Co-Diovan

Per 80/12.5 mg tab Valsartan 80 mg, hydrochlorothiazide 12.5 mg. Per 160/12.5 mg tab Valsartan 160 mg, hydrochlorothiazide 12.5 mg. Per 160/25 mg tab Valsartan 160 mg, hydrochlorothiazide 25 mg. Per 320/12.5 mg tab Valsartan 320 mg, hydrochlorothiazide 12.5 mg. Per 320/25 mg tab Valsartan 320 mg, hydrochlorothiazide 25 mg

HTN.

1 tab daily.

May be taken with or without food.

Hypersensitivity to valsartan, hydrochlorothiazide or sulfonamides. Anuria. Concomitant use w/ aliskiren in type 2 diabetes. Pregnancy.

Concomitant use w/ K supplements, K-sparing diuretics, salt substitutes containing K, or other drugs that may increase K levels (eg, heparin). May onset hypokalemia or exacerbate preexisting hypokalemia. Discontinue if hypokalemia is accompanied by clinical signs (eg, muscular weakness, paresis, or ECG alterations). Monitor for imbalances in electrolytes, particularly K; regular monitoring of serum Na conc is recommended. Correction of serum electrolyte is recommended prior to initiation of therapy. Risk of hypotension in Na- &/or vol-depleted patients. Renal artery stenosis, biliary obstructive disorders & severe hepatic impairment. SLE. Patients w/ history of angioedema or are experiencing angioedema; discontinue immediately & do not re-administer. May cause or exacerbate hyperuricemia & precipitate gout in susceptible patients. Hypercalcemia. Allergy or asthma. Acute transient myopia & acute angle-closure glaucoma. Heart failure, severe chronic heart failure or other conditions w/ simulation of renin-angiotensin-aldosterone-system; renal impairment may occur. Avoid concomitant use w/ aliskiren in severe renal impairment (GFR <30 mL/min). Concomitant use w/ ACE inhibitors or aliskiren. Increased risk of non-melanoma skin cancer (NMSC) [eg, basal cell carcinoma (BCC) & squamous cell carcinoma (SCC)] w/ increasing cumulative dose of hydrochlorothiazide. Limit & protect skin from excessive sun exposure. Regularly check skin for new/suspicious lesions. Not to be used in women planning to get pregnant. Pregnancy & lactation. Childn <18 yr.

Hydrochlorothiazide: Increased blood lipids. Hypomagnesemia, hyperuricemia, decreased appetite; orthostatic hypotension; mild nausea & vomiting; urticaria & other forms of rash; erectile dysfunction.

Reversible increase in serum lithium conc & toxicity. Valsartan: Increased incidence of hypotension, hyperkalemia & changes in renal function w/ other agents acting on the renin-angiotensin-system. May alter serum K levels w/ K supplements, K-sparing diuretics, salt substitutes containing K or drugs that alter serum K levels (eg, heparin). May attenuate antihypertensive effect w/ NSAIDs including selective COX-2 inhibitors. Increased risk of worsening of renal function w/ NSAIDs (in elderly, vol depleted, or w/ compromised renal function). Increased systemic exposure w/ inhibitors of the uptake transporter (eg, rifampin, ciclosporin) or efflux transporter (eg, ritonavir). Hydrochlorothiazide: Potentiated antihypertensive action of other antihypertensive drugs (eg, guanethidine, methyldopa, β-blockers, vasodilators, Ca channel blockers, ACE inhibitors, ARBs & direct renin inhibitors). Potentiated action of skeletal muscle relaxants (eg, curare derivatives). May increase hypokalemic effect w/ kaliuretic diuretics, corticosteroids, ACTH, amphotericin, carbenoxolone, penicillin G, salicylic acid derivatives or antiarrhythmics. Intensified hyponatemic effect w/ antidepressants, antipsychotics, antiepileptics. May alter glucose tolerance of antidiabetic agents. Induced hypokalemia or hypomagnesemia w/ digitalis glycosides. May weaken the diuretic & antihypertensive activity w/ NSAIDs (eg, salicylic acid derivative, indomethacin). May increase incidence of hypersensitivity reactions to allopurinol. May increase risk of adverse effects w/ amantadine. May reduce renal excretion & enhance the myelosuppressive effects of antineoplastic agents (eg, cyclophosphamide, methotrexate). May increase bioavailability w/ anticholinergic agents (eg, atropine, biperiden). May decrease bioavailability w/ prokinetic drugs (eg, cisapride). Decreased absorption w/ cholestyramine or colestipol. May potentiate rise in serum Ca w/ vit D or Ca salts. May increase risk of hyperuricemia & gout-type complications w/ ciclosporin. Hypercalcemia w/ Ca salts. May enhance hyperglycemic effect of diazoxide. Hemolytic anemia w/ methyldopa. May potentiate orthostatic hypotension w/ alcohol, barbiturates, or narcotics. May reduce response to pressor amines eg, noradrenaline.

Angiotensin II Antagonists / Diuretics

C09DA03 - valsartan and diuretics ; Belongs to the class of angiotensin II receptor blockers (ARBs) in combination with diuretics. Used in the treatment of cardiovascular disease.

Rx