Vinorelbine
• Vitamin D
• Vitamin D analogs
• Voriconazole
• Vorinostat
• Vortioxetine
• Yohimbine
• Zafirlukast
• Ziconotide
• Ziprasidone