Valsartan + Hydrochlorothiazide: Brands, Price & Uses in Bangladesh

Valsartan + Hydrochlorothiazide is a fixed-dose combination antihypertensive (an angiotensin receptor blocker plus a thiazide diuretic) indicated for:

• Hypertension: Treatment of high blood pressure in adult patients whose blood pressure is not adequately controlled on monotherapy with either component alone. Valsartan + Hydrochlorothiazide is also indicated as initial therapy in patients likely to need multiple drugs to reach their blood pressure goal.

Valsartan + Hydrochlorothiazide is not indicated for the initial treatment of hypertension in patients who are volume-depleted, nor as a substitute for the individual components when initiating therapy. It lowers blood pressure but has not been specifically studied to demonstrate reduction of cardiovascular morbidity or mortality; benefit is inferred from blood pressure lowering. Use should be individualized by a physician based on response to and tolerability of the individual components.

Adult Dose - Hypertension

Pediatric Dose

Safety and efficacy of Valsartan + Hydrochlorothiazide as a fixed-dose combination have not been established in children; it is not recommended for pediatric use (see Pediatric Uses).

Renal Impairment

Valsartan + Hydrochlorothiazide is not recommended in patients with severe renal impairment (estimated glomerular filtration rate below 30 mL/min/1.73m²) because thiazides may be ineffective and can precipitate azotemia in this population; the drug is contraindicated in anuria. Caution and monitoring of renal function are advised in mild-to-moderate renal impairment.

Hepatic Impairment

No dose adjustment of valsartan is generally required in mild-to-moderate hepatic impairment without cholestasis; Valsartan + Hydrochlorothiazide should be used cautiously in hepatic impairment because minor alterations in fluid and electrolyte balance may precipitate hepatic coma.

If a dose of Valsartan + Hydrochlorothiazide is missed, it should be taken as soon as remembered unless it is nearly time for the next dose, in which case the missed dose should be skipped; doses should not be doubled.

Side effects of Valsartan + Hydrochlorothiazide arise from its two components.

Common

• Dizziness or light-headedness
• Headache
• Fatigue
• Upper respiratory tract symptoms
• Diarrhea
• Mild hypotension, especially after the first few doses

Less Common/Serious

• Electrolyte disturbances: hypokalemia, hyponatremia, and, less commonly, hyperkalemia (net effect requires monitoring - see Precautions and Warnings)
• Hyperuricemia and precipitation of gout
• Hyperglycemia and worsening of glycemic control in diabetic patients (thiazide-related)
• Symptomatic hypotension, particularly in volume- or salt-depleted patients
• Deterioration of renal function, particularly with pre-existing renal impairment or volume depletion
• Photosensitivity reactions (thiazide-related)
• Angioedema (rare)

Patients should seek prompt medical advice for severe dizziness, fainting, muscle cramps or weakness, palpitations, marked reduction in urination, or swelling of the face/lips/tongue while taking Valsartan + Hydrochlorothiazide.