amlodipine and valsartan (Exforge)

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GENERIC NAME: amlodipine and valsartan


DRUG CLASS AND MECHANISM: Exforge is a combination of two drugs used for treating high blood pressure (hypertension), amlodipine and valsartan. The FDA approved Exforge in June 2007.

Amlodipine belongs to a class of drugs called calcium channel blockers. These medications block the transport of calcium into the smooth muscle cells lining the coronary arteries and other arteries of the body. Since calcium is important in promoting contraction of muscles, blocking calcium transport relaxes the muscles that surround arteries, dilating (enlarging) the arteries of the body including the arteries of the heart (coronary arteries). Dilating arteries lowers blood pressure.

Valsartan is an oral drug that belongs to a class of drugs called angiotensin receptor blockers (ARBs) . Angiotensin, formed in the blood by the action of angiotensin converting enzyme (ACE) on a chemical in blood called angiotensinogen. Angiotensin is a powerful chemical that attaches to angiotensin receptors found in many tissues but primarily on smooth muscle cells surrounding blood vessels. Angiotensin's attachment to the receptors causes the blood vessels to narrow (constrict) which leads to an increase in blood pressure (hypertension). Valsartan blocks the angiotensin receptor. By blocking the action of angiotensin, valsartan dilates blood vessels and reduces blood pressure.



PREPARATIONS: Tablets: 5/160, 5/320, 10/160, and 10 mg/320 mg,

STORAGE: Tablets should be stored at room temperature, 15-30 C (59-86 F).

PRESCRIBED FOR: Exforge is used for treating high blood pressure in patients not adequately controlled on one blood pressure medication or for initial therapy if it is not likely that one drug will achieve adequate control.

DOSING: The usual dose is 5/160 to 10mg/320 mg daily. The majority of the effect is seen within 2 weeks.

DRUG INTERACTIONS: Combining valsartan with potassium-sparing diuretics (for example, spironolactone [Aldactone], triamterene [Maxzide, Dyazide], amiloride), potassium supplements, or salt substitutes containing potassium may lead to hyperkalemia (elevated potassium in the blood), and in heart failure patients, it increases serum creatinine, a test used for monitoring function of the kidneys.

PREGNANCY: When used in the second or third trimester of pregnancy valsartan may cause injury and even death to the fetus. Valsartan should not be used during pregnancy. When pregnancy is detected, Exforge should be stopped as soon as possible.

NURSING MOTHERS: It is not known whether Exforge is secreted into human milk. To prevent adverse effects in the infant, mothers should use alternative agents or discontinue nursing.

SIDE EFFECTS: Side effects include headache, dizziness, fatigue, abdominal pain, cough, diarrhea and nausea. Patients may also experience hyperkalemia, impotence, reduced renal function, and allergic reactions. Angioedema (swelling of soft tissues including those of the throat and larynx) is a rare but serious side effect of valsartan.

Reference: FDA prescribing information for Exforge

Last Editorial Review: 7/27/2010 3:42:20 PM

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