AMLODIPINE-VALSARTAN-HCTZ (AMLODIPINE BESYLATE/VALSARTAN/HYDROCHLOROTHIAZIDE)

Moderate

• acarbose

• Advil

• Advil Allergy Sinus

• Advil Allergy-congestion Rlf

• Advil Cold & Sinus

• Advil Congestion Relief

• Advil Liqui-gel

• Advil Migraine

• Advil Pm

• Advil Pm Liqui-gels

• Aldactazide

• Aldactone

• Aleve

• Aleve Cold & Sinus

• Aleve Sinus & Headache

• Aleve-d Sinus & Cold

• Aleve-d Sinus & Headache

• Alka-seltzer Gold

• All Day Pain Relief

• All Day Pain Relief Sinus & Co

• All Day Relief

• Amaryl

• amiloride

• amiloride-hydrochlorothiazide

• Anaprox

• Anaprox Ds

• Angeliq

• Ansaid

• Apidra

• Apidra Solostar

• Arthrotec 50

• Astagraf Xl

• Bactrim

• Bactrim Ds

• Beyaz

• boceprevir

• bumetanide

• Caldolor

• Cambia

• Cataflam

• Celebrex

• celecoxib

• Ceralyte-70

• Ceraors 75

• Cerasport

• Cerasport Ex1

• Child Ibuprofen

• Children's Advil

• Children's Ibu-drops

• Children's Ibuprofen

• Children's Medi-profen

• Children's Motrin

• Children's Profen Ib

• chlorphen-phenyleph-ibuprofen

• chlorphen-pseudoeph-ibuprofen

• cholestyramine (with sugar)

• Cholestyramine Light

• cholestyramine-aspartame

• Cold & Sinus Pain Relief

• Cold-sinus Relief

• Colestid

• Colestid Flavored

• colestipol

• cyclosporine

• cyclosporine modified

• Cytra K Crystals

• Cytra-3

• Cytra-k

• Daypro

• Demadex

• Diabeta

• diazoxide

• diclofenac epolamine

• diclofenac potassium

• diclofenac sodium

• diclofenac submicronized

• diclofenac-misoprostol

• Digox

• digoxin

• DM-GG-potassium citrate

• drospirenone-e.estradiol-lm.FA

• drospirenone-estradiol

• drospirenone-ethinyl estradiol

• Duetact

• Duexis

• Dyazide

• Dyrenium

• Ec-naprosyn

• Effer-k

• eplerenone

• ethacrynate sodium

• etodolac

• Feldene

• fenoprofen

• Flanax

• Flector

• flurbiprofen

• furosemide

• Gengraf

• Gianvi (28)

• glimepiride

• glipizide

• glipizide-metformin

• Glucotrol

• Glucotrol Xl

• Glucovance

• glyburide

• glyburide micronized

• glyburide-metformin

• Glynase

• Glyset

• Hecoria

• Humalog

• Humalog Kwikpen

• Humalog Mix 50-50

• Humalog Mix 50-50 Kwikpen

• Humalog Mix 75-25

• Humalog Mix 75-25 Kwikpen

• Humulin 70/30

• Humulin N

• Humulin N Kwikpen

• Humulin R

• Humulin R U-500 "Concentrated"

• hydrocodone-ibuprofen

• Hyperlyte Cr

• I-prin

• Ibu-drops

• Ibudone

• ibuprofen

• Ibuprofen Cold

• Ibuprofen Cold-sinus(with Pse)

• Ibuprofen Ib

• Ibuprofen Jr Strength

• ibuprofen lysine (PF)

• Ibuprofen Pm

• ibuprofen-diphenhydramine

• ibuprofen-diphenhydramine HCl

• ibuprofen-famotidine

• ibuprofen-oxycodone

• ibuprofen-phenylephrine HCl

• Incivek

• Indocin

• indomethacin

• indomethacin sodium

• Infant's Ibuprofen

• Infant's Medi-profen

• Infant's Motrin

• Infants Ibu-drops

• Infants Profenib

• Inspra

• insulin asp prt-insulin aspart

• insulin aspart

• insulin detemir

• insulin glargine

• insulin glulisine

• insulin lispro

• insulin lispro protam-lispro

• insulin NPH and regular human

• insulin regular hum U-500 conc

• insulin regular human

• isoniazid-rifamp-pyrazinamide

• Juxtapid

• K-effervescent

• K-phos No 2

• K-phos Original

• K-phos-neutral

• K-tab

• Kaochlor

• ketoconazole

• ketoprofen

• ketorolac

• Klor-con

• Klor-con 10

• Klor-con M10

• Klor-con M15

• Klor-con M20

• Klor-con/ef

• Lanoxin

• Lanoxin Pediatric

• Lantus

• Lantus Solostar

• Lasix

• Levemir

• Levemir Flexpen

• lomitapide

• Loryna (28)

• Maxzide

• Maxzide-25Mg

• Medi-lyte

• Medi-profen

• Mediproxen

• mefenamic acid

• meloxicam

• Midol (naproxen)

• miglitol

• Mobic

• Motrin Ib

• Motrin Pm

• Mycobutin

• nabumetone

• Nalfon

• Nano Vm T/f

• Naprelan Cr

• Naprosyn

• naproxen

• naproxen sodium

• naproxen-esomeprazole

• naproxen-pseudoephedrine

• nateglinide

• Neoprofen (ibuprofen Lysn)(pf)

• Neoral

• niacin-simvastatin

• Novolin 70/30

• Novolin N

• Novolin R

• Novolog

• Novolog Flexpen

• Novolog Mix 70-30

• Novolog Mix 70-30 Flexpen

• Novolog Penfill

• NPH insulin human recomb

• Nutrilyte Ii

• Ocella

• oxaprozin

• Pedialyte

• Pediatric Electrolyte

• pediatric multivit #18-iron-FA

• PEG 3350-bowel 2,two part prep

• Pennsaid

• Phos-nak

• Phospha 250 Neutral

• pioglitazone-glimepiride

• piroxicam

• Ponstel

• pot & sod citrate-citric acid

• potassium

• potassium & sodium phosphates

• potassium bicarb & chloride

• potassium bicarb-citric acid

• potassium chlorid-D5-0.45%NaCl

• potassium chloride

• potassium chloride in 0.9%NaCl

• potassium chloride in D5W

• potassium chloride in LR-D5

• potassium chloride-0.45 % NaCl

• potassium chloride-D5-0.2%NaCl

• potassium chloride-D5-0.3%NaCl

• potassium chloride-D5-0.9%NaCl

• potassium citrate

• potassium citrate-citric acid

• potassium Cl-calcium phos-mag

• potassium gluconate

• potassium phosphate dibasic

• potassium phosphate, monobasic

• potassium&sodium monobas phos

• Precose

• Prevalite

• Priftin

• Primsol

• Proglycem

• Prograf

• Provil

• pseudoephedrine-ibuprofen

• Questran

• Questran Light

• Reprexain

• rifabutin

• Rifadin

• Rifamate

• rifampin

• rifampin-isoniazid

• rifapentine

• Rifater

• Safyral

• Sandimmune

• Simcor

• simvastatin

• Sinus & Cold-d

• sod & pot chlorid-sod cit-rice

• sod phos,di & mono-K phos mono

• sodium & potassium bicarbonate

• sodium Cl-potassium chloride

• Sodium Edecrin

• sodium-K+-mag-Ca-chlor-acetate

• sodium-potas-chloride-dextrose

• Solaraze

• Sorbutuss

• spironolacton-hydrochlorothiaz

• spironolactone

• Sprix

• Starlix

• Suclear

• sulfamethoxazole-trimethoprim

• Sulfatrim

• sulindac

• Syeda

• tacrolimus

• Taron-crystals

• telaprevir

• Theralith Xr

• Thermotabs

• tolazamide

• tolbutamide

• tolmetin

• torsemide

• Tpn Electrolytes

• Tpn Electrolytes Ii

• triamterene

• triamterene-hydrochlorothiazid

• Tricitrates

• trimethoprim

• Urocit-k 10

• Urocit-k 15

• Urocit-k 5

• Vestura (28)

• Vicoprofen

• Victrelis

• Vimovo

• vit B6-mag cit & ox-potass cit

• Voltaren-xr

• Vytorin 10-10

• Vytorin 10-20

• Wal-profen

• Wal-profen Cold-sinus

• Wal-proxen

• Yasmin (28)

• Yaz 28

• Zarah

• Zipsor

• Zocor

• Zorvolex

Moderate

• Basal cell carcinoma of skin

• Diabetes mellitus

• Disease of liver

• Hypercalcemia

• Hypercholesterolemia

• Hyperparathyroidism

• Neutropenic disorder

• Squamous cell carcinoma of skin

• Sympathectomy

• Systemic lupus erythematosus

Amlodipine

• Severity Level:

  2

• Additional Notes: Uncontrolled htn can result in increased maternal/fetal morbidity and mortality

Hydrochlorothiazide

• Severity Level:

  B

• Additional Notes: Not recommended in pre-eclampsia and other pregnancy-induced hypertension.

Valsartan

• Severity Level:

  1

• Additional Notes: Fetal death/morbidity w/use in 2nd & 3rd trimester, stop when pregnancy detected

Contraindicated

None

General	Excretion Potential	Effect on Infant	Notes
			None

Precaution Exists

Amlodipine

Insufficient data avail; consider maternal treatment benefit vs infant risk

Limited amounts excreted with no known adverse effects in infant.

Insufficient human data; manufacturer does not rec

General	Excretion Potential	Effect on Infant	Notes
Evaluate use carefully	Excreted	Not known; no or inclusive data	Insufficient data avail; consider maternal treatment benefit vs infant risk

Hydrochlorothiazide

Insufficient data avail; consider maternal treatment benefit vs infant risk

Limited amounts excreted with no known adverse effects in infant.

Insufficient human data; manufacturer does not rec

General	Excretion Potential	Effect on Infant	Notes
Evaluate use carefully	Excreted	Not known; no or inclusive data	Limited amounts excreted with no known adverse effects in infant.

Valsartan

Insufficient data avail; consider maternal treatment benefit vs infant risk

Limited amounts excreted with no known adverse effects in infant.

Insufficient human data; manufacturer does not rec

General	Excretion Potential	Effect on Infant	Notes
Evaluate use carefully	Unknown	Not known; no or inclusive data	Insufficient human data; manufacturer does not rec

No Known Risk

None

General	Excretion Potential	Effect on Infant	Notes
			None

Contraindicated

None

Precaution Exists

Amlodipine

General-Not recommended as first line therapy in the elderly. Cardiovascular-Start at 2.5 mg/day and slowly titrate upward. Peripheral edema may be common. Lower drug clearance may result in increased sensitivity to blood pressure lowering effects. Gastrointestinal-May cause or worsen pre-existing constipation.

Cardiovascular-Increased sensitivity to effects on blood pressure. Metabolic-More likely to develop hypokalemia, hypomagnesemia, or hyponatremia. Endocrine-May exacerbate SIADH. May worsen glucose control in patients with diabetes. Renal-Not effective with CrCL < 30mL/min.

Organ / System	HEP	REN	CARD	ENDO	NEURO / PSYCH	PULM
Increased Risk / Adverse Effects	N	Y	Y	N	N	N

BEERS: N     HEDIS: N     STOPP: Y

Hydrochlorothiazide

General-Not recommended as first line therapy in the elderly. Cardiovascular-Start at 2.5 mg/day and slowly titrate upward. Peripheral edema may be common. Lower drug clearance may result in increased sensitivity to blood pressure lowering effects. Gastrointestinal-May cause or worsen pre-existing constipation.

Cardiovascular-Increased sensitivity to effects on blood pressure. Metabolic-More likely to develop hypokalemia, hypomagnesemia, or hyponatremia. Endocrine-May exacerbate SIADH. May worsen glucose control in patients with diabetes. Renal-Not effective with CrCL < 30mL/min.

Organ / System	HEP	REN	CARD	ENDO	NEURO / PSYCH	PULM
Increased Risk / Adverse Effects	Y	N	Y	N	N	Y

BEERS: Y     HEDIS: N     STOPP: Y

No Known Risk

None

0-9	A-Z
I10	Essential (primary) hypertension
I11	Hypertensive heart disease
I11.0	Hypertensive heart disease with heart failure
I11.9	Hypertensive heart disease without heart failure
I12	Hypertensive chronic kidney disease
I12.0	Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease
I12.9	Hypertensive chronic kidney disease with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
I13	Hypertensive heart and chronic kidney disease
I13.0	Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
I13.1	Hypertensive heart and chronic kidney disease without heart failure
I13.10	Hypertensive heart and chronic kidney disease without heart failure, with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
I13.11	Hypertensive heart and chronic kidney disease without heart failure, with stage 5 chronic kidney disease, or end stage renal disease
I13.2	Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease
I15.1	Hypertension secondary to other renal disorders