Literature DB >> 12215069

Valsartan/hydrochlorothiazide: a review of its pharmacology, therapeutic efficacy and place in the management of hypertension.

Keri Wellington1, Diana M Faulds.   

Abstract

UNLABELLED: The combination of valsartan [an angiotensin II type 1 (AT(1)) receptor blocker] and hydrochlorothiazide (a thiazide diuretic), administered once daily, has been evaluated in the treatment of patients with hypertension in clinical trials ranging in duration from 8 weeks to 3 years. These studies showed that combination treatment with valsartan 80 or 160mg and hydrochlorothiazide 12.5 or 25mg induced significant reductions from baseline in systolic blood pressure (SBP) and diastolic BP (DBP) in patients with mild to severe hypertension. Clinical trials have demonstrated that the combination of valsartan 80 or 160mg with hydrochlorothiazide 12.5 or 25mg is significantly more effective than either drug alone. Furthermore, valsartan plus hydrochlorothiazide was effective at reducing BP in patients unresponsive to monotherapy with either agent alone. Effective BP control with valsartan plus hydrochlorothiazide was maintained in long-term studies, with reductions observed after 3 months of treatment being similar to those seen after 1, 2 or 3 years. Fixed-dose valsartan/hydrochlorothiazide showed similar BP reductions to amlodipine and to valsartan plus benazepril. Valsartan/hydrochlorothiazide also provided effective 24-hour ambulatory SBP/DBP control. Headache, dizziness and fatigue were the most common adverse events occurring in clinical trials; the incidence of these events in valsartan plus hydrochlorothiazide recipients was not significantly different to that in placebo recipients. Hypokalaemia occurred in 4.5% of valsartan plus hydrochlorothiazide recipients; valsartan attenuated the hydrochlorothiazide-associated decrease in serum potassium concentrations.
CONCLUSIONS: the combination of valsartan and hydrochlorothiazide is an effective treatment for patients with hypertension. Clinical trials have demonstrated that the combination is more effective than either drug alone, and is effective in patients not responding to monotherapy with either agent. Furthermore, the adverse event profile of valsartan/hydrochlorothiazide is similar to that of placebo. Unless there are compelling or specific indications for other drugs, current data support the use of valsartan/hydrochlorothiazide when patients are unresponsive to monotherapy with either agent. Results from clinical trials evaluating the effects of valsartan/hydrochlorothiazide on cardiovascular morbidity and mortality will help to further define the role of the combination in the management of hypertension.

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Year:  2002        PMID: 12215069     DOI: 10.2165/00003495-200262130-00015

Source DB:  PubMed          Journal:  Drugs        ISSN: 0012-6667            Impact factor:   9.546


  54 in total

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2.  Pharmacological profile of valsartan, a non-peptide angiotensin II type 1 receptor antagonist. 3rd communication: hemodynamic effects of valsartan in rats and dogs.

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Journal:  Arzneimittelforschung       Date:  1997-05

3.  Effect of the angiotensin II receptor antagonist valsartan on lipid profile and glucose metabolism in patients with hypertension.

Authors:  M Hanefeld; C Abletshauser
Journal:  J Int Med Res       Date:  2001 Jul-Aug       Impact factor: 1.671

4.  Add-on angiotensin receptor blockade with maximized ACE inhibition.

Authors:  R Agarwal
Journal:  Kidney Int       Date:  2001-06       Impact factor: 10.612

5.  Protein binding in plasma of valsartan, a new angiotensin II receptor antagonist.

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7.  Pharmacokinetics of valsartan in patients with liver disease.

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Journal:  Clin Pharmacol Ther       Date:  1997-09       Impact factor: 6.875

8.  Microalbuminuria reduction with valsartan in patients with type 2 diabetes mellitus: a blood pressure-independent effect.

Authors:  Giancarlo Viberti; Nigel M Wheeldon
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Review 9.  The importance of left ventricular hypertrophy in human hypertension.

Authors:  T Kahan
Journal:  J Hypertens Suppl       Date:  1998-09

10.  Pharmacological profile of valsartan: a potent, orally active, nonpeptide antagonist of the angiotensin II AT1-receptor subtype.

Authors:  L Criscione; M de Gasparo; P Bühlmayer; S Whitebread; H P Ramjoué; J Wood
Journal:  Br J Pharmacol       Date:  1993-10       Impact factor: 8.739

View more
  10 in total

Review 1.  Valsartan/hydrochlorothiazide: a review of its use in the management of hypertension.

Authors:  Antona J Wagstaff
Journal:  Drugs       Date:  2006       Impact factor: 9.546

Review 2.  Aliskiren: a review of its use as monotherapy and as combination therapy in the management of hypertension.

Authors:  Sean T Duggan; Claudine M Chwieduk; Monique P Curran
Journal:  Drugs       Date:  2010-10-22       Impact factor: 9.546

Review 3.  Economic benefits of treating high-risk hypertension with angiotensin II receptor antagonists (blockers).

Authors:  Antonio Coca
Journal:  Clin Drug Investig       Date:  2008       Impact factor: 2.859

4.  Efficacy and Safety of Valsartan 160mg/Hydrochlorothiazide 25mg Combination in Patients with Hypertension not Adequately Controlled by Valsartan 160mg/Hydrochlorothiazide 12.5mg.

Authors:  Peter Trenkwalder; Hans-Joachim Ulmer; Gottfried Weidinger; Renate Handrock
Journal:  Clin Drug Investig       Date:  2004       Impact factor: 2.859

5.  The efficacy and safety of valsartan in obese and non-obese pediatric hypertensive patients.

Authors:  Kevin E C Meyers; Kenneth Lieberman; Susan Solar-Yohay; Guangyang Han; Victor Shi
Journal:  J Clin Hypertens (Greenwich)       Date:  2011-07-14       Impact factor: 3.738

6.  Simultaneous determination of related substances of telmisartan and hydrochlorothiazide in tablet dosage form by using reversed phase high performance liquid chromatographic method.

Authors:  Sutirtho Mukhopadhyay; Kiran Kadam; Laxman Sawant; Dhanashree Nachane; Nancy Pandita
Journal:  J Pharm Bioallied Sci       Date:  2011-07

Review 7.  Valsartan in the treatment of heart attack survivors.

Authors:  Bodh I Jugdutt
Journal:  Vasc Health Risk Manag       Date:  2006

8.  Simultaneous determination of amlodipine, valsartan and hydrochlorothiazide by LC-ESI-MS/MS and its application to pharmacokinetics in rats.

Authors:  Shankar Ganesh Gadepalli; Pragney Deme; Madhusudana Kuncha; Ramakrishna Sistla
Journal:  J Pharm Anal       Date:  2013-12-19

9.  Development of an HPLC-UV Method for the Analysis of Drugs Used for Combined Hypertension Therapy in Pharmaceutical Preparations and Human Plasma.

Authors:  Serife Evrim Kepekci Tekkeli
Journal:  J Anal Methods Chem       Date:  2013-03-24       Impact factor: 2.193

Review 10.  Maximising antihypertensive effects of angiotensin II receptor blockers with thiazide diuretic combination therapy: focus on irbesartan/hydrochlorothiazide.

Authors:  J M Flack
Journal:  Int J Clin Pract       Date:  2007-09-20       Impact factor: 2.503

  10 in total

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