Valsartan and Hydrochlorothiazide

Angiotensin-II Antagonist · Angiotensin II antagonist/Thiazide diuretic

Indications

Hypertension not adequately controlled by valsartan alone.

Dosage

Adults: 1 tab daily using the strength as clinically appropriate. Children: Not recommended.

Adverse Effects

Hyperlipidaemia, electrolyte disturbances, hyperuricaemia, postural hypotension, anorexia, GI upset, urticaria, rash, impotence. Very rarely syncope, thrombocytopenia, renal dysfunction, angioedema. Photosensitivity and angle-closure glaucoma (discontinue).

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Severe renal or hepatic impairment, cirrhosis, biliary obstruction, renal artery stenosis, severe CHF, anuria, cholestasis, primary hyperaldosteronism, refractory hypokalaemia, hyponatraemia or hypercalcaemia, hyperuricaemia. Precautions: Mild to moderate renal or hepatic impairment, salt or volume depletion, SLE, diabetes, post MI; monitor serum electrolytes, creatinine and uric acid. Kidney transplant, aortic or mitral stenosis, obstructive hypertrophic cardiomyopathy, asthma, history of angioedema.

Interactions

Lithium, corticosteroids, K+-sparing diuretics or K+ supplements, heparin, muscle relaxants, cyclosporin, hypoglycaemic agents, NSAIDS, methotrexate, cyclophosphamide, pressor amines, allopurinol, digitalis, calcium supplements, diazoxide, anticholinergics, insulin, carbenoxolone, penicillin G, salicylic acid, Vit D analogue, cholestyramine, colestipol, alcohol, barbiturates, narcotics.

Advice to Patient

Take with or without meals.

Pharmacokinetics

VALSARTAN: Onset of action: Approx. 2 hrs. Duration: 24 hrs. Metabolism: To inactive metabolite. Bioavailability: Tab: 25%. Susp: Approx. 40%. Half-life elimination: Children 1-5 yrs: Approx. 4 hrs. 6-16 yrs: Approx. 5 hrs. Adults: Approx. 6 hrs. Time to peak, serum: Children 1-16 yrs: Oral susp: 2 hrs. Adults: 2-4 hrs. Excretion: Faeces (83%). Urine (13%). HYDROCHLOROTHIAZIDE: Onset of action: Diuresis: Infants: 2-6 hrs. Adults: Approx. 2 hrs. Peak effect: 4-6 hrs. Duration: Infants: 8 hrs. Adults: 6-12 hrs. Absorption: Well absorbed, absorption is decreased in patients with CHF. Metabolism: Not metabolized. Bioavailability: 65%-75%. Half-life elimination: Approx. 6-15 hrs. Time to peak: Approx. 1-5 hrs. Excretion: Urine.

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.