Hydrochlorothiazide + Valsartan

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Generic Name of Hydrochlorothiazide + Valsartan - Learn More

Hydrochlorothiazide + Valsartan

Hydrochlorothiazide + Valsartan Precaution - What You Need to Know

Hydrochlorothiazide + Valsartan, a combination of a thiazide diuretic and an angiotensin II receptor antagonist, requires careful consideration in certain populations. Special precautions should be observed in pregnant or breastfeeding women, individuals with renal or hepatic impairment, and patients with electrolyte imbalances, dehydration, or a history of cardiovascular disorders. The medication can cause a reduction in blood pressure, so blood pressure should be closely monitored during treatment, especially in those with a history of hypotension.

- Pregnancy and Breastfeeding: The combination of Hydrochlorothiazide and Valsartan is contraindicated during pregnancy, particularly in the second and third trimesters, as it can cause fetal harm, including renal dysfunction, oligohydramnios, and skull ossification defects. Both drugs are excreted in breast milk, so caution is advised when used in breastfeeding mothers.
- Renal Impairment: Patients with renal insufficiency or those on dialysis need special consideration, as Hydrochlorothiazide may further reduce kidney function, and Valsartan may increase serum potassium levels. Frequent monitoring of renal function is necessary.
- Electrolyte Imbalances: Monitoring of serum electrolytes, particularly potassium, sodium, and magnesium, is essential. Hydrochlorothiazide can cause hypokalemia, whereas Valsartan may contribute to hyperkalemia.
- Cardiovascular Disease: In patients with conditions like heart failure or coronary artery disease, close monitoring of blood pressure is crucial to prevent hypotension.
- Misuse or Dependency: The combination does not pose significant risks for misuse or physical dependency, but caution is advised in patients with a history of substance abuse.

Hydrochlorothiazide + Valsartan Indication - Uses and Benefits

Hydrochlorothiazide + Valsartan is primarily indicated for the treatment of hypertension (high blood pressure) and heart failure. The combination works synergistically to lower blood pressure and reduce the workload on the heart. The thiazide diuretic, Hydrochlorothiazide, helps decrease blood volume by promoting urine output, while Valsartan, an angiotensin II receptor blocker, dilates blood vessels and reduces blood pressure.

- Hypertension: This drug combination is widely used as a first-line or adjunctive treatment for patients with hypertension, often when monotherapy is insufficient.
- Heart Failure: It is also indicated in the management of heart failure to reduce the risk of hospitalization and mortality.
- Off-label Uses: Some off-label uses may include the treatment of chronic kidney disease in hypertensive patients or use in patients with diabetic nephropathy, though evidence for these uses is still under evaluation.

Hydrochlorothiazide + Valsartan Contraindications - Important Warnings

The use of Hydrochlorothiazide + Valsartan is contraindicated in certain conditions where the drug combination would be unsafe or ineffective.

- Hypersensitivity: Patients with known hypersensitivity to either Hydrochlorothiazide, Valsartan, or other components of the formulation should not use this medication.
- Pregnancy: The combination is contraindicated during pregnancy due to the risk of fetal harm, including renal dysfunction and intrauterine growth restriction.
- Severe Renal Impairment: This drug is contraindicated in patients with severe renal impairment (e.g., creatinine clearance <30 mL/min), as both components of the medication can worsen renal function.
- Hyperkalemia: This drug combination should not be used in patients with hyperkalemia (serum potassium >5.5 mEq/L) due to the risk of worsening electrolyte imbalances.
- Bilateral Renal Artery Stenosis: In patients with bilateral renal artery stenosis or stenosis of the artery to a solitary kidney, the use of this combination can precipitate renal failure.
- Age Restrictions: The use of this medication in pediatric patients under 18 years old is generally not recommended, as safety and efficacy have not been established.

Hydrochlorothiazide + Valsartan Side Effects - What to Expect

Hydrochlorothiazide + Valsartan may cause a range of side effects, some of which are common and mild, while others may be more severe.

- Common Side Effects:
- Dizziness or lightheadedness
- Fatigue
- Headache
- Cough (though rare, more common with Valsartan than Hydrochlorothiazide)
- Abdominal pain
- Serious Side Effects:
- Hyperkalemia (high potassium levels)
- Hypotension (especially during the initial stages of treatment)
- Renal dysfunction (elevated serum creatinine)
- Angioedema (swelling of deeper layers of skin, particularly in the face or throat)
- Severe allergic reactions
- Long-term Effects: Prolonged use can result in persistent electrolyte imbalances, such as hypokalemia (from Hydrochlorothiazide) or hyperkalemia (from Valsartan), and renal impairment.

Monitoring for side effects includes regular checks of blood pressure, electrolytes, renal function, and any signs of allergic reactions. If severe side effects such as angioedema or signs of renal dysfunction (reduced urine output, swelling, fatigue) occur, immediate medical intervention is necessary.

Hydrochlorothiazide + Valsartan Pregnancy Category ID - Safety Information

3

Hydrochlorothiazide + Valsartan Mode of Action - How It Works

Hydrochlorothiazide + Valsartan combines two distinct mechanisms of action to manage hypertension and heart failure.

- Hydrochlorothiazide: As a thiazide diuretic, Hydrochlorothiazide works by inhibiting sodium reabsorption in the distal convoluted tubule of the nephron in the kidneys. This leads to increased excretion of sodium, chloride, and water, reducing blood volume and, consequently, blood pressure.
- Valsartan: Valsartan, an angiotensin II receptor antagonist, blocks the binding of angiotensin II to its receptor (AT1 receptor), preventing the vasoconstrictive and aldosterone-secreting effects of angiotensin II. This causes vasodilation, reduces aldosterone secretion, and decreases blood pressure.

Together, the combination effectively reduces blood pressure through both volume reduction (due to Hydrochlorothiazide) and vasodilation (due to Valsartan). The dual action makes this combination effective for both controlling hypertension and managing the symptoms of heart failure by decreasing the strain on the heart.

Hydrochlorothiazide + Valsartan Drug Interactions - What to Avoid

Hydrochlorothiazide + Valsartan has the potential for various drug-drug interactions that may alter its therapeutic effect or increase the risk of adverse outcomes.

- ACE Inhibitors or ARBs: Concurrent use with other ACE inhibitors or angiotensin II receptor blockers (ARBs) may lead to an increased risk of hyperkalemia, hypotension, and renal dysfunction. Therefore, such combinations should generally be avoided.
- Potassium Supplements: Since Hydrochlorothiazide can cause potassium loss and Valsartan can elevate potassium levels, the combined use of potassium supplements or potassium-sparing diuretics can result in hyperkalemia. Monitoring is required if these drugs are used together.
- NSAIDs: Nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce the blood pressure-lowering effects of both Hydrochlorothiazide and Valsartan, as well as impair renal function. Caution is needed when co-administering NSAIDs.
- Lithium: The combination may increase the serum concentration of lithium, leading to potential toxicity. Close monitoring of lithium levels is recommended if both drugs are used together.
- Food and Alcohol: Alcohol may enhance the hypotensive effect of this medication, so alcohol consumption should be limited. There are no major food interactions, but it is recommended to take the medication with food to minimize gastrointestinal irritation.

Hydrochlorothiazide + Valsartan Pregnancy Category Note - Key Information

Pregnancy category: 1st trimester, C; 2nd and 3rd trimesters, D

Hydrochlorothiazide + Valsartan Adult Dose - Recommended Dosage

For adults, the recommended starting dose of Hydrochlorothiazide + Valsartan typically involves a combination of 12.5 mg of Hydrochlorothiazide and 80 mg of Valsartan once daily. The dose may be adjusted based on patient response and tolerability.

- Titration: Dosing may be gradually increased, typically to 25 mg of Hydrochlorothiazide and 160 mg of Valsartan once daily. The maximum recommended dose is 25 mg of Hydrochlorothiazide and 320 mg of Valsartan daily.
- Administration: This medication is taken orally, preferably once a day, with or without food. Consistent daily use at the same time is recommended for optimal effect.
- Specific Populations: In elderly patients or those with renal impairment, dose adjustments may be necessary.

Hydrochlorothiazide + Valsartan Child Dose - Dosage for Children

The use of Hydrochlorothiazide + Valsartan in children is not typically recommended, as safety and efficacy have not been established in pediatric populations. Clinical studies are limited, and pediatric dosing guidelines are not well defined.

- General Recommendations: If the drug combination is prescribed off-label in children (under the supervision of a specialist), it should be done with careful consideration and close monitoring of blood pressure, renal function, and electrolytes.
- Safety Concerns: Pediatric patients may have different pharmacokinetics and responses to the medication, particularly in terms of kidney function and electrolyte balance. Consequently, careful titration and monitoring are crucial if used.

Hydrochlorothiazide + Valsartan Renal Dose - Dosage for Kidney Conditions

In patients with renal impairment, Hydrochlorothiazide + Valsartan requires careful consideration:

- Mild Renal Impairment (Creatinine Clearance 30–60 mL/min): Start at the lowest dose and monitor renal function closely. Adjustments may be needed based on the response.
- Severe Renal Impairment (Creatinine Clearance <30 mL/min): This combination is generally not recommended in patients with severe renal impairment due to the risk of further renal deterioration and electrolyte imbalances.
- Dialysis: Hydrochlorothiazide is not significantly dialyzable, and the combination should be avoided in patients undergoing dialysis.

Regular monitoring of renal function (serum creatinine and electrolytes) is essential during therapy, especially during the initiation phase or with dose adjustments.