Amlodipine + Hydrochlorothiazide + Valsartan
Uses of Amlodipine + Hydrochlorothiazide + Valsartan
The combination of Amlodipine, Hydrochlorothiazide, and Valsartan belongs to the class of medications known as calcium channel blockers, thiazide diuretics, and angiotensin II receptor blockers. It is indicated for the treatment of hypertension, aiming to lower blood pressure through a multifaceted approach.
How Amlodipine + Hydrochlorothiazide + Valsartan Works
Amlodipine, a calcium channel blocker, relaxes blood vessels, reducing peripheral resistance. Hydrochlorothiazide, a thiazide diuretic, increases urine production, leading to decreased blood volume. Valsartan, an angiotensin II receptor blocker, blocks the effects of angiotensin II, further contributing to blood vessel dilation and blood pressure reduction. Together, these components address hypertension through complementary mechanisms.
Side Effects of Amlodipine + Hydrochlorothiazide + Valsartan
Dizziness, Headache, Swelling of Ankles, Flushing, and Increased Blood Potassium Levels.
Warnings
Kidney Use With Care
It is important to monitor serum potassium and creatinine levels when Amlodipine + Hydrochlorothiazide + Valsartan is used in patients with renal impairments. The usage of this drug is not recommended for patients with severely impaired renal function.
Alcohol Not Advisable
It is not advisable to drink alcohol with Amlodipine + Hydrochlorothiazide + Valsartan as the alcohol may cause additive effect of lowering the blood pressure resulting in symptoms such as dizziness or lightheadedness.
Pregnancy Not Safe
There is evidence of risk to the fetus in human studies, but the potential benefits of Amlodipine + Hydrochlorothiazide + Valsartan may warrant the usage despite the risks. It is recommended to change to alternative antihypertensives with established safety profiles in pregnancy, unless angiotensin receptor blocker (ARB), Calcium Channel Blocker, and Thiazide Diuretic therapy are indicated in women planning for pregnancy. It has been demonstrated that exposure to Amlodipine + Hydrochlorothiazide + Valsartan during the second and third trimesters may induce fetotoxicity and neonatal toxicity.
Driving Not advisable
Do not drive unless you are feeling well. Amlodipine + Hydrochlorothiazide + Valsartan may cause side effects such as dizziness or tiredness, all of which could affect the ability to concentrate and drive.
Liver Limited Data
It is best to avoid using Amlodipine + Hydrochlorothiazide + Valsartan in patients with severe liver impairment as there is no data available. Dose adjustment is only required for patients with moderate liver impairment and close monitoring of blood pressure and renal function is strongly indicated. Amlodipine + Hydrochlorothiazide + Valsartan should not be used in patients with biliary obstruction.
Lactation Limited Data
This drug is excreted in the milk of lactating rats but it is unknown whether olmesartan is excreted in human breast milk. Since there is no data on the usage of Olmesartan during breastfeeding, it is recommended to change to alternative antihypertensives with better safety profile.
Written by Dr Sri Viknarajan, MD (Universiti Hasanuddin, Indonesia)
Reviewed by Dr Nur Syuhada binti Zulkifli, MD, Universiti Kebangsaan Malaysia (UKM).
