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Exforge Hct SpecificationRequires Prescription (YES/NO)YesGenericsValsartan, Amlodipine and HydrochlorothiazideUsed ForHypertensionHow it worksValsartan : Angiotensin II is formed from angiotensin I in a reaction catalyzed by angiotensin-converting enzyme (ACE, kininase II). Angiotensin II is the principal pressor agent of the renin-angiotensin system, with effects that include vasoconstriction, stimulation of synthesis and release of aldosterone, cardiac stimulation, and renal reabsorption of sodium. Amlodipine is a dihydropyridine calcium channel blocker Amlodipine binds to both dihydropyridine and non-dihydropyridine binding sites. The contractile processes of cardiac muscle and vascular smooth muscle are dependent upon the movement of extracellular calcium ions into these cells through specific ion channels. Hydrochlorothiazide : The mode of action of thiazides is through inhibition of the Na+Cl- symporter perhaps by competing for the Cl- site, thereby affecting the renal tubular mechanisms of electrolyte reabsorption, directly increasing excretion of sodium and chloride in approximately equivalent amounts and indirectly, reducing plasma volume, with consequent increases in plasma renin activity, increases in aldosterone secretion, increases in urinary potassium loss, and decreases in serum potassium. Exforge Hct Usage And SafetyDosageValsartan, Amlodipine and HydrochlorothiazideSide EffectsAgranulocytosis, bone marrow failure , Hemoglobin and Hematocrit decreased , Hemolytic anemia , Leukopenia, Neutropenia , Thrombocytopenia sometimes with purpura , Aplastic anemia , Anorexia , Hypercalcaemia , Hyperglycemia , Hyperlipidemia , Hyperuricaemia , Hypochloraemic alkalosis , Hypokalemia , Hypomagnesaemia , Headache , Hypertonia , Visual disturbance , Arrhythmias (including bradycardia, ventricular tachycardia, and atrial fibrillation).Drug InteractionsAmlodipine : CYP3A4 inhibitors (protease inhibitors: ritonavir, azole antifungals: ketoconazole or itraconazole, macrolides: erythromycin or clarithromycin, verapamil or diltiazem) , CYP3A4 inducers (e.g. anticonvulsants: carbamazepine, phenobarbital, phenytoin, fosphenytoin, primidone; rifampicin and Hypericum perforatum ) , Sildenafil , Simvastatin , Immunosuppressants , Dantrolene infusion , Grape fruit. Valsartan : Potassium-sparing diuretics (e.g., spironolactone, triamterene, amiloride) , heparin , NSAIDs, including selective COX-2 inhibitors , rifampicin, ciclosporin , ritonavir , Lithium . Hydrochlorothiazide Metformin , antidepressants, antipsychotics, antiepileptics such as carbamazepine , cholestyramine or colestipol , Cyclosporine , Lithium , Alcohol, barbiturates or narcotics , Amantadine , Beta blockers and diazoxide , Cytotoxic agents , Digitalis glycosides , Iodine contrasting agents , Methyldopa , tubocurarine.IndicationIt (Valsartan, Amlodipine and Hydrochlorothiazide) is indicated for the treatment of essential hypertension in adults.When not to Use? Hypersensitivity condition to valsartan, amlodipine, hydrochlorothiazide or other sulphonamide or dihydropyridine derivatives.? Second and third trimesters of pregnancy? Severe hepatic impairment, biliary cirrhosis or cholestasis.Exforge Hct PrecautionsPrecautionIt should be used with caution in patients with unilateral or bilateral renal artery stenosis or stenosis to a solitary kidney since blood urea and serum creatinine may increase in such patients.Exforge Hct WarningsWarning 1Use 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. Resulting oligohydramnios can be associated with fetal lung hypoplasia and skeletal deformations.Warning 2In patients with an activated renin-angiotensin system, such as volume and/or salt-depleted patients receiving high doses of diuretics, symptomatic hypotension may occur. This condition should be corrected prior to administration of Valsartan/amlodipine/HCT, or the treatment should start under close medical supervision.Warning 3Changes in renal function including acute renal failure can be caused by drugs that inhibit the renin-angiotensin system and by diuretics.Exforge Hct Additional InformationPregnancy categoryAlways consult your physician before using any medicine.Storage (YES/NO)Store this medicine at room temperature, away from direct light and heat.