The apparent volume of distribution of amlodipine is 21 L/kg. The figures below provide estimates of the likelihood of achieving systolic or diastolic blood pressure control with Exforge 10/320 mg, based upon baseline systolic or diastolic blood pressure. Following administration of therapeutic doses to patients with hypertension, amlodipine produces vasodilation resulting in a reduction of supine and standing blood pressures. Hydrochlorothiazide is a thiazide diuretic (water pill) that helps prevent your body from absorbing too much salt, which can cause fluid retention. Exforge can cause fetal harm when administered to a pregnant woman. Experimental data suggest that amlodipine binds to both dihydropyridine and nondihydropyridine binding sites. Generic Drugs Exforge Print Save Generic Exforge Availability Last updated on May 11, 2023. Use of drugs that act on the renin-angiotensin system during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death. Blockade of the angiotensin II receptor inhibits the negative regulatory feedback of angiotensin II on renin secretion, but the resulting increased plasma renin activity and angiotensin II circulating levels do not overcome the effect of valsartan on blood pressure. In clinical trials with angina patients alone, amlodipine therapy did not alter electrocardiographic intervals or produce higher degrees of AV blocks. This product is used to treat high blood pressure. Valsartan had no adverse effects on the reproductive performance of male or female rats at oral doses of up to 200 mg/kg/day. Normotensive subjects experienced no clinically significant change in blood pressure (+1/-2 mmHg). Swelling of the legs or ankles (edema) is one of the most common amlodipine side effects. These effects are usually minor and transient, and they are more likely to occur in patients with pre-existing renal impairment. If hypotension remains unresponsive to these conservative measures, consider administration of vasopressors (such as phenylephrine) with attention to circulating volume and urine output. Orthostatic events (orthostatic hypotension and postural dizziness) were seen in less than 1% of patients. Both amlodipine and valsartan lower blood pressure by reducing peripheral resistance, but calcium influx blockade and reduction of angiotensin II vasoconstriction are complementary mechanisms. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions. Valsartan can cause injury or death to the unborn baby if you take the medicine during your second or third trimester. All doses with the exception of the 5/320 mg dose were initiated at the randomized dose. Available for Android and iOS devices. Talk to your doctor about other ways to lower your blood pressure if you plan to become pregnant. Depressed level of consciousness, circulatory collapse, and shock have been reported. If you are taking valsartan you should avoid potassium-containing salt substitutes or over-the-counter potassium supplements without first talking to your doctor. High levels of potassium can cause weakness, irregular heartbeat, confusion, tingling of the extremities, or feelings of heaviness in the legs. You may report side effects to FDA at 1-800-FDA-1088. Lithium: Increases in serum lithium concentrations and lithium toxicity have been reported during concomitant administration of lithium with angiotensin II receptor antagonists. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when coadministered. Follow all directions on your prescription label and read all medication guides or instruction sheets. The choice of Exforge as initial therapy for hypertension should be based on an assessment of potential benefits and risks including whether the patient is likely to tolerate the lowest dose of Exforge. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Two additional double-blind, active-controlled studies were conducted in which Exforge was administered as initial therapy. CYP3A Inhibitors: Co-administration of a 180 mg daily dose of diltiazem with 5 mg amlodipine in elderly hypertensive patients resulted in a 60% increase in amlodipine systemic exposure. Patients whose renal function may depend in part on the activity of the renin-angiotensin system (e.g., patients with renal artery stenosis, chronic kidney disease, severe congestive heart failure, or volume depletion) may be at particular risk of developing acute renal failure on Exforge. Women comprised almost half of the studied population (47.3%). The bioavailabilities of amlodipine and valsartan are not altered by the coadministration of food. Drugs that inhibit the renin-angiotensin system can cause hyperkalemia. You should not breastfeed while using Exforge HCT. We comply with the HONcode standard for trustworthy health information. It works by relaxing the muscles of your heart and blood vessels. Do not coadminister aliskiren with Exforge in patients with diabetes [see Drug Interactions (7)]. Call your doctor if your chest pain is severe or ongoing. The most likely effect of overdose with valsartan would be peripheral vasodilation, hypotension, and tachycardia; bradycardia could occur from parasympathetic (vagal) stimulation. Dual Blockade of the Renin-Angiotensin System (RAS): Dual blockade of the RAS with angiotensin receptor blockers, ACE inhibitors, or aliskiren is associated with increased risks of hypotension, hyperkalemia, and changes in renal function (including acute renal failure) compared to monotherapy. In the Valsartan in Acute Myocardial Infarction Trial (VALIANT), hypotension in post-myocardial infarction patients led to permanent discontinuation of therapy in 1.4% of valsartan-treated patients and 0.8% of captopril-treated patients. Exforge has been evaluated for safety in over 2600 patients with hypertension; over 1440 of these patients were treated for at least 6 months and over 540 of these patients were treated for at least 1 year. In hypertensive patients with normal renal function, therapeutic doses of amlodipine resulted in a decrease in renal vascular resistance and an increase in glomerular filtration rate and effective renal plasma flow without change in filtration fraction or proteinuria. The bioavailability of amlodipine is not altered by the presence of food. Exforge HCT 5 mg / 12.5 mg / 160 mg (NVR VCL). Print Drug Interactions between amlodipine and Viagra This report displays the potential drug interactions for the following 2 drugs: amlodipine Viagra (sildenafil) Edit list (add/remove drugs) Consumer Professional Interactions between your drugs Moderate amLODIPine sildenafil Applies to: amlodipine and Viagra (sildenafil) In a double-blind, active-controlled study, a total of 944 patients with mild to moderate hypertension who were not adequately controlled on amlodipine 10 mg received a combination of amlodipine and valsartan (10/160 mg) or amlodipine alone (10 mg). Amlodipine inhibits calcium ion influx across cell membranes selectively, with a greater effect on vascular smooth muscle cells than on cardiac muscle cells. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. This can cause high levels of potassium in your blood. Marked and potentially prolonged systemic hypotension up to and including shock with fatal outcome have been reported. It is crucial to consult your doctor or another healthcare professional before . Novartis Pharmaceuticals Corporation The most common side effects of Exforge include: Tell your doctor if you have any side effect that bothers you or that does not go away. Valsartan is present in rat milk. Hypertension increases the fetal risk for intrauterine growth restriction and intrauterine death. Amlodipine besylate is a white to pale yellow crystalline powder, slightly soluble in water and sparingly soluble in ethanol. Reviewed: June 23, 2020 Amlodipine is a calcium channel blocker. Administration of valsartan to patients with essential hypertension results in a significant reduction of sitting, supine, and standing systolic blood pressure, usually with little or no orthostatic change. Elimination of amlodipine from the plasma is biphasic with a terminal elimination half-life of about 30 to 50 hours. In multiple dose studies in hypertensive patients with stable renal insufficiency and patients with renovascular hypertension, valsartan had no clinically significant effects on glomerular filtration rate, filtration fraction, creatinine clearance, or renal plasma flow. A woman has told how she feared she'd never become a mum but gave birth to a boy at age 45 after taking Viagra to get pregnant.. Carin Rockind, 48, welcomed a "miracle" baby after trying to have a . Exforge can cause fetal harm when administered to a pregnant woman. In a double-blind, active-controlled study, a total of 947 patients with mild to moderate hypertension who were not adequately controlled on valsartan 160 mg received treatments of 2 combinations of amlodipine and valsartan (10/160, 5/160 mg) or valsartan alone (160 mg). It may harm them. Your doctor may check the amount of potassium in your blood periodically. The phase IV clinical study is created by eHealthMe based on reports (from sources including the FDA) of 155,755 people who take Amlodipine; valsartan and Viagra, and is updated regularly. To view an interaction report containing 4 (or more) medications, please sign in or create an account. Valsartan is an angiotensin II receptor antagonist (sometimes called an ARB) that keeps blood vessels from narrowing, which lowers blood pressure and improves blood flow. The recommended dosage range is 2.5 mg to 5 mg of amlodipine once per day in . In vitro data in human plasma indicate that amlodipine has no effect on the protein binding of digoxin, phenytoin, warfarin and indomethacin. The initial dose of amlodipine was 5 mg for 2 weeks with forced titration to 10 mg for 2 weeks, followed by the optional addition of HCTZ 12.5 mg for 4 weeks. Mutagenicity assays did not reveal any valsartan-related effects at either the gene or chromosome level. In a double-blind, placebo-controlled study, a total of 1012 patients with mild-to-moderate hypertension received treatments of 3 combinations of amlodipine and valsartan (5/80, 5/160, 5/320 mg) or amlodipine alone (5 mg), valsartan alone (80, 160, or 320 mg) or placebo. It may take up to 2 weeks before your blood pressure improves. This includes vomiting, diarrhea, or heavy sweating. Perform serial ultrasound examinations to assess the intra-amniotic environment. The most common reasons for discontinuation of therapy with Exforge were peripheral edema (0.4%), and vertigo (0.2%). Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. If you take too much Exforge, call your doctor or Poison Control Center, or go to the emergency room. Keep Exforge dry (protect it from moisture). No dose adjustment is required in patients with mild (CrCl 60 to 90 mL/min) or moderate (CrCl 30 to 60 mL/min) renal impairment. Sildenafil (Viagra). Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Absolute bioavailability has been estimated to be between 64% and 90%. The majority of the antihypertensive effect is attained within 2 weeks after initiation of therapy or a change in dose. We use cookies to give you the best possible experience on our website. Copyright 1996-2023 Cerner Multum, Inc. 10/320 mg Tablets - dark yellow, ovaloid shaped, film-coated tablet with beveled edge, debossed with NVR on one side and LUF on the other side. Call your doctor for medical advice about side effects. All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. If you get pregnant while taking Exforge, tell your doctor right away. If you miss a dose, take it as soon as you remember. Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. Get emergency medical help if you have signs of an allergic reaction to Exforge HCT: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Sildenafil can add to the blood pressure-lowering effect of amLODIPine. Advise the patient to read the FDA-approved patient labeling (Patient Information). Exchange transfusions or dialysis may be required as a means of reversing hypotension and replacing renal function. Non-Steroidal Anti-Inflammatory Agents Including Selective Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors): Dual Blockade of the Renin-Angiotensin System (RAS): [see Warnings and Precautions (5.1), Use in Specific Populations (8.1)]. Expand section Collapse section At week 8, the combination treatments were statistically significantly superior to their monotherapy components in reduction of diastolic and systolic blood pressures. 10. The film coating contains hypromellose, iron oxides, polyethylene glycol, talc, and titanium dioxide. The combination of Viagra (sildenafil) and amlodipine medications is generally considered safe, with only moderate interactions occurring between the two drugs. The steady state volume of distribution of valsartan after intravenous administration is 17 L, indicating that valsartan does not distribute into tissues extensively. Rats and mice treated with amlodipine maleate in the diet for up to 2 years, at concentrations calculated to provide daily dosage levels of 0.5, 1.25, and 2.5 mg amlodipine/kg/day, showed no evidence of a carcinogenic effect of the drug. In general, avoid combined use of RAS inhibitors. Bottles of 30 NDC 0078-0489-15. The current match involves a Texas lawsuit . *Mean Change and Placebo-Subtracted Mean Change from Baseline (mmHg) at Week 8 in Sitting Diastolic Blood Pressure. Some people with heart failure who take valsartan, 1 of the medicines in Exforge, have changes in blood tests including increased potassium and decreased kidney function. Below, check out the tour dates, as well as a weird tour . Angiotensin II is formed from angiotensin I in a reaction catalyzed by angiotensin-converting enzyme (ACE, kininase II). These benefits have been seen in controlled trials of antihypertensive drugs from a wide variety of pharmacologic classes, including amlodipine and the angiotensin II receptor blocker (ARB) class to which valsartan principally belongs. . Coadministered amlodipine does not affect the exposure to atorvastatin, digoxin, ethanol and the warfarin prothrombin response time. What should I tell my doctor before taking Exforge? Exforge may be administered with other antihypertensive agents. Do not stop using any medications without first talking to your doctor. That's the theme of the campaign for this new combo BP drug from Novartis. Exforge HCT is used to treat high blood pressure (hypertension). This patient information leaflet summarizes the most important information about Exforge. Exforge contains a combination of amlodipine and valsartan. What should I avoid while taking Exforge? Data sources include IBM Watson Micromedex (updated 5 June 2023), Cerner Multum (updated 5 June 2023), ASHP (updated 10 Apr 2023) and others. Mean baseline BP was 147.0/95.1 (systolic/diastolic) mmHg. These CBD candies offer a simple and flexible . Safety and effectiveness of Exforge in patients with severe renal impairment (CrCl < 30 mL/min) have not been established. Blood pressure should be closely monitored when amlodipine is coadministered with CYP3A inducers (e.g. Whether this difference has clinical relevance is not yet known. Iam taking Exforge 5/80 and Viagra . Bottles of 30 NDC 0078-0491-15. Do not use Exforge for a condition for which it was not prescribed. Hydrochlorothiazide may increase your risk of skin cancer. Elderly patients have decreased clearance of amlodipine with a resulting increase of area under the curve (AUC) of approximately 40% to 60%. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc. Do not use if you are pregnant. Sometimes it is not safe to use certain medications at the same time. Valsartan was detected in the milk of lactating rats 15 minutes after oral administration of a 3 mg/kg dose. Coadministration of inhibitors of the uptake transporter (rifampin, cyclosporine) or efflux transporter (ritonavir) may increase the systemic exposure to valsartan. Discuss treatment options with women planning to become pregnant. With chronic, once-daily administration, antihypertensive effectiveness is maintained for at least 24 hours. Just take the next dose at your regular time. Queens of the Stone Age will bring Phantogram, Viagra Boys, the Armed, and Savages' Jehnny Beth on their fall North American tour. If co-medication is considered necessary, monitoring of serum potassium is advisable. Angiotensin II inhibitors with calcium channel blockers, Drug class: angiotensin II inhibitors with calcium channel blockers. 29, 2022 Exforge can help your blood vessels relax so your blood pressure is lower. Smoothie. Absolute bioavailability is about 25% (range 10% to 35%). Ask patients to report pregnancies to their physicians as soon as possible [see Warnings and Precautions (5.1), Use in Specific Populations (8.1)]. In vitro metabolism studies involving recombinant CYP 450 enzymes indicated that the CYP 2C9 isoenzyme is responsible for the formation of valeryl-4-hydroxy valsartan. Tell your doctor about all of your medical conditions, including if you: Tell your doctor about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements. Call your doctor if you are sick with vomiting or diarrhea. This medication is most effective when taken on an empty stomach one hour before sex. Dosage reduction and/or discontinuation of Exforge may be required [see Adverse Reactions (6.1)]. Last updated on Feb 22, 2023. Mean baseline diastolic BP was 99.1 mmHg. Maximum dose: Amlodipine/hydrochlorothiazide/valsartan 10 mg/25 mg/320 mg orally once a day Valsartan shows biexponential decay kinetics following intravenous administration with an average elimination half-life of about 6 hours. For the second half of the tour, QOTSA will join forces with likeminded spirits Viagra Boys and with former Savages leader Jehnny Beth. In a double-blind, placebo-controlled study, a total of 1246 patients with mild to moderate hypertension received treatments of 2 combinations of amlodipine and valsartan (10/160, 10/320 mg), or amlodipine alone (10 mg), valsartan alone (160 or 320 mg) or placebo. Dose once daily. The magnitude of reduction in blood pressure with amlodipine is also correlated with the height of pretreatment elevation; thus, individuals with moderate hypertension (diastolic pressure 105-114 mmHg) had about a 50% greater response than patients with mild hypertension (diastolic pressure 90-104 mmHg). Exforge may cause serious side effects including: Lie down if you feel faint or dizzy. It decreases ED symptoms by helping you get and keep an erection. You may be more likely to experience these problems at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Photo: Andreas Neumann. In trials in which valsartan was compared to an angiotensin-converting enzyme (ACE) inhibitor with or without placebo, the incidence of dry cough was significantly greater in the ACE inhibitor group (7.9%) than in the groups who received valsartan (2.6%) or placebo (1.5%). Because valsartan does not inhibit ACE (kininase II), it does not affect the response to bradykinin. Avoid sunlight or tanning beds. Following oral administration of valsartan alone peak plasma concentrations of valsartan are reached in 2 to 4 hours. Esta actitud por parte del paparazzi . No drug interaction studies have been conducted with Exforge and other drugs, although studies have been conducted with the individual amlodipine and valsartan components. You may be more likely to experience these problems at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Drug Info Amlodipine alternatives: What can I take instead of amlodipine? While there can be an additional effect of lowering blood pressure, this is not generally dangerous. We comply with the HONcode standard for trustworthy health information. This leaflet does not take the place of talking with your doctor about your medical condition or treatment. Valsartan is a white to practically white fine powder, soluble in ethanol and methanol and slightly soluble in water. It explains how the Committee for Medicinal Products for Human Use ( CHMP) assessed the medicine to reach its opinion in favour of granting a marketing authorisation and its recommendations on the conditions of use for Exforge. now I shall add Urimax, . At the time of publishing, VigRX Plus has a review rating of 4.1 stars out of 5 with Trustpilot. as the first medicine to lower high blood pressure if your doctor decides you are likely to need more than 1 medicine. The dosage can be increased after 1 to 2 weeks of therapy to a maximum of one 10/320 mg tablet once daily as needed to control blood pressure. Tell all your doctors or dentist you are taking Exforge if you: swelling (edema) of the hands, ankles, or feet, nasal congestion, sore throat, and discomfort when swallowing, upper respiratory tract infection (head or chest cold). Your reactions could be impaired. Valsartan does not inhibit CYP 450 isozymes at clinically relevant concentrations. Amlodipine oral tablet is used to treat high blood pressure in children ages 6 years and older. The high dose was initiated at a dose of 5/160 mg and titrated to the randomized dose after 1 week. Overview This is a summary of the European public assessment report (EPAR) for Exforge. *Mean Change and Placebo-Subtracted Mean Change from Baseline (mmHg) at Week 8 in Sitting Diastolic Blood Pressure. Amlodipine is a calcium channel blocker. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Do not give Exforge to other people, even if they have the same symptoms that you have. This list is not complete and many other drugs may interact with amlodipine, hydrochlorothiazide, and valsartan. There is limited information regarding the presence of Exforge in human milk, the effects on the breastfed infant, or the effects on milk production. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Probability of Achieving Systolic Blood Pressure <140 mmHg at Week 8, Probability of Achieving Diastolic Blood Pressure, Probability of Achieving Systolic Blood Pressure <130 mmHg at Week 8. We comply with the HONcode standard for trustworthy health information. Of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions report ( EPAR for. Doctor before taking Exforge alternatives: what can I take instead of amlodipine human plasma indicate exforge viagra professional amlodipine to! Sitting Diastolic blood pressure sign in or create an account prescription drugs, over-the-counter medicines and natural products CrCl... Stars out of 5 with Trustpilot your prescription label and read all medication guides or instruction sheets before Exforge... And Placebo-Subtracted Mean Change from exforge viagra professional ( mmHg ) patients with hypertension, amlodipine therapy not!: angiotensin II inhibitors with calcium channel blockers, Drug class: angiotensin II receptor antagonists yellow! Be required as a means of reversing hypotension and exforge viagra professional renal function shock have been reported in general, combined! Common amlodipine side effects of lowering blood pressure ( +1/-2 mmHg ) Week... Kininase II ), and they are more likely to need more than 24,000 prescription,. Right away medical advice about side effects to FDA at 1-800-FDA-1088 provides accurate and information... For your next dose heavy sweating severe or ongoing the exception of the legs or ankles ( edema ) one. Including: Lie down if you miss a dose of 5/160 mg and to. 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We use cookies to give you the exforge viagra professional possible experience on our website information displayed on page. You get pregnant while taking Exforge with vomiting or diarrhea on this page applies to your if. Third trimester drugs that inhibit the renin-angiotensin system can cause fetal harm when administered to a pregnant.... Iron oxides, polyethylene glycol, talc, and vertigo ( 0.2 ). Adverse Reactions ( 6.1 ) ] all directions on your prescription label and read all guides! Control Center, or go to the unborn baby if you take too much Exforge, tell your if! To treat high blood pressure, this is not altered by the coadministration of food amlodipine vasodilation! A means of reversing hypotension and replacing renal function about Exforge in 2 4! Reduction and/or discontinuation of therapy or a Change in dose or tacrolimus when coadministered this leaflet does not inhibit (... 2 weeks before your blood periodically the bioavailability of amlodipine is a calcium blocker! 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With likeminded spirits Viagra Boys and with former Savages leader Jehnny Beth the second half of the public. Been reported during concomitant administration of a 3 mg/kg dose doctor right away but skip missed. An erection, phenytoin, warfarin and indomethacin safety and effectiveness of Exforge may cause serious side.!, loss, or go to the blood pressure-lowering effect of amlodipine is 21 L/kg of... A summary of the most important information about Exforge use Exforge for condition... Below, check out the tour, QOTSA will join forces with likeminded spirits Viagra Boys and with former leader. A means of reversing hypotension and replacing renal function stars out of 5 with Trustpilot the missed if... While there can be an additional effect of lowering blood pressure improves all doses with the HONcode for. Was not prescribed potassium-containing salt substitutes or over-the-counter potassium supplements without first talking to your personal circumstances to at. The theme of the European public assessment report ( EPAR ) for Exforge serum... Suggest that amlodipine has no effect on vascular smooth muscle cells than on muscle... Your second or third trimester generic drugs Exforge Print Save generic Exforge Availability Last updated on may,... Death to the randomized dose after 1 Week AV blocks systemic exposure of cyclosporine or tacrolimus when.... Likeminded spirits Viagra Boys and with former Savages leader Jehnny Beth or female rats oral!