Patient Medication Information: uses, side effects, how to take - Q-Valsartan HCTZ
ABOUT THIS MEDICATION
What the medication is used for:
Q-VALSARTAN HCTZ lowers high blood pressure.
High blood pressure increases the workload of the heart and arteries. If this condition continues for a long time, damage to the blood vessels of the brain, heart, and kidneys can occur, and may eventually result in a stroke, heart failure or kidney failure. High blood pressure also increases the risk of heart attacks. Reducing your blood pressure decreases your risk of developing these illnesses.
What it does:
Q-VALSARTAN HCTZ contains a combination of 2 drugs, valsartan and hydrochlorothiazide:
Valsartan is an angiotensin receptor blocker (ARB).
You can recognize an ARB because its medicinal ingredient ends in “-SARTAN”. It lowers blood pressure. Q-VALSARTAN HCTZ does this by specifically blocking angiotensin II. Angiotensin II is a natural hormone produced in the body to keep blood pressure at normal levels. One function of angiotensin II is to increase blood pressure, usually when it becomes too low. Valsartan works by blocking the effect of angiotensin II. As a result, blood pressure is lowered.
Hydrochlorothiazide is a diuretic or “water pill” that
increases urination. This lowers blood pressure.
Together valsartan and hydrochlorothiazide lower blood pressure.
This medicine does not cure high blood pressure. It helps to control it. Therefore, it is important to continue taking
Q-VALSARTAN HCTZ regularly even if you feel fine.
If you have any questions about how Q-VALSARTAN HCTZ works or why this medicine has been prescribed for you, ask your doctor.
When it should not be used:
Do not take Q-VALSARTAN HCTZ if you:
- Are allergic to valsartan, hydrochlorothiazide or to any non-medicinal ingredient in the formulation.
- Are allergic to any sulfonamide-derived drugs (sulfa drugs); most of them have a medicinal ingredient that ends in “-MIDE”. Ask your physician or pharmacist if you are not sure what sulfonamide-derived drugs are.
- Have experienced an allergic reaction (angioedema) with swelling of the hands, feet, or ankles, face, lips, tongue, throat, or sudden difficulty breathing or swallowing to any ARB. Be sure to tell your doctor, nurse, or pharmacist that this has happened to you.
- Have difficulty urinating or produce no urine.
- Suffer from severe liver disease with destruction of the small bile ducts within the liver (biliary cirrhosis) leading to the builds up bile in the liver (cholestasis).
- Are taking a medicine that contains aliskiren and you have diabetes or kidney disease.
Are pregnant or intend to become pregnant. Taking Q-
VALSARTAN HCTZ during pregnancy can cause injury and even death to your baby.
- Are breastfeeding. Q-VALSARTAN HCTZ passes into breast milk.
Have one of the following rare hereditary diseases:
- Galactose intolerance
- Lapp lactase deficiency
- Glucose-galactose malabsorption Because lactose is a non-medicinal ingredient in Q-VALSARTAN HCTZ.
- Have serious kidney disease.
- Have a too low level of potassium or sodium or if you have a too high level of calcium in your blood despite treatment.
- Have uric acid crystals in the joints (gout).
- Are under 18 years old.
If either of these apply to you, tell your doctor without taking Q-VALSARTAN HCTZ.
What the medicinal ingredients are:
Valsartan and hydrochlorothiazide.
What the non-medicinal ingredients are:
Q-VALSARTAN HCTZ tablets also contain the following non-medicinal ingredients:
- 80/12.5 mg tablets: Colloidal silicon dioxide, sodium dodesyl sulphate, crospovidone, lactose monohydrate, magnesium stearate, microcrystalline cellulose, povidone, pregelatinized starch. The coating contains hypromellose, iron oxide red, iron
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oxide yellow, polyethylene glycol 8000, titanium dioxide and talc.
160/12.5 mg: colloidal silicon dioxide, sodium
dodesyl sulphate, crospovidone, lactose monohydrate, magnesium stearate,. The coating contains hypromellose, iron microcrystalline cellulose, povidone, pregelatinized starch oxide red, polyethylene glycol 400, talc and titanium dioxide.
160/25 mg: Colloidal silicon dioxide, sodium
dodesyl sulphate, crospovidone, lactose monohydrate, magnesium stearate, microcrystalline cellulose, povidone, pregelatinized starch.. The coating contains hypromellose, iron oxide black, iron oxide red, iron oxide yellow, polyethylene glycol 8000, talc and titanium dioxide.
320/12.5 mg: Colloidal silicon dioxide, sodium
dodesyl sulphate, crospovidone, lactose monohydrate, magnesium stearate, microcrystalline cellulose, povidone, pregelatinized starch. The coating contains hypromellose, iron oxide black, iron oxide red, polyethylene glycol 4000, talc and titanium dioxide.
320/25 mg: Colloidal silicon dioxide, sodium
dodesyl sulphate, crospovidone, lactose monohydrate, magnesium stearate, microcrystalline cellulose, povidone, pregelatinized starch. The coating contains hypromellose, iron oxide yellow, polyethylene glycol 8000, talc and titanium dioxide.
If you are on a special diet, or if you are allergic to any substance, ask your doctor or pharmacist whether any of these ingredients may cause a problem.
What dosage forms it comes in:
Q-VALSARTAN HCTZ is available in five tablet strengths containing valsartan and hydrochlorothiazide 80 mg/12.5 mg, 160 mg/12.5 mg, 160 mg/25 mg, 320 mg/12.5 mg, 320 mg/25 mg.
The pink, oval biconvex film-coated tablet debossed
with VH1 on one side of the tablet and M on the other side contains 80 mg of valsartan and 12.5 mg of hydrochlorothiazide as the active ingredients.
The reddish, oval biconvex film-coated tablet
debossed with VH2 on one side of the tablet and M on the other side contains 160 mg of valsartan and 12.5 mg of hydrochlorothiazide as the active ingredients.
The brown, oval biconvex film-coated tablet
debossed with VH3 on one side of the tablet and M on the other side contains 160 mg of valsartan and 25 mg of hydrochlorothiazide as the active ingredients.
The pink, oval biconvex film-coated tablet debossed
with VH4 on one side of the tablet and M on the other side contains 320 mg of valsartan and 12.5 mg of hydrochlorothiazide as the active ingredients.
- The yellow, oval biconvex film-coated tablet debossed with VH5 on one side of the tablet and M on the other side contains 320 mg of valsartan and 25 mg of hydrochlorothiazide as the active ingredients.
WARNINGS AND PRECAUTIONS
Serious Warnings and Precautions - Pregnancy
Q-VALSARTAN HCTZ should not be used during pregnancy. If you discover that you are pregnant while taking Q-VALSARTAN HCTZ, stop the medication and please contact your doctor, nurse, or pharmacist as soon as possible.
BEFORE you use Q-VALSARTAN HCTZ talk to your doctor, nurse or pharmacist if you:
- Are allergic to any drug used to lower blood pressure, including angiotensin converting enzyme (ACE) inhibitors, or penicillin.
- Have narrowing of an artery or a heart valve.
- Have heart failure.
- Have diabetes, liver or kidney disease.
- Have lupus or gout.
- Are on dialysis.
- Are dehydrated or suffer from excessive vomiting, diarrhea, or sweating.
- Are taking a salt substitute that contains potassium, potassium supplements, or a potassium-sparing diuretic (a specific kind of “water pill”).
- Are on a low-salt diet.
- Are less than 18 years old.
- Suffer from severe liver disease with destruction of the small bile ducts within the liver (biliary cirrhosis) leading to the builds up bile in the liver (cholestasis);
- Ever had swelling mainly of the face and throat while taking other drugs (including an ACE-inhibitor). If you get those symptoms, stop taking Q-VALSARTAN HCTZ and contact your doctor straight away. You should never take Q-VALSARTAN HCTZ again;
- Have low levels of potassium in your blood (with or without symptoms such as muscle weakness, muscle spasms, abnormal heart rhythm).
- Have low levels of sodium in your blood (with or
- without symptoms such as tiredness, confusion, muscle twitching, convulsions).
- Have high levels of calcium in your blood (with or without symptoms such as nausea, vomiting, constipation, stomach pain, frequent urination, thirst, muscle weakness and twitching).
- Have high levels of uric acid in the blood.
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- Are suffering from allergy or asthma
Have high levels of cholesterol or triglycerides in your
blood;
Are suffering from vomiting or diarrhea, or taking high
doses of a diuretic (water pill);
Are taking a medicine that contains aliskiren, used to
lower high blood pressure. The combination with Q-VALSARTAN HCTZ is not recommended.
Are taking an angiotensin converting enzyme (ACE)
inhibitor.
Hydrochlorothiazide in Q-VALSARTAN can cause Sudden Eye Disorders:
- Myopia: sudden nearsightedness or blurred vision.
Glaucoma: an increased pressure in your eyes, eye pain. Untreated, it may lead to permanent vision loss.
These eye disorders are related and can develop within hours to weeks of starting Q-VALSARTAN HCTZ.
You may become sensitive to the sun while taking Q-VALSARTAN HCTZ. Exposure to sunlight should be minimized until you know how you respond.
You should have regular blood tests before and during treatment with Q-VALSARTAN HCTZ. These will monitor the amount of electrolytes (such as potassium, sodium, calcium or magnesium) in your blood and may also monitor your kidney function.
You are pregnant, breast-feeding or thinking of becoming pregnant?
Taking Q-VALSARTAN HCTZ during pregnancy can cause injury and even death to your baby. This medicine should not be used during pregnancy. If you are planning to become pregnant while taking Q-VALSARTAN HCTZ, contact immediately your doctor.
It is also advisable not to take Q-VALSARTAN HCTZ during breast-feeding. The diuretic component of Q-VALSARTAN HCTZ passes into the breast milk and may also reduce your milk supply. If you are breast-feeding, avoid using Q-VALSARTAN HCTZ unless recommended by your doctor.
Similar medicines were associated with serious harm to fetuses when they were taken during pregnancy. It is therefore important to tell your doctor immediately if you think you may have become pregnant, or planning to become pregnant. Your doctor will discuss with you the potential risk of taking Q-VALSARTAN HCTZ during pregnancy.
Driving and using machines: Before you perform tasks which may require special attention, wait until you know how
you respond to Q-VALSARTAN HCTZ. Dizziness, lightheadedness, or fainting can especially occur after the first dose and when the dose is increased.
INTERACTIONS WITH THIS MEDICATION
As with most medicines, interactions with other drugs are possible. Tell your doctor, nurse, or pharmacist about all medicines you take, including drugs prescribed by other doctors, vitamins, minerals, natural supplements, or alternative medicines.
Certain medicines tend to increase your blood pressure, for example, non prescription preparations for appetite control, asthma, colds, coughs, hay fever and sinus problems.
Before surgery and general anesthesia (even at the dentist’s office), tell the physician or dentist that you are taking Q-VALSARTAN HCTZ, as there may be a sudden drop in blood pressure associated with general anesthesia.
The following may interact with Q-VALSARTAN HCTZ:
- Alcohol, barbiturates (sleeping pills), or narcotics (strong pain medications). They may cause low blood pressure and dizziness when you go from lying or sitting to standing up.
- Amphotericin B, an antifungal drug.
- Anticancer drugs, including cyclophosphamide and methotrexate.
- Antidepressants, in particular selective serotonin reuptake inhibitors (SSRIs), including citalopram, escitalopram, and sertraline.
- Antidiabetic drugs, including insulin and oral medicines.
- Bile acid resins used to lower cholesterol.
- Other blood pressure lowering drugs, including ACE inhibitors or aliskiren.
- Calcium or vitamin D supplements.
- Corticosteroids used to treat joint pain and swelling.
- Digoxin, a heart medication, or other digitalis glycosides.
- Drugs that slow down or speed up bowel function, including atropine, metoclopramide, and domperidone.
- Drugs used to treat epilepsy, including carbamazepine and topiramate.
- Gout medications, including allopurinol and probenecid.
- Lithium, antipsychotics, medicines used to treat some psychological conditions such as bipolar disease.
- Nonsteroidal anti-inflammatory drugs (NSAIDs), used to reduce pain and swelling. Examples include ibuprofen, naproxen, and celecoxib.
- Skeletal muscle relaxants used to relieve muscle spasms, including tubocurare.
- other diuretics (water pills),
- Pressor amines such as epinephrine (substances that raise blood pressure),
- Potassium-sparing agents
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Potassium supplement or salt substitutes containing
potassium. Your doctor may monitor the levels of potassium in your blood periodically,
Some antibiotics (rifamycin group), a drug used to protect
against transplant rejection (cyclosporine) or an antiretroviral drug used to treat HIV/AIDS infection (ritonavir). These drugs may increase the effect of Q-VALSARTAN HCTZ.
Amantadine (medicine to treat Parkinson's disease and
also used to treat or prevent certain illnesses caused by viruses),
Anticholinergic agents (medicines used to treat a variety
of disorders such as gastrointestinal cramps, urinary bladder spasm, asthma, motion sickness, muscular spasms, Parkinson's disease and as an aid to anaesthesia)
Cortisone-like medicines, carbenoxolone (a medicine
used to treat ulceration and inflammation), antibiotics such as penicillin G, antiarrhythmics (medicines used to treat heart problems),
Cyclosporine (a medicine used in transplantation and in
autoimmune disorders)
- Warfarin (medicine to prevent blood clot)
- Diazoxide (medicine to increase blood glucose level)
Taking carbamazepine with hydrochlorothiazide (a medicinal ingredient in Q-VALSARTAN HCTZ) may cause a low sodium level in the blood. Symptoms of low sodium level in the blood may include: nausea, vomiting, headache, muscular cramps or weakness, and general uneasiness. As it worsens, confusion, decreased consciousness, convulsions (fits), or coma may occur. Tell your doctor if this happens to you.
Sedatives, tranquilizers, narcotics, alcohol and analgesics may increase the blood-pressure lowering effect of Q-VALSARTAN HCTZ, so tell your physician or pharmacist if you are taking any of these.
PROPER USE OF THIS MEDICATION
Take Q-VALSARTAN HCTZ exactly as prescribed. It is recommended to take your dose at about the same time everyday.
Q-VALSARTAN HCTZ can be taken with or without food. If Q-VALSARTAN HCTZ causes upset stomach, take it with food or milk.
Patients who have high blood pressure often do not notice any signs or symptoms of this condition. So even though you are feeling well, your health may be getting worse. This makes it all the more important for you to continue your treatment program and to keep your appointments with your doctor.
If you have any questions about how long to take Q-
VALSARTAN HCTZ, talk to your doctor or your pharmacist.
Usual Adult Dose:
Take Q-VALSARTAN HCTZ as directed. Dosage must be individualized. Q-VALSARTAN HCTZ is not for initial therapy. Once you are stabilized on both individual components of Q-VALSARTAN HCTZ the usual dosage is one 80 mg/12.5mg tablet once a day. In some cases, your doctor may prescribe a higher dose (e.g., the 160mg/12.5mg, 160 mg/25 mg, 320mg/12.5mg or the 320mg/25mg tablet).
Overdose:
If you experience severe dizziness and/or fainting, contact your doctor immediately so that medical attention may be given promptly.
| In case of drug overdose, contact a health care practitioner, | ||
| hospital emergency department or regional Poison Control | ||
| Centre immediately, even if there are no symptoms. |
Missed Dose:
Try to take your dose at the same time each day, preferably in the morning. If you have forgotten to take your dose during the day, carry on with the next one at the usual time. Do not double doses.
SIDE EFFECTS AND WHAT TO DO ABOUT THEM
Side effects may include:
- back or leg pain, muscle cramps, spasms and pain, weakness, restlessness
- dizziness, pins and needles in your fingers, headache
- constipation, diarrhea, nausea, vomiting, decreased appetite, upset stomach, enlargement of the glands in your mouth
- bleeding under the skin, rash, red patches on the skin
- drowsiness, insomnia
- reduced libido
- joint pain
- Cough
- Fatigue (unusual tiredness or weakness, sometimes sign of potassium loss)
- Upper respiratory tract infection
- Blistering skin (sign of dermatitis bullous)
If any of these affects you severely, tell your doctor, nurse or pharmacist.
- Q-VALSARTAN HCTZ can cause abnormal blood test results. Your doctor will decide when to perform blood tests and will interpret the results.
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| SERIOUS SIDE EFFECTS, HOW OFTEN THEY | ||||
| HAPPEN AND WHAT TO DO ABOUT THEM | ||||
| Symptom / effect | Talk with your doctor or pharmacist | Stop taking drug and seek immediate emergency medical attention | ||
| Only if severe | In all cases | |||
| Common | Allergic reactions: Skin rash, skin eruption or other effect on the skin or eyes | √ | ||
Low Blood Pressure: dizziness, fainting, lightheadedness May occur when you go from lying or sitting to standing up. | √ | |||
Decreased or increased levels of potassium in the blood: irregular heartbeats, muscle weakness and generally feeling unwell | √ | |||
Uncommon
Allergic Reaction: rash, hives, swelling of the face, lips, tongue or throat, difficulty swallowing or breathing | √ | ||
Kidney Disorder: change in frequency of urination, nausea, vomiting, swelling of extremities, fatigue | √ | ||
Liver Disorder: yellowing of the skin or eyes, dark urine, abdominal pain, nausea, vomiting, loss of appetite | √ |
| SERIOUS SIDE EFFECTS, HOW OFTEN THEY | ||||
| HAPPEN AND WHAT TO DO ABOUT THEM | ||||
Symptom / effect Increased blood sugar: frequent urination, thirst, and hunger Electrolyte Imbalance: weakness, drowsiness, muscle pain or cramps, irregular heartbeat Abdominal pain | Talk with your doctor or pharmacist | Stop taking drug and seek immediate emergency medical attention | ||
| Only if severe | In all cases | |||
| √ | ||||
| √ | ||||
| √ | ||||
| Rare | Rhabdomyolysis: muscle pain that you cannot explain, muscle tenderness or weakness, dark brown urine | √ | ||
Decreased White Blood Cells: infections, fatigue, fever, aches, pains, and flu-like symptoms | √ | |||
Decreased Platelets: bruising, bleeding, fatigue and weakness | √ | |||
| Very rare | Toxic Epidermal Necrolysis: severe skin peeling, especially in mouth and eyes | √ | ||
Unknown
Eye disorders:
increased pressure in your eyes, eye pain | √ |
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| SERIOUS SIDE EFFECTS, HOW OFTEN THEY | ||||
| HAPPEN AND WHAT TO DO ABOUT THEM | ||||
Symptom / effect Anemia: fatigue, loss of energy, weakness, shortness of breath. Inflammation of the Pancreas: abdominal pain that lasts and gets worse when you lie down, nausea, vomiting Blistering skin reactions with symptoms such as rash, red skin, blistering of the lips, eyes or mouth, skin peeling and fever | Talk with your doctor or pharmacist | Stop taking drug and seek immediate emergency medical attention | ||
| Only if severe | In all cases | |||
| √ | ||||
| √ | ||||
| √ | ||||
| Rare or very rare | Possible signs of a blood disorder (symptoms like sore throat, fever, or chills) | √ | ||
Jaundice: Yellow eyes or skin | √ | |||
| Irregular heart beat | √ | |||
Necrotizing vasculitis; (Inflammation of vessels with or without pain) | √ | |||
Tiredness, confusion, muscle twitching, convulsions (possible symptoms of hypernatremia) | √ | |||
Respiratory problems including pneumonitis and pulmonary edema | √ | |||
| SERIOUS SIDE EFFECTS, HOW OFTEN THEY | ||||
| HAPPEN AND WHAT TO DO ABOUT THEM | ||||
Symptom / effect Bone marrow failure, aplastic anemia: (Weakness, bruising and frequent infections) | Talk with your doctor or pharmacist | Stop taking drug and seek immediate emergency medical attention | ||
| Only if severe | In all cases | |||
| √ | ||||
This is not a complete list of side effects. For any unexpected effects while taking Q-VALSARTAN HCTZ, contact your doctor, nurse or pharmacist.
HOW TO STORE IT
Store your Q-VALASARTAN HCTZ tablets at controlled room temperature (15°C to 30°C). Protect from moisture.
Do not take Q-VALSARTAN HCTZ past the expiry date shown on the pack.
Always remember
This medicine has been prescribed to you for your current medical problem only. Do not give it to other people.
It is very important that you take this medicine exactly as your doctor tells you in order to get the best results and reduce the chance of side effects.
Keep out of the reach and sight of children.
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REPORTING SUSPECTED SIDE EFFECTS
You can report any suspected adverse reactions associated with the use of health products to the Canada Vigilance Program by one of the following 3 ways:
Report online at www.healthcanada.gc.ca/medeffect Call toll-free at 1-866-234-2345
Complete a Canada Vigilance Reporting Form and:
- Fax toll-free to 1-866-678-6789, or
Mail to: Canada Vigilance Program,
Health Canada
Postal Locator 0701E
Ottawa, ON K1A 0K9
Postage paid labels, Canada Vigilance Reporting Form and the adverse reaction reporting guidelines are available on the MedEffect™ Canada Web site at
www.healthcanada.gc.ca/medeffect
NOTE: Should you require information related to the management of side effects, contact your health professional. The Canada Vigilance Program does not provide medical advice.
MORE INFORMATION
This document can be found at: www.qdpharmaceuticals.ca.
The full Product Monograph prepared for health professionals can be obtained by contacting the sponsor, QD Pharmaceuticals ULC at: 1-800-661-3429
Revised on: September 12, 2014