Hydrochlorothiazide Valsartan

Hydrochlorothiazide Valsartan Brand Name– Diovan HCT

What is Hydrochlorothiazide Valsartan

Hydrochlorothiazide and valsartan are used together in a once daily oral preparation to manage hypertension.

Hydrochlorothiazide is a thiazide diuretic which enhances sodium and chloride excretion. Valsartan is a specific angiotensin II antagonist which selectively and competively blocks the AT₁ 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 AT₁ 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.

Greater antihypertensive efficacy is achieved by adding a small dose of a diuretic to the angiotensin II antagonist.

Valsartan tends to reverse the potassium loss, but not the rise in serum uric acid levels associated with hydrochlorothiazide.

Diovan HCT® was approved for US marketing by the FDA on March 10, 1998.

Indications

• hypertension

Side Effects

1. abdominal pain
2. agranulocytosis
3. alopecia
4. anaphylactoid reactions
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. bronchospasm
16. bullous rash
17. chest pain (unspecified)
18. constipation
19. cough
20. dehydration
21. depression
22. diarrhea
23. dizziness
24. drowsiness
25. dyspepsia
26. dyspnea
27. dysuria
28. elevated hepatic enzymes
29. epistaxis
30. erythema multiforme
31. exfoliative dermatitis
32. fatigue
33. fever
34. flatulence
35. flushing
36. glycosuria
37. gout
38. headache
39. hemolytic anemia
40. hepatitis
41. hyperbilirubinemia
42. hypercalcemia
43. hypercholesterolemia
44. hyperglycemia
45. hyperhidrosis
46. hyperkalemia
47. hypertriglyceridemia
48. hyperuricemia
49. hypokalemia
50. hypomagnesemia
51. hyponatremia
52. hypotension
53. hypovolemia
54. impotence (erectile dysfunction)
55. increased urinary frequency
56. influenza
57. insomnia
58. jaundice
59. leukopenia
60. libido decrease
61. metabolic alkalosis
62. muscle cramps
63. myalgia
64. myasthenia
65. myopia
66. nasal congestion
67. nausea
68. nephrolithiasis
69. neutropenia
70. ocular hypertension
71. oliguria
72. orthostatic hypotension
73. palpitations
74. pancreatitis
75. paresthesias
76. peripheral edema
77. pharyngitis
78. photosensitivity
79. pneumonitis
80. pruritus
81. pulmonary edema
82. purpura
83. rash
84. renal failure (unspecified)
85. restlessness
86. rhabdomyolysis
87. sialadenitis
88. sinus tachycardia
89. sinusitis
90. Stevens-Johnson syndrome
91. syncope
92. teratogenesis
93. thrombocytopenia
94. tinnitus
95. toxic epidermal necrolysis
96. urticaria
97. vasculitis
98. vertigo
99. vomiting
100. weakness
101. xanthopsia
102. xerostomia

Monitoring Parameters

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

Contraindications

• ACE-inhibitor induced angioedema
• angioedema
• anuria
• asthma
• breast-feeding
• children
• diabetes mellitus
• electrolyte imbalance
• geriatric
• gout
• heart failure
• hepatic disease
• hypercalcemia
• hyperglycemia
• hyperkalemia
• hyperuricemia
• hypokalemia
• hypomagnesemia
• hyponatremia
• hypotension
• hypovolemia
• orthostatic hypotension
• pancreatitis
• penicillin hypersensitivity
• pregnancy
• renal artery stenosis
• renal disease
• renal failure
• renal impairment
• sulfonamide hypersensitivity
• sunlight (UV) exposure
• surgery
• sympathectomy
• syncope
• systemic lupus erythematosus (SLE)
• thiazide diuretic hypersensitivity

Interactions

• Acarbose
• Acetaminophen; Butalbital; Caffeine; Codeine
• Acetaminophen; Caffeine; Dihydrocodeine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
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• 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; Pseudoephedrine
• Acetaminophen; Tramadol
• Acetazolamide
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• Acrivastine; Pseudoephedrine
• Albiglutide
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• Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
• Aliskiren; Hydrochlorothiazide, HCTZ
• Aliskiren; Valsartan
• Allopurinol
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