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Exforge Drug Information
Exforge is the brand name of a combination medication used to treat high blood pressure (hypertension), approved by the U.S. Food & Drug Administration (FDA) in June 2007. It contains the generic ingredients amlodipine and valsartan in four different ratios: 5/160 mg, 10/160 mg, 5/320 mg, and 10/320 mg. The ingredients work in different ways to lower blood pressure and are thus complementary.
Amlodipine (Norvasc) is a calcium channel blocker that works by affecting how the body uses ionic calcium. This causes muscles in arteries to relax, resulting in vasodilation ("opened" blood vessels) that lowers blood pressure.
Valsartan (Diovan) is an angiotensin II blocker, in the same class as olmesartan (Benicar). It works by blocking the action of the blood-pressure raising hormone angiotensin II.
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Is There An Advantage to Exforge?
Most patients suffering from hypertension need more than one drug to control their blood pressure. The drugs should be in complementary classes. Except in the mildest cases of hypertension, it is recommended that therapy start with two different drugs from the very beginning (Dzjak et al. 2009).
Exforge is known as a fixed dose combination drug because two complementary medications are found at preset doses in a single tablet. Fixed drug combinations have the advantages of simplifying the treatment for the patient and improving compliance (Dzjak et al. 2009). As anyone who has had to take multiple medications can tell you, the fewer pills that are needed, the easier it is to make sure you take all your medication correctly every day.
Depending on drug prices and one's insurance plan, a fixed drug combination like Exforge may cost less than two different name-brand prescriptions. Contact your prescription benefits plan or (if self-paying) pharmacy for more information.
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Exforge Side Effects
Most side effects of Exforge are mild and transient. Few patients (1.8% in trials) have such severe side effects that they have to stop taking the drug.
Side effects attributed to the amlodipine in Exforge are most likely to include headache, dizziness, anxiety, nausea, swelling, heart palpitations, and flushing.
Side effects attributed to valsartan are not very common, but can include dizziness, sleeplessness, headache, fatigue, gastrointestinal problems, upper respiratory symptoms, joint pain, and swelling.
A very small number of patients taking Exforge will experience too great a drop in blood pressure, a potentially dangerous condition known as hypotension. In clinical studies, this was seen in 0.4% of patients. The risk is greatest for people with heart failure or history of heart attack and in patients undergoing dialysis or who have upcoming surgery.
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Exforge and Pregnancy
Exforge is in Pregnancy Category C for the first trimester and Category D for the second and third trimesters. Valsartan is very dangerous to unborn babies in the second and third trimesters and can cause skull deformity, low blood pressure, kidney failure, and death. Except in very rare circumstances, Exforge should be avoided during pregnancy, especially after the first 12 weeks. If your doctor thinks you should take Exforge during pregnancy, make sure you have a thorough understanding of the benefits compared to the risks to the fetus.
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- Exforge drug label (PDF) from the FDA.
- G. V. Dzjak, L. I. Vasiljeva, K. L. Yuryev. "Exforge (amlodipine + valsartan): the benefits of fixed-dose combination therapy of calcium antagonist and angiotensin receptor blocker in the treatment of patients with arterial hypertension." Practitioners (Ukrainian Medical Journal) 2009; 70:III-IV. Article in Russian, translated by Google Translate.
- The Pill Book, 12th Edition, 2006. Harold M. Silverman, Pharm. D., Editor-in-Chief. New York: Bantam Books.