valsartan and hydrochlorothiazide

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

What is valsartan/hydrochlorothiazide? How does it work (mechanism of action)?

WARNING: The U.S. Food and Drug Administration is alerting health care professionals and patients of a voluntary recall of several drug products containing the active ingredient valsartan, used to treat high blood pressure and heart failure. This recall is due to an impurity, N-nitrosodimethylamine (NDMA), which was found in the recalled products. However, not all products containing valsartan are being recalled. NDMA is classified as a probable human carcinogen (a substance that could cause cancer) based on results from laboratory tests. Don't stop taking valsartan suddenly. Talk to your doctor if you take valsartan/hydrophlorothiazide.

What is valsartan, and how does it work (mechanism of action)?

Valsartan/hydrochlorothiazide is a combination of two medications that is used to treat high blood pressure and congestive heart failure. It belongs to a class of drugs called angiotensin receptor blockers (ARBs) which also includes:

Angiotensin, formed in the blood by the action of angiotensin converting enzyme (ACE), 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 muscles to contract and the blood vessels to narrow (vasoconstrict) which leads to an increase in blood pressure (hypertension). Valsartan blocks the angiotensin receptor. By blocking the action of angiotensin, valsartan dilates (widens) blood vessels and reduces blood pressure. Valsartan belongs to the class of drugs called ARBs or angiotensin II receptor blockers

Hydrochlorothiazide is a diuretic (water pill) used for treating high blood pressure and accumulation of fluid. It works by blocking salt and water reabsorption in the kidneys, thus causing increased output of urine containing increased amounts of water and salt (diuresis). The mechanism of its action in lowering high blood pressure is not well understood. The combination of valsartan and hydrochlorothiazide reduces blood pressure more that either drug alone.

The FDA approved valsartan/hydrochlorothiazide in March 1998.

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What are the uses for valsartan/hydrochlorothiazide?

Valsartan/hydrochlorothiazide is used for the treatment of blood pressure in patients with or without a history of congestive heart failure.

What are the side effects of valsartan/hydrochlorothiazide?

Side effect of valsartan/hydrochlorothiazide are the same as its individual components.

Valsartan is generally well-tolerated. The most common side effects of valsartan include:

Patients also may experience:

Rare but serious side effects of valsartan are:

  • rhabdomyolysis (inflammation and destruction of muscle), and
  • angioedema (swelling of soft tissues including those of the throat and larynx).

What is the dosage for valsartan/hydrochlorothiazide?

The recommended starting dose of valsartan/hydrochlorothiazide is 80/12.5 to 160 mg/ 12.5 mg by mouth once daily. If blood pressure is not controlled, doses may be increased every 1 to 2 weeks to a maximum of 320 mg/25 mg per day.

Which drugs or supplements interact with valsartan/hydrochlorothiazide?

Valsartan/hydrochlorothiazide can increase lithium (Lithobid, Eskolith) levels in the body. Patients may experience increased side effects of lithium like:

Patients should seek medical attention in cases of lithium toxicity.

Valsartan/hydrochlorothiazide should be used with caution with nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen (Naprosyn), ibuprofen (Motrin), meloxicam (Mobic), and celecoxib (Celebrex) because they can worsen kidney function and lower water removing effects of valsartan/hydrochlorothiazide.

Is valsartan/hydrochlorothiazide safe to take if I'm pregnant or breastfeeding?

  • Valsartan/hydrochlorothiazide is not recommended for pregnant females. It may cause injury and even death to the developing fetus.
  • Valsartan/hydrochlorothiazide is not recommended for females who are breastfeeding because it may enter breast milk.

What else should I know about valsartan/hydrochlorothiazide?

Valsartan/hydrochlorothiazide:
  • Valsartan/hydrochlorothiazide is available as tablets of 40, 80, 160 and 320 mg. Tablets are scored and can be split.How should I keep valsartan/hydrochlorothiazide
  • Valsartan/hydrochlorothiazide tablets should be stored between 15 C and 30 C (59 and 86 F).
  • valsartan/hydrochlorothiazide is available in generic form. You need a prescription to obtain this drug.

Summary

Valsartan and hydrochlorothiazide (Diovan HCT) is a combination of two prescription medicaiton used to treat high blood pressure. Side effects, drug interactions, dosing, storage, and pregnancy safety information should be reviewed prior to taking any medication.

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You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

References
REFERENCE:

FDA Prescribing Informaiton.

FDA Press Release July 13, 2018. FDA announces voluntary recall of several medicines containing valsartan following detection of an impurity.
<https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm613532.htm>

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