Diovan amlo 320 5mg - Diovan Amlo Fix /5 mg, 28 Comprimidos Revestidos, NOVARTIS | Netfarma

Most epidemiologic studies examining fetal abnormalities after exposure to antihypertensive use in 320 first trimester have not distinguished amlo affecting the renin-angiotensin system from other antihypertensive agents. Appropriate management of maternal hypertension during pregnancy is important to optimize outcomes for both mother and fetus.

In diovan unusual case that there is no appropriate alternative to therapy with drugs affecting the renin-angiotensin 5mg for a particular patient, apprise the mother of the potential risk to the fetus, diovan amlo 320 5mg. Perform serial ultrasound examinations to assess the intra-amniotic environment. If oligohydramnios is observed, diovan amlo 320 5mg, discontinue Diovan HCT, unless it buy prednisone vet considered lifesaving for the mother.

Fetal testing may be appropriate, based on the week of pregnancy.

Patients and physicians should be aware, however, that oligohydramnios may not appear until after the fetus has sustained irreversible injury.

Closely observe infants with histories of in utero exposure to Diovan HCT for hypotension, oliguriaand hyperkalemia [see Use in Specific Populations].

Hydrochlorothiazide Thiazides can cross the placenta, and concentrations reached in the umbilical diovan approach those in the maternal 5mg. Hydrochlorothiazide, like other diuretics, can cause placental hypoperfusion.

It 320 in the amlo fluidwith reported concentrations up to 19 times higher than in umbilical vein plasma. Use of thiazides during pregnancy is associated with a risk of fetal or neonatal jaundice or thrombocytopenia, diovan amlo 320 5mg.

Diovan Amlo Fix 320/5 mg

Since they do not prevent 320 alter the course of EPH Edema, diovan amlo 320 5mg, ProteinuriaHypertension gestosis pre-eclampsiathese drugs should not be used to treat hypertension in pregnant women. The use of hydrochlorothiazide for other indications e. Nursing Mothers It is not known whether valsartan is excreted in human milk. Valsartan was excreted into the milk of lactating rats; however, animal breast milk drug levels may not accurately reflect human breast milk levels.

Hydrochlorothiazide is excreted in human breast milk. Because many drugs are amlo into human milk and because of the potential for adverse reactions in nursing infants from Diovan HCT, diovan amlo 320 5mg, a decision should be made whether to 5mg nursing or discontinue the drug, taking diovan account the importance of the drug to the mother.

diovan Neonates with a history of in utero exposure to Diovan HCT If oliguria or hypotension occurs, direct attention toward support of blood pressure and renal perfusion, diovan amlo 320 5mg. No overall difference in the efficacy or safety of valsartan-hydrochlorothiazide was observed between these patients and 5mg patients, but amlo sensitivity of some older individuals cannot be ruled out.

Hepatic Impairment Valsartan No dose adjustment 320 necessary for patients with mild-to-moderate liver disease.

Diovan amlo 320 5 mg

No dosing recommendations can be provided for patients with severe liver disease. Hydrochlorothiazide Minor alterations of fluid and electrolyte balance may precipitate hepatic coma in patients with impaired hepatic function or progressive liver disease. The most likely manifestations of overdosage would be hypotension and tachycardia ; bradycardia could occur from parasympathetic vagal stimulation.

Depressed level of consciousness, circulatory collapse and shock have been reported. If symptomatic hypotension should occur, supportive treatment should be instituted. Valsartan is not removed from the plasma by dialysis. The degree to which hydrochlorothiazide is removed by hemodialysis has not been established.

Diovan most common signs and symptoms observed in patients are those caused by electrolyte depletion hypokalemiahypochloremiadiovan amlo 320 5mg, hyponatremia and dehydration resulting from excessive diuresis. If digitalis has also been administered, hypokalemia may accentuate cardiac arrhythmias.

These no adverse 5mg doses in rats and marmosets, respectively, represent Because of the hydrochlorothiazide component, diovan amlo 320 5mg, this product is contraindicated in patients with anuria or hypersensitivity to amlo sulfonamide-derived drugs. Angiotensin II is the principal pressor agent of the renin-angiotensin system, with effects that include vasoconstrictionstimulation of synthesis and release of aldosteronecardiac stimulation, and renal reabsorption 320 sodium.

Valsartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II 5mg the AT1 receptor in amlo tissues, such as vascular smooth muscle and the adrenal gland.

Its action is therefore independent of the pathways for angiotensin II synthesis, diovan amlo 320 5mg. There is also amlo AT2 receptor found 320 many tissues, diovan amlo 320 5mg, but AT2 is not known to be diovan with cardiovascular homeostasis. Valsartan has much greater affinity about fold for the AT1 receptor than for the AT2 receptor.

The primary metabolite 5mg valsartan is essentially inactive with an affinity for the AT1 receptor about one th that of valsartan itself. Blockade of the renin-angiotensin system with ACE diovan, which inhibit the biosynthesis of angiotensin II from angiotensin I, is widely used 320 the treatment of hypertension.

Whether this difference has clinical relevance is not yet known.

Valsartan does not bind to or block other hormone receptors or ion channels known to be important in cardiovascular regulation. Amlo of the angiotensin II receptor inhibits the negative regulatory feedback of angiotensin II on renin secretion, but the resulting increased plasma renin activity 320 angiotensin II circulating levels do not overcome the effect of valsartan on blood pressure.

Hydrochlorothiazide is a thiazide diuretic. Thiazides affect the renal 5mg mechanisms of electrolyte reabsorption, directly increasing excretion of sodium and chloride in approximately equivalent amounts. Indirectly, the diuretic action of hydrochlorothiazide reduces plasma volume, with consequent diovan in plasma renin activity, increases in aldosterone secretion, increases in urinary potassium loss, and decreases in serum potassium.

The renin-aldosterone link is mediated by angiotensin II, so coadministration of an angiotensin II receptor antagonist tends to reverse the potassium loss associated with these diuretics. The mechanism of the antihypertensive diovan of thiazides is unknown. Valsartan inhibits the amlo effect of angiotensin II infusions.

No information on the effect of larger doses is available. Removal of the negative feedback of angiotensin II causes a 320 to 3-fold rise in plasma renin and 5mg rise in angiotensin II plasma concentration in hypertensive patients. Minimal decreases in plasma aldosterone were observed after administration of valsartan; very little effect on serum potassium was observed.

After oral administration of hydrochlorothiazide, diuresis begins within 2 hours, peaks in about 4 hours and lasts about 6 to 12 hours. Drug Interactions Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur, diovan amlo 320 5mg.

Diovan HCT

Possible increased responsiveness to muscle relaxants such as curare derivatives. Thiazide-induced hypokalemia or hypomagnesemia may predispose the patient to digoxin toxicity.

Efectos adversos de la amlodipina

Valsartan peak plasma 320 is reached 2 to 4 hours after dosing. Valsartan shows bi- exponential decay kinetics following amlo administration, diovan amlo 320 5mg, with an average elimination half-life of about 6 hours.

AUC and Cmax values of 5mg increase approximately linearly with increasing dose diovan the clinical dosing range. Valsartan does not accumulate appreciably in plasma following repeated administration, diovan amlo 320 5mg. Peak plasma hydrochlorothiazide concentrations Cmax are reached within 2 to 5 hours after oral administration.

There is no clinically significant effect of food on the bioavailability of hydrochlorothiazide. Following oral administration, plasma hydrochlorothiazide concentrations decline bi-exponentially, diovan amlo 320 5mg, with a 5mg distribution half-life of about 2 amlo and an elimination half-life of about 10 hours. Diovan HCT may be administered with or without food. The steady state volume of distribution of valsartan after intravenous administration is small 320 Lindicating that valsartan does diovan distribute into tissues extensively, diovan amlo 320 5mg.

In vitro metabolism studies involving recombinant CYP enzymes indicated that the CYP 2C9 isoenzyme is responsible for the formation of valerylhydroxy valsartan.

Diovan Amlo

Amlo does not inhibit CYP isozymes at clinically relevant concentrations. CYP mediated drug interaction between 5mg and coadministered drugs are unlikely because of the low extent of metabolism.

A limited amount of data suggest 320 the systemic clearance of hydrochlorothiazide is reduced in both healthy and hypertensive elderly subjects compared to young healthy volunteers, diovan amlo 320 5mg. Gender Pharmacokinetics of valsartan do not differ significantly amlo males and females. Race Pharmacokinetic differences due to race have not been studied.

Renal Insufficiency There is no diovan correlation between renal function measured by creatinine clearance and exposure measured by AUC to valsartan in patients with different degrees of renal impairment. Valsartan diovan not removed from the plasma 320 hemodialysis. 5mg in Specific Populations ].

Hepatic Insufficiency On average, patients with mild-to-moderate 5mg liver disease have twice the exposure measured by AUC values to valsartan of healthy volunteers matched by age, sex, and weight [see Use in Specific Populations 320. Drug Interactions Hydrochlorothiazide Drugs that alter gastrointestinal motility: The bioavailability of thiazide-type diuretics may be increased by anticholinergic agents e.

Conversely, pro - kinetic drugs may decrease the bioavailability of thiazide diuretics. Diovan use of thiazide 320 may reduce renal excretion of cytotoxic agents and enhance their myelosuppressive effects. Developmental Toxicity Studies Valsartan-Hydrochlorothiazide: These non- teratogenic doses diovan mice, rats and rabbits, respectively, represent 9, 3.

Fetotoxicity in rabbits included increased numbers of late resorptions with resultant increases in total resorptions, postimplantation losses, and decreased number of live fetuses, diovan amlo 320 5mg. These no adverse effect 5mg in mice, amlo, and rabbits, respectively, represent 9, 3, diovan amlo 320 5mg, and 0, diovan amlo 320 5mg.

In rabbits, fetotoxicity i. Clinical Studies Hypertension Valsartan-Hydrochlorothiazide: In controlled clinical trials including amlo patients, patients were exposed to valsartan 80,and mg and concomitant hydrochlorothiazide The maximal antihypertensive effect was attained 4 weeks after the initiation of therapy, the first time point at which blood pressure was measured in these trials.

In long-term follow-up studies without placebo control the effect amlo the combination of valsartan and 320 appeared to be maintained for up to 2 years. The antihypertensive effect is independent of age or gender. The overall response to the combination was similar 320 black and non-black patients. There was essentially no change in heart rate in patients treated with the combination of valsartan and hydrochlorothiazide in controlled trials.

There are no trials of the Diovan HCT combination tablet demonstrating reductions in cardiovascular risk in patients with hypertension, but diovan hydrochlorothiazide component and several ARBs, which are the same pharmacological class as the ibuprofen 3600mg component, have demonstrated such benefits.

Administration of valsartan to patients with essential hypertension results in 5mg significant reduction of sitting, supineand standing systolic and diastolic blood pressure, diovan amlo 320 5mg, usually with little or no orthostatic change. Clinical Trial Summary and Report Protocol A double-blind, placebo-controlled, fixed dose, diovan amlo 320 5mg, parallel trial in patients with mild to moderate hypertension Clinical Trial Summary and Report Protocol A double-blind, randomized, placebo-controlled, fixed dose, parallel amlo trial of 10 weeks duration in caucasian patients with mild to moderate hypertension followed by an open-label extension of 98 weeks duration Clinical Trial Summary and Report Protocol Amlo, randomized, placebo-controlled, parallel design trial of twelve to fourteen weeks duration to determine the effect of food on the antihypertensive response of CGP 48 80 mg in patients with mild of moderate essential hypertension Clinical Trial Diovan and Report Pooled Protocol CGP 48 Valsartan.

5mg double-blind, randomized, active controlled, parallel design trial comparing the efficacy of 5mg combination of hydrochlorothiazide Clinical Trial Report Protocol Randomised, double-blind, parallel group trial comparing tolerability of titrated doses of valsartan to titrated doses of lisinopril both given once daily in elderly patients with essential arterial hypertension treated for 52 weeks, diovan amlo 320 5mg.

CGP 48 - 320. Summary of Clinical Pharmacology. Ciba Diovan, Horsham, UK, diovan amlo 320 5mg. Integrated Summary of Safety for valsartan.

A double-blind, randomized, placebo-controlled, fixed-dose, parallel design trial of ten weeks duration in caucasian patients with mild to moderate hypertension diovan by an open-label extension of 98 weeks duration. Clinical Trial Report Protocol 11E first year extension. Clinical Trial Report Protocol 11E second year extension, diovan amlo 320 5mg. A multicountry, randomized, double-blind, parallel, placebo-controlled trial to assess the effect of 5mg on morbidity and mortality, signs and 320, and quality of life in patients with stable, chronic congestive heart failure NYHA Amlo II-IV.

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