Amlodipine + Valsartan + Hydrochlorothiazide brands and prices in Pakistan

About Amlodipine with valsartan and hydrochlorothiazide

This is a prescription tablet that has three blood pressure medicines in it. Amlodipine is a calcium channel blocker: it relaxes and widens blood vessels. Valsartan is an angiotensin II receptor blocker (ARB): it stops a natural substance from tightening blood vessels. Hydrochlorothiazide is a thiazide diuretic (water tablet): it helps the body get rid of extra salt and water. Together they lower blood pressure. It is not meant as a first treatment; it is used when other blood pressure medicines have not been enough.

Who should not take it, or should take care

• Do not take it if you are allergic to amlodipine or other calcium channel blockers, valsartan, hydrochlorothiazide, sulfa (sulphonamide) medicines, or any other ingredient.
• Do not take it if you are pregnant beyond the first trimester. Tell your doctor if you are pregnant, might be, or are planning a pregnancy; you will usually be switched to another medicine.
• Breastfeeding: it is not recommended, especially for newborn or premature babies. Ask your doctor about other options.
• Do not take it if you have liver disease or blocked bile flow (biliary cirrhosis or cholestasis).
• Do not take it if you have severe kidney problems, are on dialysis, or cannot pass urine.
• Do not take it if you have low potassium or sodium, or high calcium, in your blood that has not been corrected, or if you have gout.
• Do not take it if you have very low blood pressure, a narrowed heart valve (aortic stenosis), shock caused by a heart problem, or heart failure after a heart attack.
• Do not take it with a blood pressure medicine containing aliskiren if you have diabetes or kidney problems.
• Tell your doctor if you have heart failure or heart disease, have recently had a heart attack, have kidney problems or a kidney transplant, or have liver problems.
• Tell your doctor if you have diabetes, high cholesterol or triglycerides, lupus, gallstones, glaucoma or gout.
• Tell your doctor if you have ever had angioedema (swelling of the face, lips or tongue) with another blood pressure medicine.
• Tell your doctor if you have been vomiting, have diarrhoea or have been sweating a lot, as your blood pressure may drop too low.
• It is not recommended for people with primary aldosteronism (an adrenal gland condition).
• Older people can usually take it, but their blood pressure should be checked regularly.

Medicines and drinks that can interact

• ACE inhibitors (such as lisinopril, enalapril or ramipril) and aliskiren: these are not recommended with this medicine
• Lithium (for some mood disorders)
• Potassium supplements, salt substitutes that contain potassium, potassium-sparing water tablets and heparin, which can raise potassium too much
• Anti-inflammatory painkillers (NSAIDs) such as ibuprofen or naproxen
• Steroid medicines, such as dexamethasone or hydrocortisone
• Other blood pressure or heart medicines, including verapamil, diltiazem, digoxin and nitrates, and other water tablets
• Diabetes medicines (including insulin) and gout medicines
• Simvastatin (a cholesterol medicine)
• Ciclosporin and tacrolimus (medicines that calm the immune system)
• Some antifungal, antibiotic and HIV medicines (such as ritonavir), some cancer medicines and some epilepsy medicines
• Strong painkillers, sleeping pills, barbiturates, muscle relaxants and anaesthetics
• Laxatives, and vitamin D or calcium supplements
• St John's wort (a herbal medicine)
• Cold and flu remedies with decongestants, and appetite suppressants, which can raise blood pressure
• Grapefruit and grapefruit juice: avoid them, as they can make the medicine's effect stronger in an unpredictable way
• Alcohol: talk to your doctor first, as it can make your blood pressure drop too low and make you dizzy or faint

Always tell your doctor and pharmacist about every medicine, supplement and herbal product you take.

Using it safely

• Take it exactly as your doctor tells you. Swallow the tablet whole with a glass of water, with or without food, but not with grapefruit juice.
• Keep taking it even if you feel well. High blood pressure often has no symptoms. Do not stop unless your doctor tells you to.
• If you forget a tablet, take it when you remember unless the next one is nearly due. Never take two at once.
• If you take too much, get medical help straight away.
• You will need regular check-ups and blood tests to check your kidneys, blood pressure and salts such as potassium.
• Hydrochlorothiazide can make skin more sensitive to the sun and, if used for a long time, may raise the risk of some skin and lip cancers. Protect your skin from sun and sunbeds, and tell your doctor about any new or changing skin patches.
• If you feel dizzy, sit or lie down. Do not drive or use machines if you feel dizzy, sleepy, sick or have a headache.
• Tell your dentist or surgeon that you take it before any operation or dialysis.
• Healthy habits such as keeping a healthy weight and eating less salt help it work better.
• Store it out of the reach of children, and return unused medicine to a pharmacy.

Common questions

Why do I need three medicines in one tablet?
Many people need more than one medicine to bring their blood pressure down. Each of the three works in a different way. Having them in one tablet means fewer tablets to take, once your doctor knows this mix works for you.

Can I take it if I am pregnant or planning a baby?
It can seriously harm an unborn baby, especially after the first trimester. If you are planning a pregnancy, ask your doctor about other blood pressure medicines. If you become pregnant while taking it, contact your doctor straight away.

Why are my ankles swollen?
Swollen ankles, feet or hands are a common side effect, mainly from the amlodipine part. Tell your doctor if it bothers you, but do not stop the medicine on your own.

Can I drink alcohol with it?
Talk to your doctor first. Alcohol can make your blood pressure fall too low, which can make you dizzy or faint.

Does it affect my eyes or skin?
Rarely, the hydrochlorothiazide part can cause eye problems such as sudden blurred sight or eye pain; get help straight away if this happens. It can also make your skin more sensitive to sun, so use sun protection and have new skin patches checked.

Prepared from the sources listed by the MedInfoBase team. General information, not medical advice: it gives no doses. Your doctor or pharmacist decides the medicine and dose for you.