Meds and you

27 September 2013

Amlodipine and Valsartan

The combination of amlodipine and valsartan is a combination of a calcium channel blocker and an angiotensin receptor antagonist.


The combination of amlodipine and valsartan is the active ingredient of Exforge tablets (Nappi code: 711253-001, 711524-001).

General information

The combination of amlodipine and valsartan is a combination of a calcium channel blocker and an angiotensin receptor antagonist. Both calcium channel blockers and angiotensin receptor antagonists are drugs prescribed, amongst others, for the treatment of high blood pressure. They cause blood vessels to relax and widen, thereby reducing high blood pressure.

In South Africa this combination is registered for the treatment of mild to moderately high blood pressure.

This medication is not a cure for high blood pressure, but is effective in keeping it under control. For it to be effective, you must take it regularly. High blood pressure declines slowly and it may take a few weeks for the combination of amlodipine and valsartan to reach its full effect. Keep taking this medicine during this period, even if you are feeling better, or fail to notice any improvement.

The first couple of doses of this medication may cause a sudden drop in blood pressure, which may cause dizziness or blackouts when you suddenly get up. It is therefore advised to be resting when starting treatment, and to lie down for 2 hours afterwards.

This medication should be avoided during pregnancy, especially the second and third trimester. Speak to your doctor about the use of this drug if you are planning to get pregnant as it may cause harm to the unborn baby.

How does this combination work?

Valsartan blocks the effect of angiotensin II, a naturally occurring substance that narrows blood vessels. As a result blood vessels widen and high blood pressure is reduced.

Amlodipine is a calcium channel blocker. Calcium plays an important role in the contraction of heart muscle, as well as smooth muscle in the walls of arteries. By blocking the channels through which calcium enters cells in these muscles, relaxation of these muscles is obtained. The results are a reduced workload of the heart (and a decrease in occurrence of angina), as well as a return to normal and safe levels of widening of blood vessels causing high blood pressure. 

Fast facts

Drug schedule: schedule 3

Available as: this combination is available as tablets.

What does it do? The combination of amlodipine and valsartan lowers blood pressure and reduces the workload on the heart.

Overdose risk: medium

Dependence risk: low

Is this combination available as a generic? no

Is this combination available on prescription only? yes

User information

Onset of effect: although an effect may be seen much sooner, the maximum effect of this combination is reached within 3 - 6 weeks.

Duration of action: up to 24 hours

Dietary advice: this medication can be taken with or without food.

Stopping this medicine: it may be dangerous to discontinue this drug abruptly as symptoms of the condition being treated may recur. Don't discontinue this drug without speaking to your doctor.

Suddenly stopping the drug may cause your blood pressure to increase dangerously. Your dosage should be decreased gradually only as directed by your doctor.

Special precautions

Consult your doctor before using this drug if:

  • if you have liver or kidney disease
  • if you have congestive heart failure
  • you have a narrowing to the arteries of the kidneys
  • you have unstable angina
  • you are allergic to ANY medicine
  • you are taking other medication

Pregnancy: avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.

Breastfeeding: avoid. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.

Porphyria: avoid. It is unknown how this medication may affect your condition. Consult your doctor before use.

Infants and children: this medication is not intended for use in children.

The elderly: caution is advised in the elderly as side effects are more likely to occur.

Driving and hazardous work: caution is advised as use of this medication may lead to dizziness, light-headedness and/or sedation. Avoid such activities until you know how this medication affects you.

Alcohol: avoid concomitant use of alcohol with this medication.

Possible side effects:



Side effects Frequency   Consult your doctor  
  Common Rare Only if severe In all cases
dizziness x   x  
headache x   x  
diarrhoea/constipation   x x  
flushing x   x  
nausea   x x  
taste disturbance   x x  
drowsiness   x x  
urine retention   x   x
swelling or weight gain   x   x
weakness   x   x
palpitations   x   x
hair loss   x   x
shortness of breath   x   x
skin rash/itch   x   x
cough   x   x
tiredness/unwell feeling   x   x
swelling of mouth/difficulty breathing   x   x
increase in agina attacks   x   x



Drug interactions



other blood-pressure-lowering agents further reduction of blood pressure
beta-blocking drugs increased risk of heart failure
cimetidine increased risk amlodipine toxicity
ritonavir increased risk of amlodipine toxicity
theophylline increased risk of theophylline toxicity
digoxin increased risk of digoxin toxicity
potassium supplements may cause potassium toxicity
anaesthetic drugs may lower blood pressure further
ciclosporin may cause potassium toxicity
rifampicin may reduce effect of valsartan
lithium risk of lithium toxicity
non-steroidal anti-inflammatory drugs reduced effect of this combination


Overdose action

A small overdose is no cause for concern. In case of intentional large overdose, seek emergency medical attention. Symptoms may include dizziness and fainting.

Recommended dosage

Adults: not to exceed dose as for each individual agent.




This material is not intended to substitute medical advice, but is for informational purposes only.   Please consult a physician for specific treatment and recommendations.




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