Complete adverse effect profile including incidence rates and management
Important Safety Information
This is not a complete list of all possible side effects. Contact your healthcare provider if you experience any unexpected symptoms. For serious or life-threatening side effects, seek emergency medical attention immediately.
6 ADVERSE REACTIONS Most common adverse events (≥2% incidence) are dizziness, peripheral edema, headache, dyspepsia, fatigue, muscle spasms, back pain, nausea and nasopharyngitis.
(6.1) To report SUSPECTED ADVERSE REACTIONS, contact Strides Pharma Inc at 1-877-244-9825 and/or www.strides.com or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch .
6.1 Clinical Trials Experience Because clinical studies are conducted under widely varying conditions, adverse reaction rates observed in the clinical studies of a drug cannot be directly compared to rates in the clinical studies of another drug and may not reflect the rates observed in clinical practice.
In the controlled trial of amlodipine/valsartan/hydrochlorothiazide, where only the maximum dose (10/320/25 mg) was evaluated, safety data were obtained in 582 patients with hypertension.
Adverse reactions have generally been mild and transient in nature and have only infrequently required discontinuation of therapy.
The overall frequency of adverse reactions was similar between men and women, younger (< 65 years) and older (≥ 65 years) patients, and black and white patients.
In the active controlled clinical trial, discontinuation because of adverse events occurred in 4.0% of patients treated with amlodipine/valsartan/hydrochlorothiazide 10/320/25 mg compared to 2.9% of patients treated with valsartan/HCTZ 320/25 mg, 1.6% of patients treated with amlodipine/valsartan 10/320 mg, and 3.4% of patients treated with HCTZ/amlodipine 25/10 mg.
The most common reasons for discontinuation of therapy with amlodipine/valsartan/hydrochlorothiazide were dizziness (1.0%) and hypotension (0.7%).
The most frequent adverse events that occurred in the active controlled clinical trial in at least 2% of patients treated with amlodipine/valsartan/hydrochlorothiazide are presented in the following table.
Aml/Val/HCTZ Val/HCTZ Aml/Val HCTZ/Aml Preferred Term 10/320/25 mg N=582 n (%) 320/25 mg N=559 n (%) 10/320 mg N=566 n (%) 25/10 mg N=561 n (%) Dizziness 48 ( 8.2) 40 ( 7.2) 14 ( 2.5) 23 ( 4.1) Edema 38 ( 6.5) 8 ( 1.4) 65 (11.5) 63 ( 11.2) Headache 30 (5.2) 31 (5.5) 30 (5.3) 40 (7.1) Dyspepsia 13 ( 2.2) 5 ( 0.9) 6 ( 1.1) 2 ( 0.4) Fatigue 13 ( 2.2) 15 ( 2.7) 12 ( 2.1) 8 ( 1.4) Muscle spasms 13 ( 2.2) 7 ( 1.3) 7 ( 1.2) 5 ( 0.9) Back pain 12 ( 2.1) 13 ( 2.3) 5 ( 0.9) 12 ( 2.1) Nausea 12 ( 2.1) 7 ( 1.3) 10 ( 1.8) 12 ( 2.1) Nasopharyngitis 12 (2.1) 13 (2.3) 13 (2.3) 12 (2.1) Orthostatic events (orthostatic hypotension and postural dizziness) were seen in 0.5% of patients.
5 WARNINGS AND PRECAUTIONS Hypotension: Correct volume depletion prior to initiation (5.2) Increased angina and/or myocardial infarction (5.3) Monitor renal function and potassium in susceptible patients (5.4, 5.5) Exacerbation or activation of systemic lupus erythematosus (5.7) Observe for signs of fluid or electrolyte imbalance (5.9) Acute angle-closure glaucoma (5.10) 5.1 Fetal Toxicity Valsartan Amlodipine/valsartan/hydrochlorothiazide can cause fetal harm when administered to a pregnant woman.
Use 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.
Potential neonatal adverse effects include skull hypoplasia, anuria, hypotension, renal failure, and death.
When pregnancy is detected, discontinue Amlodipine/valsartan/hydrochlorothiazide as soon as possible [see Use in Specific Populations (8.1)].
Like all medications, Amlodipine, Valsartan, Hydrochlorothiazide can cause side effects. However, not everyone who takes this medication will experience them. Many side effects are dose-dependent and may improve as your body adjusts to the medication. Others may require dose adjustment or medical attention.
Contact your healthcare provider promptly if you experience:
Seek immediate emergency medical care if you experience signs of: