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
  • Acrivastine; Pseudoephedrine
  • Albiglutide
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  • Alemtuzumab
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  • Alfentanil
  • Aliskiren
  • Aliskiren; Amlodipine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Aliskiren; Valsartan
  • Allopurinol
  • Alogliptin
  • Alogliptin; Metformin
  • Alogliptin; Pioglitazone
  • Alpha-glucosidase Inhibitors
  • Alprostadil
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  • Aminolevulinic Acid
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  • Chlorpheniramine; Hydrocodone
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  • Hydrocodone
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  • Ribociclib
  • Ribociclib; Letrozole
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Risperidone
  • Ritonavir
  • Rocuronium
  • Rofecoxib
  • Rosiglitazone
  • Salicylates
  • Salmeterol
  • Saquinavir
  • Saxagliptin
  • Scopolamine
  • Segesterone Acetate; Ethinyl Estradiol
  • Selegiline
  • Semaglutide
  • Serotonin norepinephrine reuptake inhibitors
  • Sertraline
  • Sevoflurane
  • SGLT2 Inhibitors
  • Sildenafil
  • Silodosin
  • Simeprevir
  • Simvastatin
  • Simvastatin; Sitagliptin
  • Sincalide
  • Sirolimus
  • Sitagliptin
  • Sodium Phosphate Monobasic Monohydrate; Sodium Phosphate Dibasic Anhydrous
  • Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
  • Sofosbuvir; Velpatasvir
  • Sofosbuvir; Velpatasvir; Voxilaprevir
  • Solifenacin
  • Sotalol
  • Spironolactone
  • St. John’s Wort, Hypericum perforatum
  • Streptozocin
  • Succinylcholine
  • Sufentanil
  • Sulfacetamide
  • Sulfacetamide; Sulfur
  • Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
  • Sulfinpyrazone
  • Sulfonylureas
  • Sulindac
  • Tacrolimus
  • Tamsulosin
  • Tapentadol
  • Tazarotene
  • Tegaserod
  • Telaprevir
  • Telithromycin
  • Telotristat Ethyl
  • Temsirolimus
  • Terbutaline
  • Tetrabenazine
  • Tetracaine
  • Thalidomide
  • Thiazolidinediones
  • Thiopental
  • Thiothixene
  • Timolol
  • Tiotropium; Olodaterol
  • Tipranavir
  • Tizanidine
  • Tolazamide
  • Tolbutamide
  • Tolmetin
  • Tolterodine
  • Tolvaptan
  • Topiramate
  • Toremifene
  • Tramadol
  • Trandolapril
  • Trandolapril; Verapamil
  • Tranylcypromine
  • Trazodone
  • Treprostinil
  • Tretinoin, ATRA
  • Triamterene
  • Trihexyphenidyl
  • Trimethoprim
  • Trospium
  • Tubocurarine
  • Tucatinib
  • Umeclidinium; Vilanterol
  • Valdecoxib
  • Valproic Acid, Divalproex Sodium
  • Vecuronium
  • Vemurafenib
  • Venlafaxine
  • Verapamil
  • Verteporfin
  • Vilazodone
  • Vinorelbine
  • Vitamin D
  • Vitamin D analogs
  • Voriconazole
  • Vorinostat
  • Vortioxetine
  • Yohimbine
  • Zafirlukast
  • Ziconotide
  • Ziprasidone
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