Diovan-HCT

Brand Names: Diovan-HCT

Common Name: valsartan - hydrochlorothiazide

What is this drug used for?

This is a combination product that contains 2 medications: valsartan and hydrochlorothiazide. This combination medication is used to treat high blood pressure. Valsartan belongs to a family of medications known as angiotensin II receptor blockers and helps to lower blood pressure by relaxing blood vessels. Hydrochlorothiazide belongs to a family of medications known as diuretics or "water pills" and helps control blood pressure by getting rid of excess salt and water. The full effects of this medication are usually seen within about 4 weeks.

This medication is most often used when a person has taken valsartan and hydrochlorothiazide as separate medications without any problems.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

Is there any reason not to take this drug?

Valsartan - hydrochlorothiazide should not be taken by anyone who:

• is allergic to valsartan, hydrochlorothiazide, or to any ingredients of this medication
• is allergic to other sulfonamide-derived medications
• is pregnant
• has anuria (inability to pass urine)

What about possible side effects?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• arm or leg pain
• cold- or flu-like symptoms
• diarrhea
• fatigue
• headache
• runny nose
• sore throat

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• chest pain
• dizziness, lightheadedness, or fainting
• muscle pain or weakness

Stop taking the medication and seek medical attention immediately if any of the following side effects occur:

• chills, fever, or sore throat
• symptoms of a severe allergic reactions, such as difficulty breathing, hives, swelling of the lips, mouth, or tongue

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

What if I am taking other drugs?

There may be an interaction between valsartan - hydrochorothiazide and any of the following:

ACTH allopurinol alcohol, barbiturates (e.g., phenobarbital, butalbital), or narcotics (e.g., codeine, morphine) amantadine atropine biperiden calcium supplements certain chemotherapy medications (e.g., cyclophosphamide, methotrexate) cholestyramine corticosteroids (e.g., prednisone) cyclosporine diazoxide

diuretics (e.g., furosemide, amiloride) digoxin epinephrine insulin lithium medications which increase potassium levels (e.g., potassium supplements, spironolactone, triamterene, or amiloride, or salt substitutes containing potassium) methyldopa nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen, naproxen) tubocurarine vitamin D supplements warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. In many cases, interactions are intended or are managed by close monitoring. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Other information:

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Cholesterol: Increases in cholesterol and triglyceride levels may occur when taking hydrochlorothiazide. Your doctor may monitor for this with blood tests.

Diabetes: Hydrochlorothiazide may make it more difficult for people with diabetes to control their blood sugar. An adjustment to doses of antidiabetes agents, including insulin, may be required. Monitor your blood sugar levels closely if you are taking this medication.

Electrolytes: The levels of electrolytes such as potassium, sodium, magnesium, and chloride can be reduced, and the levels of calcium can be increased by the use of hydrochlorothiazide. Your doctor will periodically check to see if these levels are in balance. Warning signs or symptoms of fluid and electrolyte imbalance include:

• decreased urination
• drowsiness
• dryness of mouth
• lethargy
• low blood pressure
• muscle pains or cramps
• muscular fatigue
• nausea and vomiting
• racing heartbeat
• restlessness
• thirst
• weakness

Gout: High levels of uric acid may occur in the blood, or gout may be brought on for certain people receiving hydrochlorothiazide.

Kidney problems: Use of this medication may affect the function of the kidneys, especially for those who already have impaired kidney function. Kidney function should be monitored closely in cases where people have preexisting impaired kidney function. This medication is not recommended for people with severely impaired kidney function.

Liver problems: The ability of the body to remove this medication from the body may be affected in people with liver problems. Be sure to tell your doctor if you have liver problems.

Low blood pressure: Occasionally, a greater-than-expected drop in blood pressure occurs after taking this medication. In some cases, this happens after the first dose. It is more likely to occur if you have a reduced salt intake, are on dialysis, or are experiencing diarrhea or vomiting. Blood pressure should be monitored more often in these situations, and those who have low blood pressure or are just starting to take this medication should move slowly from a reclined to an upright position to reduce the risk of dizziness.

Lupus: There have been reports of worsening or activation of lupus in people taking hydrochlorothiazide.

Pregnancy: This medication should not be taken by pregnant women. If you discover you are pregnant while taking this medication, stop taking it and tell your doctor at once.

Breast-feeding: It is not known if valsartan passes into breast milk. Hydrochlorothiazide passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children.

Special Instructions:

Once the dose of each component (valsartan and hydrochlorothiazide) has been determined by your doctor, the appropriate dose of the combination tablets can be taken once daily. The usual adult dose of valsartan ranges from 80 mg to 160 mg once daily, with a maximum of 320 mg, while the hydrochlorothiazide ranges from 12.5 mg to 25 mg once daily, with a maximum of 25 mg.

This medication may be taken with or without food, but it should be taken in the same manner each day.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important that this medication be taken exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

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