Amlodipine, Valsartan, and Hydrochlorothiazide (Oral)

Amlodipine, valsartan, and hydrochlorothiazide are different medicines which are used together to tackle hypertension, also known as high blood pressure, and help prevent the knock-on effects this condition can cause.

Overview

Amlodipine, valsartan, and hydrochlorothiazide are three distinct medicines, each with different qualities, which can work together to combat hypertension in the human body.

Amlodipine, firstly, is what is known as a calcium channel blocker, or a CCB for short. This drug works by controlling the amount of calcium which is present in your heart cells, and also by monitoring the levels present in your blood vessels. By doing so, it helps the heart to work more efficiently by making your blood vessels less tense and allowing more of that all-important oxygen and blood to reach your heart.

Secondly, valsartan works as an angiotensin II receptor blocker - or an ARB. This particular drug works by reducing the amount of angiotensin II in your body, as this substance contributes to the tightening of blood vessels. By helping your blood vessels to work more freely, your heart can once again take less strain.

Finally, hydrochlorothiazide is what you may know as a water pill - or, to give it its technical term, a thiazide diuretic. In some cases, the more water there is present in the human body, the higher your blood pressure can be. Hydrochlorothiazide helps your body to get rid of excess water by boosting the flow of urine, and hence cuts the blood pressure of the patient.

Amlodipine, valsartan, and hydrochlorothiazide is taken orally as a tablet and is only available when a physician or medical professional prescribes it. Its brand name in the USA is Exforge HCT - meaning you may see it referred to in this way on the side of packaging in pharmacies and stores.

Conditions treated

Type of medicine

  • Calcium channel blocker
  • Angiotensin II receptor blocker
  • Diuretic

Side effects

Some side effects of taking amlodipine, valsartan, and hydrochlorothiazide are particularly serious. In the event that you experience any of these symptoms, you should seek emergency medical help. At the emergency room, you or someone with you should make clear that you are taking amlodipine, valsartan, and hydrochlorothiazide and be detailed about your symptoms.

Serious side effects of amlodipine, valsartan, and hydrochlorothiazide include problems with your eyes, such as blurriness or a total loss of vision or pain in the eye area. Problems with your vital organs can include issues with your heart, such as an unusually speedy heart rate, or problems with your kidneys like persistent ankle or hand swelling which will not go away.

Chest pain is also classified as a severe side effect of taking amlodipine, valsartan, and hydrochlorothiazide, as it can suggest that a heart attack or other heart problems are imminent. Chest pain itself is one such sign, while other signs - like pain in the jaw, upper back or head, suffering from nausea or experiencing difficulty breathing - are also counted as serious side effects.

Finally, symptoms of low blood pressure are counted as serious side effects which require urgent medical attention. You should familiarise yourself with the symptoms of low blood pressure before you take this medication, just in case they arise while you are following the course. For reference, symptoms of low blood pressure include - but are not limited to - rashes on the skin, a sensation that you're about faint or pass out, and lightheadedness.

As well as the serious side effects outlined above, there are a number of less serious side effects which are possible. These are also the most common side effects, and as a result are more likely to happen to you when you take amlodipine, valsartan, and hydrochlorothiazide. Remember, however, that the experience of one patient can differ radically from the experience of another patient, and as a result, there is no guarantee that you will or will not experience the problems outlined here.

The less serious side effects of taking amlodipine, valsartan, and hydrochlorothiazide include feeling dizzy, fatigue, and spasms in your muscles. Furthermore, while persistent swelling is more serious, temporary or mild swelling of areas such as your feet, hands or ankles is less serious.

In the event that you experience any of these side effects, you should first assess the severity of the symptoms. If they are classified as mild and do not last for a long time, you can usually wait for them to pass. If they are classified as severe, you should consult a physician or medical professional right away.

Taking almost any medicine brings with it the risk of developing unwanted consequences of the medication's power. These side effects can range from dangerous to simply unpleasant. As with any medicine, using amlodipine, valsartan, and hydrochlorothiazide brings with it a number of potential side effects which should be monitored closely.

Before taking amlodipine, valsartan, and hydrochlorothiazide, you should ask your physician or healthcare professional to go through the list of potential side effects with you so that you are fully aware of the possible problems you may experience. If you don't understand what consequences may come with your usage of amlodipine, valsartan, and hydrochlorothiazide, always ask your healthcare professional to clarify.

The box in which the medication arrives should always come with an instruction booklet which has a list of potential side effects in it. If this is not present when you unpack your medication, you should speak to your pharmacist or healthcare professional right away. Remember to keep this document, as you may need to refer back to it later in the medication process.

Dosage

When it comes to medicine dosage, the exact amount you are prescribed can vary depending on your personal circumstances and health situation. You should always follow the dosage prescribed by your physician, as this is the level that is right for you.

  • There are some standard dosages of amlodipine, valsartan, and hydrochlorothiazide which are used in some prescriptions. In the first instance, a patient will often be prescribed one tablet to take once a day, and this may go up following two weeks of treatment.

The standard maximum daily dosage as set by the authorities is 10 milligrams (mg) of amlodipine, 25 mg of hydrochlorothiazide and 320 mg of valsartan.

  • In some cases, dosage adjustments can be made when physicians prescribe amlodipine, valsartan, and hydrochlorothiazide. Again, these depend on the individual circumstances of the patient and are not always appropriate in all sets of circumstances.

For patients who suffer from hepatic insufficiency (which occurs when the liver fails to carry out some of its required functions), lower dosages than the standard will often be considered. This is because patients who suffer from this condition have a higher exposure to amlodipine.

Similarly, patients who suffer from progressive liver disease, lower than usual hepatic function or both may require a lower dosage of hydrochlorothiazide. In the event of severe progressive liver disease or severe low hepatic function, the drug may be avoided entirely. This is because high exposure to the drug may cause an imbalance in electrolytes and fluid within the body, and this can cause hepatic coma.

Furthermore, the standard maximum dosage (10mg of amlodipine, 25 mg of hydrochlorothiazide and 320 mg of valsartan) will usually only be prescribed with caution for patients who are over the age of 65 or who suffer from diseases such as coronary heart disease and heart failure. This is because adequate research has not been carried out into the effects that amlodipine, valsartan, and hydrochlorothiazide can have on these groups.

If you fall into one of these groups, you should expect to receive more frequent monitoring of your blood pressure levels whilst you are taking amlodipine, valsartan, and hydrochlorothiazide. Although this may appear time-consuming, it is a good habit to get into and can really pay dividends when it comes to staying healthy.

  • At the discretion of a physician, amlodipine, hydrochlorothiazide and valsartan can be substituted for its individual components. Your physician should speak to you regarding this and explain why your medication is being changed.
  • In the event that you miss a dose of your amlodipine, valsartan, and hydrochlorothiazide, don't worry. What you should do first is work out how long it is until your next scheduled dose, and use that information to decide what to do next. If it is a long time until your next dose needs to be taken, you should go ahead and take the tablet you missed earlier. However, if your next dose is impending or due to be taken in a short time, you should skip the dose you missed, take the next one and then return to your normal dosage program. Never take a double dose of this medicine, as it can cause problems.

Interactions

Many drugs carry interaction warnings, which mean that they have the potential to combine with other drugs you are taking once both sets of medication are inside your body. Amlodipine, valsartan, and hydrochlorothiazide are no exception, and that is why your physician or other healthcare professional should always have your full, up to date medical history so that they are able to make safe judgments about what medications you can take.

The other drugs which interact with amlodipine, valsartan, and hydrochlorothiazide can broadly be split into three categories: those drugs which can cause major interactions, those which can cause moderate interactions, and those which can cause minor interactions.

  • There are just over 100 drugs which can cause major interactions. These include a number of drugs with citric acid in them, including citric acid/potassium bicarbonate and citric acid/potassium citrate. Other major interactions can occur with a wide range of other drugs with hydrochlorothiazide in them. These include lisinopril, triamterene, quinapril, moexipril and spironolactone.

Care should always be taken when using other medications which have potassium in them, as these drugs can interact strongly with amlodipine, valsartan, and hydrochlorothiazide. These include potassium bicarbonate, potassium acetate, potassium acid phosphate and potassium chloride. In addition, some drugs from the Uro family also come with strong interaction warnings. These include Urogesic blue (composed of methylene blue, hyoscyamine, sodium biphosphate and methenamine) and Uroplus DS (composed of trimethoprim and sulfamethoxazole).

  • The second category of drugs are those which interact moderately with amlodipine, valsartan, and hydrochlorothiazide, and with 763 drugs in this category, it is by far the largest.

Drugs which interact moderately with amlodipine, valsartan, and hydrochlorothiazide include a number of household medicine cupboard staples, so you should pay particular attention to this category if you are a regular user of over the counter medicines. These include A-G Profen (ibuprofen), A-Hydrocort (hydrocortisone) and a variety of prenatal multivitamins including Choice OB Plus and a number of drugs in the Equi-Natal range, including Equi-Natal Care, Equi-Natal M, Equi-Natal Plus and more.

  • The final category of drugs which can interact with amlodipine, valsartan, and hydrochlorothiazide are those which have minor effects only. In this category can be found a number of drugs from the Extendryl range, such as Extendryl Chews (containing phenylephrine, chlorpheniramine and methscopolamine), Extendryl DM (which is composed of methscopolamine, chlorpheniramine and dextromethorphan) and Extendryl JR (made up of methscopolamine, chlorpheniramine and phenylephrine).

Other drugs which have the potential to interact in a minor fashion with amlodipine, valsartan, and hydrochlorothiazide include some medications from the Nohist range. These include Nohist PE, NoHist EXT and Nohist Plus Jr. Similar drugs with the potential for minor interactions include some from the SymPak family, such as SymPak II, SymPak DM and SymPak PDX.

  • In addition to the many drugs which can interact with amlodipine, valsartan, and hydrochlorothiazide, there are also certain food and drink products which have the potential to interact with your usage of these medications.

Drinking alcohol whilst taking amlodipine, valsartan, and hydrochlorothiazide can cause interactions, and it can lead to symptoms like fainting, headache or changes in the rate of your pulse. For that reason, it is a good idea to take care when standing up, make sure you don't operate complex machinery or drive a vehicle until you can ascertain whether you will experience interactions between drinking alcohol and taking amlodipine, valsartan, and hydrochlorothiazide. Often, these effects happen at the start of the treatment process rather than later, and can also be seen if you begin taking the drugs again after a break or increase your dose.

If you take any multivitamins, there is a possibility that they will interact in a negative way with amlodipine, valsartan, and hydrochlorothiazide. For example, the effects of amlodipine can be lowered substantially if you use them alongside multivitamins which have minerals in them.

Finally, there are certain dietary restrictions which may be wise if you are planning to use amlodipine, valsartan, and hydrochlorothiazide. These tend to center around the usage of supplements and substitutes. Salt substitutes which contain potassium, for example, can interact with these drugs, while potassium supplements can also interact.

This is not an exhaustive list of drugs or products which can cause major interactions with amlodipine, valsartan, and hydrochlorothiazide, so in order to prevent or manage problems, ensure your physician is fully informed.

Warnings

As with any drug, there are a wide range of warnings which come associated with taking amlodipine, valsartan, and hydrochlorothiazide. While not every warning may be relevant to you, it's wise to read the full list and ask your physician to advise you to ensure you don't miss any possible warnings which might be relevant to you.

  • Pregnant women should not take amlodipine, valsartan, and hydrochlorothiazide. If you discover that you are pregnant and you are taking this medication, you should immediately stop taking it and speak to a medical professional right away.

The reason that this medication is not suitable for those carrying a child is that it can adversely harm the renal function of your unborn baby. Because the drug affects the renin-angiotensin system, the chances of babies dying during the second or third pregnancy trimesters (the final six months of pregnancy) are higher. The problems caused center around oligohydramnios, which can affect your baby's lungs and skeleton and can increase the risk of jaundice.

Storage

When it comes to looking after your medicines, you should always ensure they are kept in suitable conditions to avoid damaging them or causing them to fail to work. Your amlodipine, valsartan, and hydrochlorothiazide pills are no exception.

  • Firstly, you should always store the tablets in a closed container to prevent them from being damaged by environmental conditions. They should be kept at room temperature. If your amlodipine, valsartan, and hydrochlorothiazide are exposed to conditions such as moisture or direct sunlight then they may become damaged. Other conditions which can affect your pills include high levels of light and excessive heat sources. Ensure that your amlodipine, valsartan, and hydrochlorothiazide do not get frozen.
  • When using these drugs, it is also vital that you keep these medicines out of the reach of children as this can help prevent accidental consumption.
  • If you no longer need your amlodipine, valsartan, and hydrochlorothiazide or it has gone out of date, you should dispose of it. If you are unsure what the best method of disposing of unnecessary medicines is, your physician or other medical professional will be able to advise.

Summary

Amlodipine, valsartan, and hydrochlorothiazide is a helpful drug in the fight against hypertension. By combining the useful effects of calcium channel blockers, angiotensin II receptor blockers and diuretics, the drug can help promote a healthy blood pressure level inside the human body.

Taken as a tablet following a prescription, amlodipine, valsartan, and hydrochlorothiazide brings a number of side effects with it. These can range from serious problems, such as loss of vision, a fast heart rate or persistent swelling around the hands or feet. In the event that you experience these serious side effects, you should seek urgent medical care. Other side effects which can arise as a result of taking amlodipine, valsartan, and hydrochlorothiazide are much less serious, such as feelings of dizziness and muscle spasms, and these usually only require medical attention if they cause lots of problems or will not go away.

When it comes to dosage, you should take your amlodipine, valsartan, and hydrochlorothiazide as prescribed by your physician or other medical professional. The standard maximum dosage is 10 milligrams (mg) of amlodipine, 25 mg of hydrochlorothiazide and 320 mg of valsartan, and these levels should not be exceeded. Dosage levels could be different in some circumstances, such as if you suffer from conditions like progressive liver disease. You should always follow your physician's advice.

As with many drugs, amlodipine, valsartan, and hydrochlorothiazide can interact with other drugs once inside the human body. Some of these drugs are available over the counter and as a result may be staples of your medicine cupboard at home, so you should always ensure you tell your doctor which medications you currently take to avoid any unpleasant effects of drug interactions. Most of the drugs in question cause moderate levels of interaction with amlodipine, valsartan, and hydrochlorothiazide, although some interact in a strong way so it is wise to exercise caution.

Pregnant women should not take amlodipine, valsartan, and hydrochlorothiazide, as it can inflict disease on unborn babies and cause them to suffer from problems like lung conditions, skeleton deformations and jaundice. You should always consult a full list of warnings prior to taking amlodipine, valsartan, and hydrochlorothiazide or any other medication.

You should always take care when storing your amlodipine, valsartan, and hydrochlorothiazide. Ensure that the tablets are kept out of the reach of any children who live in or may visit your home to prevent accidental consumption. Furthermore, ensure that you dispose of any unused or out of date amlodipine, valsartan, and hydrochlorothiazide in an appropriate fashion. If you are unsure how to go about this, you should contact your physician or other medical professional to find out more.

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Last Reviewed:
December 10, 2017
Last Updated:
April 05, 2018
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