valsartan/hydrochlorothiazide (Diovan HCT)

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:

• irbesartan (Avapro),
• losartan (Cozaar), and
• candesartan (Atacand).

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.

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

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:

• Headache
• Dizziness
• Fatigue
• Abdominal pain
• Cough
• Diarrhea
• Nausea

Patients also may experience:

• Hyperkalemia (high blood potassium)
• Impotence
• Reduced renal function
• Allergic reactions

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).

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.

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

• Increased thirst
• Decreased heart rate
• Weakness
• Blurred vision
• Decreased concentration
• Ringing in the ears

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.

• 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.

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.