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When pregnancy is detected, discontinue Diovan HCT as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and even death to the developing fetus . [ See Warnings and Precautions (5.1) ]
Diovan HCT (valsartan and hydrochlorothiazide, USP) is indicated for the treatment of hypertension.
Diovan HCT may be used in patients whose blood pressure is not adequately controlled on monotherapy.
Diovan HCT may be used as initial therapy in patients who are likely to need multiple drugs to achieve blood pressure goals.
The choice of Diovan HCT as initial therapy for hypertension should be based on an assessment of potential benefits and risks.
Patients with stage 2 hypertension are at a relatively high risk for cardiovascular events (such as strokes, heart attacks, and heart failure), kidney failure, and vision problems, so prompt treatment is clinically relevant. The decision to use a combination as initial therapy should be individualized and should be shaped by considerations such as baseline blood pressure, the target goal and the incremental likelihood of achieving goal with a combination compared to monotherapy. Individual blood pressure goals may vary based upon the patient’s risk.
Data from the high dose multifactorial trial [See Clinical Studies (14 .1 )] provides estimates of the probability of reaching a target blood pressure with Diovan HCT compared to valsartan or hydrochlorothiazide monotherapy. The figures below provide estimates of the likelihood of achieving systolic or diastolic blood pressure control with Diovan HCT 320/25 mg, based upon baseline systolic or diastolic blood pressure. The curve of each treatment group was estimated by logistic regression modeling. The estimated likelihood at the right tail of each curve is less reliable due to small numbers of subjects with high baseline blood pressures.
For example, a patient with a baseline blood pressure of 160/100 mmHg has about a 41% likelihood of achieving a goal of greater than 140 mmHg (systolic) and 60% likelihood of achieving greater than 90 mmHg (diastolic) on valsartan alone and the likelihood of achieving these goals on HCTZ alone is about 50% (systolic) or 57% (diastolic). The likelihood of achieving these goals on Diovan HCT rises to about 84% (systolic) or 80% (diastolic). The likelihood of achieving these goals on placebo is about 23% (systolic) or 36% (diastolic).
The side effects of valsartan are generally rare and appear independent of dose. Those of hydrochlorothiazide are a mixture of dose-dependent (primarily hypokalemia) and dose-independent phenomena (e.g., pancreatitis), the former much more common than the latter [See Adverse Reactions (6)].
Dose once-daily. Maximum antihypertensive effects are attained within 2 to 4 weeks after a change in dose.
Diovan HCT may be administered with or without food.
Diovan HCT may be administered with other antihypertensive agents.
Elderly patients : No initial dosage adjustment is required for elderly patients.
Renal impairment : The usual regimens of therapy with Diovan HCT may be followed as long as the patient’s creatinine clearance is less than 30 mL/min. In patients with more severe renal im
