Home Drug Guide Amlodipine besylate and Valsartan

Drug Guide

Generic Name

Amlodipine besylate and Valsartan

Brand Names Exforge, Amlodipine Besylate and Valsartan

Classification

Therapeutic: Antihypertensive

Pharmacological: Calcium channel blocker (Amlodipine), Angiotensin II receptor blocker (Valsartan)

FDA Approved Indications

  • Hypertension
  • Heart failure (specifically Valsartan)

Mechanism of Action

Amlodipine inhibits calcium influx into vascular smooth muscle and cardiac muscle, resulting in vasodilation. Valsartan blocks angiotensin II receptors, leading to vasodilation and decreased aldosterone secretion, reducing blood pressure.

Dosage and Administration

Adult: Typically, 5-10 mg once daily, with adjustments based on response.

Pediatric: Not approved for pediatric use.

Geriatric: Start at lower dose due to increased sensitivity.

Renal Impairment: Adjust dosing as necessary, monitor renal function.

Hepatic Impairment: Use with caution; start at lower doses and titrate slowly.

Pharmacokinetics

Absorption: Rapidly absorbed after oral administration.

Distribution: Amlodipine: 97.5% protein-bound; Valsartan: 94% protein-bound.

Metabolism: Amlodipine undergoes minimal first-pass metabolism; Valsartan is minimally metabolized.

Excretion: Amlodipine: primarily hepatic; Valsartan: primarily via feces; some renal excretion.

Half Life: Amlodipine: ~30-50 hours; Valsartan: ~6 hours.

Contraindications

  • History of hypersensitivity to amlodipine or valsartan.
  • Pregnancy (especially at term), known bilateral renal artery stenosis.

Precautions

  • Monitor blood pressure, renal function, and electrolytes regularly.
  • Use cautiously in hepatic impairment.

Adverse Reactions - Common

  • Swelling (edema) (Common)
  • Dizziness (Common)
  • Headache (Common)

Adverse Reactions - Serious

  • Hypotension (Serious)
  • Angioedema (Rare)
  • Elevated liver enzymes, hepatic failure (Rare)

Drug-Drug Interactions

  • Other antihypertensives, diuretics, potassium supplements, NSAIDs

Drug-Food Interactions

  • Limit alcohol intake; excessive salt may reduce efficacy.

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure, heart rate, renal function, and electrolytes.

Diagnoses:

  • Risk for hypotension
  • Impaired renal function

Implementation: Administer consistently; monitor for adverse effects.

Evaluation: Assess blood pressure and symptoms regularly to determine effectiveness and tolerability.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Rise slowly from sitting/lying to prevent dizziness.
  • Report swelling, difficulty breathing, or chest pain.
  • Maintain regular blood pressure and renal function tests.

Special Considerations

Black Box Warnings:

  • Fetal toxicity: can cause fetal death when used during pregnancy.

Genetic Factors: Genetic variations may affect drug metabolism and response.

Lab Test Interference: May affect serum potassium and renal function tests.

Overdose Management

Signs/Symptoms: Severe hypotension, tachycardia or bradycardia, dizziness.

Treatment: Supportive care; monitor vital signs; administer fluids or vasopressors as needed; activated charcoal if ingestion is recent.

Storage and Handling

Storage: Store at room temperature, 20-25°C (68-77°F).

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.