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Home > Drug Category > Blood Pressure Medication (Angiotensin Receptor Blocker) > Exforge and Equivalent

Exforge (Valsartan and Amlodipine) Information

Exforge is a combination medication containing two active ingredients: valsartan (an Angiotensin II Receptor Blocker or ARB) and amlodipine (a Dihydropyridine Calcium Channel Blocker or CCB). It is indicated for the treatment of hypertension (high blood pressure) in patients for whom combination therapy is appropriate. This fixed-dose combination is typically used when blood pressure is not adequately controlled with either component alone. Exforge is administered orally, typically once daily.

The mechanism of action involves the synergistic effects of the two components: Valsartan blocks the binding of Angiotensin II to the AT1 receptor. This inhibits vasoconstriction and aldosterone release, promoting vasodilation (widening of blood vessels) and the excretion of sodium and water, thus reducing systemic vascular resistance. Amlodipine is a CCB that inhibits the transmembrane influx of calcium ions into cardiac and vascular smooth muscle. This causes peripheral arterial vasodilation and a subsequent reduction in peripheral vascular resistance. By combining these two mechanisms, Exforge provides a potent and comprehensive decrease in blood pressure by addressing both the renin-angiotensin system and peripheral vascular tone, often resulting in a superior antihypertensive effect compared to either drug alone.

Exforge Side Effects

Exforge combines the side effect profiles of both valsartan and amlodipine. Common side effects often reported include dizziness, particularly when standing up quickly (orthostatic dizziness), headache, nasopharyngitis (sore throat/runny nose), and fatigue. Side effects specific to the CCB component (amlodipine) include peripheral edema (swelling of the ankles or feet) and flushing.

However, more serious side effects can occur, leading to significant monitoring protocols. If any of the following symptoms are experienced, the patient should stop taking the medication and seek immediate medical attention:
• Angioedema: A rare but severe and potentially life-threatening swelling of the face, lips, tongue, or throat, which can impair breathing. This requires immediate emergency medical attention.
• Fetal Toxicity (Boxed Warning): Use during pregnancy is associated with significant harm to the developing fetus, including fetal death, hypotension, renal failure, and skull hypoplasia. The valsartan component necessitates immediate discontinuation of the drug upon confirmed pregnancy.
• Increased Angina or Myocardial Infarction: In rare cases, particularly when starting CCBs or increasing the dose, patients with severe obstructive coronary artery disease may experience an increase in the frequency, duration, or severity of angina, or may develop an acute heart attack.
• Renal Impairment/Failure and Hyperkalemia: In patients whose kidney function depends on the renin-angiotensin system, the ARB component may cause acute kidney failure or worsening renal function, as well as a critical elevation of serum potassium (hyperkalemia).
• Symptomatic Hypotension: Excessive lowering of blood pressure, especially when initiating therapy or increasing the dose, which may lead to fainting (syncope).

Exforge Precautions

Due to the risk of fetal harm from the valsartan component, Exforge carries a Boxed Warning regarding use during pregnancy and must be discontinued as soon as pregnancy is detected. Women of childbearing age should be advised about the risks of use during pregnancy and discuss appropriate contraceptive use or alternative therapies if they are planning to become pregnant. It is contraindicated in patients with a known history of hypersensitivity to either valsartan or amlodipine, or a history of angioedema related to previous ARB therapy. Caution is advised when initiating therapy in volume-depleted patients (e.g., those on high-dose diuretics) or salt-depleted patients, as they are at a greater risk for symptomatic hypotension, which may require correction before starting the drug. The concurrent use of Exforge with the drug aliskiren is contraindicated in patients with diabetes or moderate to severe renal impairment (GFR less than 60 milliliters' per minute). It should be used with caution in patients with hepatic impairment, as clearance of amlodipine is reduced, requiring potential dose adjustments.

Do I need a prescription to order Exforge?

Yes, a prescription is required from your physician to order Exforge.