Exforge HCT 10mg/160mg/12.5mg Novartis Treatment of hypertension (4 blisters x 7 tablets)

Dosage form Box of 4 blisters x 7 tablets
Specifications Amlodipine, valsartan, hydrochlorothiazide

Ingredient

Composition information	Content
Amlodipine	10mg
Valsartan	160mg
Hydrochlorothiazide	12.5mg

Uses

indications

Exforge HCT drug is indicated in the following case:

Treatment of idiopathic hypertension.

Pharmacokology

Exforge HCT combines three compounds to treat hypertension in patients with idiopathic hypertension: Amlodipine belongs to Calcium, valsartan belonging to the group of Angiotensin II receptor and diuretics thiazide.

pharmacokinetics

After oral use, amlodipin's plasma peak concentration is achieved after 6-8 hours, valsartan after 3 hours and HCTZ after 2 hours. The speed and level of absorption of Amlodipine, Valsartan and HCTZ from Exforge HCT is similar to when used in separate cell forms.

Before taking Exforge HCT 10mg/160mg/12.5mg Novartis Treatment of hypertension (4 blisters x 7 tablets)

How to use

Take oral use. Should use Exforge HCT with a little water, can be used with or not with food.

Dosage

Exforge HCT dose is recommended as 1 tablet/day (all 5 types of content).

The maximum recommended dose of Exforge HCT is 10 mg /320 mg /25 mg.

Renal failure: There is no clinical data in patients with severe renal impairment. It is not necessary to adjust the dose for patients with mild to moderate renal failure. Potassium and creatinine levels need to be monitored in medium renal failure patients.

Hepatic failure: Contraindicated to use Exforge HCT in patients with severe liver failure. Caution should be used for patients with liver failure or there are biliary obstruction disorders. In patients with mild to moderate liver failure without cholestasis, the maximum recommended dose is 80 mg of valsartan. The recommended dosage of Amlodipine has not been set in patients with mild to moderate liver failure, so the lowest dose is available for amlodipine.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What to do when overdose? The main symptom of the overdose of valsartan may be obvious hypotension accompanied by dizziness. Overdose from amlodipine can lead to excessive peripheral vessels and can cause reflected tachycardia. Systemic hypotension is noticeable and prolonged, including shock with the reported death.

If you are overdose, you may consider gastric vomiting or gastric lavage. For healthy volunteers to use activated carbon immediately or two hours after taking Amlodipine has been shown to significantly reduce the absorption of Amlodipine.

Clinical hypotension due to overdose Exforge HCT requires positive cardiovascular support, including regular monitoring of heart and respiratory function, enhancement, and pay attention to the amount of fluid during circulation and urine amount. Vascular shrinkage may be helpful in restoring vascular tone and blood pressure, as long as there is no contraindication to use. Intravenous calcium intravenous calcium may be beneficial in reversing the effect of blockade of calcium channels.

Both Valsartan and Amlodipine are not sure to be removed by hemolysis while the HCTZ clearance can be achieved due to the fertilizer.

What to do when you forget 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.

Side Effects

When using Exforge HCT, you may experience unwanted effects (ADR).

Common, ADR> 1/100

Infection: Nasomitis, influenza;

nerve: headache;

The whole body and on -site: edema, concave edema, face, edema, fatigue, fleet face, weakness, hot face.

Uncommon, rare, ADR

Immune: Hypersensitivity;

eyes: visual disorders;

nerve: dizziness, drowsiness, dizziness due to posture, paresthesia;

ears and mesmerizing: dizziness, tinnitus;

Cardiovascular: tachycardia, brushing chest drum, fainting, lowering blood pressure;

Respiratory: cough, sore throat-laryngeal.

digestive: diarrhea, nausea, abdominal pain, constipation, dry mouth;

Skin and subcutaneous tissue: rash, erythema, increase sweat, foreign rash, itching;

musculoskeletal joints: joint swelling, joint pain;

The ureter: Multi -urinary;

Reproduction: erectile dysfunction.

Instructions on how to handle ADR

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

EXFORE HCT drug is contraindicated in the following cases:

Hypersensitivity to the active ingredient, derivative Dihydropyridine or any excipients listed in the excipient.

Heavy liver failure, biliary cirrhosis or cholestasis.

Use Exforge HCT simultaneously with Aliskiren -containing products in diabetes patients or kidney failure (glomerular fortune (GFR)

Pregnant women in the middle and the last 3 months of pregnancy.

Hypotension.

shock (including heart shock)

Conclusion The drainage of the left ventricle (for example, hypertrophic cardiomyopathy and severe aortic narrowing).

Unstable heart failure about hemodynamics after acute myocardial infarction.

Be cautious when used

Patients with hypotension and/or volume decrease: Excessive hypotension has occurred when using Exforge HCT.

Hyassalty hyperkilla: Caution should be careful when using potassium supplements, potassium -keeping diuretics, salt replacement substances containing potassium or other drugs that can increase potassium levels (such as heparin etc ...) and should regularly monitor potassium concentration.

Patients with kidney stenosis on one side or both sides, kidney stenosis in patients with one kidney should be cautious when using Exforge HCT because of blood urea and serum creatinine can increase in these patients.

Evala includes laryngeal swelling and subjects, causing obstruction of the gas path and/or swelling of the face, lips, throat and/or tongue reported in patients treated with valsartan. Must stop immediately and do not reuse Exforge HCT.

Patients with heart failure/myocardial infarction: Caution should be used when using calcium channel blockers including amlodipine in patients with congestion heart failure because these drugs may increase the risk of cardiovascular events and death in the future.

Patients with acute myocardial infarction: severe angina and acute myocardial infarction may develop after starting or increasing the dose of amlodipine, especially in patients with severe coronary artery disease.

as well as all other vasodilators, it is necessary to be careful when using amlodipine for patients with aortic valve stenosis or mitral stenosis, or congested cardiomyopathy.

Patients with primary Aldosteron should not be treated with Valsartan.

Do not simultaneously inhibit ACE and Angiotensin receptor blockers (ARB) in patients with diabetic kidney disease.

HCTZ may change glucose tolerance, increase cholesterol and triglycerides in serum, increase serum uric acid levels and worsen or promote gout in sensitive patients.

HCTZ reduces the calcium secretion in urine and can increase serum calcium.

HCTZ is a sulfonamide that can cause a specific reaction, leading to acute transient myopia and acute closed angle glauca. Symptoms include an acute onset of vision or eye pain and usually occur within hours to a few weeks when starting the drug.

The ability to drive and operate machinery

There has been no research on impact on the ability to drive and use machinery. When driving or using machines, it can sometimes occur dizziness or fatigue.

Pregnancy

If pregnant is detected during treatment, Exforge HCT must be discontinued as soon as possible. There have been a report on natural miscarriage, little amniotic fluid and kidney dysfunction in newborns when pregnant women accidentally use Valsartan.

The period of breastfeeding

It is unclear whether Valsartan is excreted in breast milk or not. Amlodipine has been reported to be excreted in breast milk. So do not recommend Exforge HCT for women who are breastfeeding.

Interactive drug

other medications for hypertension may increase the hypotension effect of combined treatment.

Recommendations of simvastatin dose limits to 20mg/day in patients who are taking amlodipine.

Concultural anticipular use of Angiotensin receptors (ARB) - including Valsartan or Yeast inhibitors (ACEI) with Aliskiren in patients with type 2 diabetes. Be careful when using potassium supplements, potassium diuretics, salt replacement substances containing potassium or other drugs that can increase potassium levels (such as heparin etc ...) and should regularly monitor potassium concentration.

When using the Angiotensin II receptor antagonist simultaneously with NSAID drugs, the reduction of the effectiveness of hypotension may occur.

Increased lithium and toxic lithium concentration has been reported when used simultaneously with enzyme inhibitors or angiotensin II receptor inhibitors including Exforge HCT.

Use a combination of inhibitors inhibitors (such as rifampin, ciclosporin) or transportation (such as ritonavir) may increase body contact levels with Valsartan.

HCTZ may interact with anti -diabetic drugs, changing glucose tolerance. Simultaneous use of HCTZ with Allopurinol may increase the hypersensitivity reaction rate with allopurinol. In addition, HCTZ also interacts with other drugs such as amantadine, cyclophosphamide, methotrexate, anti -cholinergic drug, ion exchange ...

Storage

Do not store over 30 ° C. Keep the medicine in the original packaging to avoid moisture.

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