amlodipine / valsartan
Exforge is a combination blood pressure medication for adults. It contains amlodipine (a calcium channel blocker, or CCB) and valsartan (an angiotensin receptor blocker, or ARB). It comes as a tablet that's taken by mouth, typically once per day. Some side effects of Exforge (amlodipine / valsartan) include swelling throughout the body and dizziness. This medication is available as generics.
What is Exforge (amlodipine / valsartan)?
What is Exforge (amlodipine / valsartan) used for?
- High blood pressure in adults
How Exforge (amlodipine / valsartan) works
Exforge (amlodipine / valsartan) is a combination of two medications that work together to lower blood pressure.
- Amlodipine is a calcium channel blocker (CCB). It relaxes your blood vessels to lower your blood pressure.
- Valsartan is an angiotensin II receptor blocker (ARB). It lowers blood pressure by blocking angiotensin II. This is a hormone that typically causes your blood vessels to become more narrow, which raises your blood pressure.
Drug facts
Side effects of Exforge (amlodipine / valsartan)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Swelling in legs or arms (5%)
- Sore throat, runny nose, and other cold-like symptoms (3-4%)
- Dizziness (2%)
Less Common Side Effects
- Low blood pressure or dizziness after standing up quickly
Exforge (amlodipine / valsartan) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Dangerously low blood pressure: dizziness, lightheadedness, pale skin, feeling faint
- Heart attack: cold and clammy skin, sweating, dizziness, tightness and pain in the chest, neck, arms, or back
- Kidney problems: feeling confused, having trouble thinking clearly, nausea, vomiting, feeling very tired, trouble making urine or urinating, swelling in your feet, ankles, or hands
- High blood potassium levels: nausea, vomiting, tingling sensation, muscle weakness, fluttering heartbeat
The following Exforge (amlodipine / valsartan) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Heart attack—pain or tightness in the chest, shoulders, arms, or jaw, nausea, shortness of breath, cold or clammy skin, feeling faint or lightheaded
- High potassium level—muscle weakness, fast or irregular heartbeat
- Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
- Low blood pressure—dizziness, feeling faint or lightheaded, blurry vision
- Worsening chest pain (angina)—pain, pressure, or tightness in the chest, neck, back, or arms
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Constipation
- Facial flushing, redness
- Fatigue
- Headache
- Nausea
- Stomach pain
- Swelling of the ankles, hands, or feet
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Pros and cons of Exforge (amlodipine / valsartan)
Pros
- Convenient to take a combination of two medications in one pill
- Only taken once a day
- Available as a lower-cost generic
Cons
- Not safe to take while pregnant or breastfeeding
- Might not be a good choice for people with liver problems
- Can cause swelling in the arms and legs
Pharmacist tips for Exforge (amlodipine / valsartan)
- Make sure to mark your calendar with your appointments to see your prescriber and to get any blood work done when you take Exforge (amlodipine / valsartan). Your care team will order tests (e.g., potassium level, kidney function, blood pressure) during treatment and might change your dose of Exforge (amlodipine / valsartan) based on your lab results.
- Take Exforge (amlodipine / valsartan) with or without food at any time of the day. If it hurts your stomach, taking it with food might help.
- It typically takes 2 weeks to see the full blood pressure-lowering effect from Exforge (amlodipine / valsartan). If you don't see a change in your blood pressure after taking it every day for 2 weeks, you should still keep taking the medication and contact your prescriber. They might need to make adjustments to the dosage of your medication.
- You're recommended to check your blood pressure at home, record them, and bring your log to your medical appointments. This helps your healthcare team better understand how well Exforge (amlodipine / valsartan) is working for you. They can recommend any dose changes, if needed.
- Take Exforge (amlodipine / valsartan) exactly as prescribed. Don't change your dose or stop taking the medication suddenly without talking to your prescriber first. Doing so can cause your blood pressure to rise quickly.
- It's best to avoid or limit how much alcohol you drink because it can cause a drop in your blood pressure. This can lead to dizziness and falls.
- You might feel dizzy when you start taking Exforge (amlodipine / valsartan) and when your prescriber raises your dose. This side effect should lessen over time as you continue taking the medication and your body gets used to your new blood pressure.
- If you can, stand up slowly or hold onto something when you stand from a sitting or lying down position. This helps avoid a sudden drop in your blood pressure that can lead to dizziness and falling. If you feel dizzy, lightheaded, tired, or confused while taking Exforge (amlodipine / valsartan), your blood pressure might be too low. Call your prescriber if this happens because your dose might need to be changed.
- Both amlodipine and valsartan can interact with many other medications, such as non-steroidal anti-inflammatory drugs (NSAIDs) (e.g., ibuprofen (Advil, Motrin)), lithium (Lithobid), and other medications that can raise potassium. Make sure to tell your care team about all the medications you're taking before and during treatment with Exforge (amlodipine / valsartan).
- Make sure to incorporate a healthy diet, including a low-salt diet, while taking Exforge (amlodipine / valsartan) to help lower your blood pressure. Depending on your risk factors and other medical problems, it's possible you might be able to stop taking Exforge (amlodipine / valsartan) if your blood pressure gets within goal. Ask your care team to help you plan healthy meals, such as ones that include low-fat milk or yogurt, whole-grains, and vegetables.
- Valsartan can cause severe harm to an unborn baby. Additionally, there aren't enough studies to know for sure how safe amlodipine and valsartan are while breastfeeding. Let your care team know if you're pregnant, thinking of becoming pregnant, or breastfeeding because they might switch you to a safer medication.
Common questions about Amlodipine/Valsartan
Exforge contains both amlodipine and valsartan, which are first-choice options for treating blood pressure. Your healthcare team might consider prescribing Exforge for you if you've been taking steady doses of these two medications separately and want to take a combination pill for convenience. But because Exforge contains set dosages of amlodipine and valsartan, it's harder to make adjustments to the strength of one particular medication.
The most common side effect of Exforge is swelling in the feet, ankles, legs, hands, or arms, which is due to amlodipine. If you experience swelling, talk to your prescriber. They might recommend tips to ease the swelling, such as asking you to sit or lie down with your legs raised or to wear compression socks. Another common side effect of Exforge is dizziness. This is especially noticeable when you first start taking the medication and your dose is raised. But the dizziness should get better over time as your body gets used to your new blood pressure. Ask your prescriber or pharmacist if you have other questions regarding the side effects of amlodipine or valsartan.
No, neither amlodipine nor valsartan in Exforge are known to cause erectile dysfunction (ED). Certain blood pressure medications, like beta blockers, can raise the risk for ED. But this isn't the case with amlodipine or valsartan. Your healthcare team might consider amlodipine or valsartan as options for you if you have ED or are concerned about ED from blood pressure medications. And if your blood pressure has been well-controlled on stable doses of amlodipine and valsartan, your care team might recommend Exforge for the convenience of taking a single pill.
No, weight gain wasn't a typical side effect reported from people taking Exforge. But, keep in mind that amlodipine can cause swelling in your body, which can cause weight gain from fluid. Let your primary care provider or cardiologist know if you experience unusual or unexpected weight gain while taking Exforge. They can try to help you figure out what's causing this weight gain.
No, Exforge doesn't contain a beta blocker. Instead, it's a combination of two medications, amlodipine (a calcium channel blocker) and valsartan (an angiotensin II receptor blocker (ARB)). While beta blockers, calcium channel blockers, and ARBs all work to lower blood pressure, they do so in different ways. Ask your healthcare team if you've more questions on the different types of blood pressure medications.
Don't cut Exforge tablets in half unless your healthcare team says it's safe to do so. Exforge is a combination medication and the tablets don't have a score line (line in the middle of the tablet to cut). It's generally not recommended to cut a combination medication, like Exforge, because the two halves of the cut pill might not contain the same amount of amlodipine and valsartan. Also, it's difficult to cut a non-scored tablet evenly (even if you're using a pill splitter), which can cause you to take the wrong dose.
Yes, Exforge is available as a lower-cost generic.
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Risks and warnings for Exforge (amlodipine / valsartan)
Exforge (amlodipine / valsartan) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Harm to unborn baby
Don't take Exforge (amlodipine / valsartan) if you're pregnant because valsartan can cause severe harm your unborn baby. This medication can affect how well the unborn baby's kidneys develop and work, which can be life-threatening.
Stop taking Exforge (amlodipine / valsartan) and let a member of your healthcare team know right away if you find out that you're pregnant during treatment. Discuss with your primary care provider or cardiologist about taking a different medication that's safer to treat your blood pressure if you're pregnant or thinking of becoming pregnant.
Low blood pressure
- Risk factors: Not enough fluid in your body | Having diarrhea or vomiting for a long time | Low salt levels in your body | Taking high doses of diuretic medications | History of narrow heart valves (aortic stenosis)
Exforge (amlodipine / valsartan) can cause your blood pressure to drop too much, which can make you feel dizzy, tired, or lightheaded. This side effect is more common when you first start Exforge (amlodipine / valsartan) or when the dose is raised. You're also at risk if you're dehydrated or if you have medical conditions that cause you to become dehydrated, such as too much diarrhea or vomiting. Make sure to stay well hydrated to avoid having blood pressure that's too low. If your blood pressure drops too much and you feel dizzy, sit down slowly while holding onto something and let your prescriber know. If you fall and hit your head, get medical help right away.
Risk of heart attack or chest pain
- Risk factors: Severe coronary artery disease
It's possible for some people to experience worsening chest pain or develop a heart attack while taking amlodipine. The risk is higher when you first start this medication or when your dose is raised. Your risk is also higher if you have a heart problem called coronary artery disease (CAD). Get medical help right away if you experience chest pain, pressure in the chest, heartburn, dizziness, or trouble breathing.
Possible kidney damage in certain people
- Risk factors: Heart failure | Certain kidney problems | Taking other medications that can cause kidney damage
Although ARBs like valsartan can protect the kidneys, it's also possible for the medication to affect your kidneys in a way that causes them to not work as well. This can happen to anyone. But the effects can be more serious in people with severe heart failure, people with certain kidney problems, or people who take medications that can worsen kidney function.
Your primary care provider or cardiologist might order lab tests every so often during treatment to make sure your kidneys are healthy and working properly. Your care team might recommend that you stop taking the medication if you develop kidney problems (or if your kidney problems worsen) while you're taking Exforge (amlodipine / valsartan). Let your primary care provider or cardiologist know if you're urinating less often than usual, as this could be a sign that your kidneys aren't working as well.
High potassium levels
- Risk factors: Taking other medications that can raise potassium levels | Heart failure | Kidney problems
Valsartan can cause high potassium levels. Your risk is higher if you take Exforge (amlodipine / valsartan) with other medications that can raise potassium, such as spironolactone (Aldactone) or eplerenone (Inspra). Tell your healthcare team right away if you experience signs of high potassium levels, such as nausea, muscle weakness, or abnormal heartbeat. You'll probably need your potassium levels checked. If left untreated, high potassium levels can be dangerous.
Exforge (amlodipine / valsartan) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 5mg/160mg | 90 tablets | $51.74 | $0.57 |
| 10mg/160mg | 30 tablets | $24.70 | $0.82 |
| 10mg/320mg | 30 tablets | $23.85 | $0.80 |
| 5mg/320mg | 90 tablets | $58.82 | $0.65 |
Typical dosage for Exforge (amlodipine / valsartan)
- Adults: The typical starting dose is 5 mg/160 mg (amlodipine/valsartan) taken by mouth once daily. Your prescriber will adjust your dose based on how well it's helping your blood pressure and if you're having side effects. The maximum dose is 10 mg/320 mg (amlodipine/valsartan) by mouth once daily.
How much does Exforge (amlodipine / valsartan) cost?
Exforge (amlodipine / valsartan) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Exforge (amlodipine / valsartan) will not be safe for you to take.
- Taking at the same time as aliskiren (Tekturna) in people with diabetes
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