Valsartan and hydrochlorothiazide: Drug information

(For additional information see "Valsartan and hydrochlorothiazide: Patient drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)

ALERT: US Boxed Warning

Fetal toxicity:

When pregnancy is detected, discontinue therapy as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus.

Brand Names: US

Diovan HCT

Brand Names: Canada

Diovan HCT;
Valsartan-HCT;
Valsartan-HCTZ

Pharmacologic Category

Angiotensin II Receptor Blocker;
Antihypertensive;
Diuretic, Thiazide

Dosing: Adult

Hypertension

Hypertension:

Oral: Initial: Valsartan 160 mg/hydrochlorothiazide 12.5 mg once daily; titrate as needed based on patient response after ~2 to 4 weeks of therapy; maximum dose: valsartan 320 mg/hydrochlorothiazide 25 mg per day.

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

CrCl ≥30 mL/minute: No dosage adjustment necessary.

CrCl <30 mL/minute: There are no dosage adjustments provided in the manufacturer’s labeling (has not been studied). Use is contraindicated in patients with anuria.

Dosing: Hepatic Impairment: Adult

Mild to moderate impairment: No dosage adjustment necessary; use with caution. Patients with mild to moderate chronic disease have twice the exposure of valsartan as healthy volunteers.

Severe impairment: There are no dosage adjustments provided in the manufacturer’s labeling (has not been studied).

Dosing: Older Adult

Refer to adult dosing.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Also see individual agents.

1% to 10%:

Cardiovascular: Hypotension (1%)

Central nervous system: Dizziness (6%)

Endocrine & metabolic: Hypokalemia (3%)

Respiratory: Nasopharyngitis (2%)

<1%: Hyperkalemia, severe hypotension

Frequency not defined: Central nervous system: Headache

Postmarketing: Alopecia, angioedema, bullous dermatitis, hepatitis, increased serum transaminases, renal insufficiency, rhabdomyolysis, syncope, vasculitis

Contraindications

Hypersensitivity to valsartan, hydrochlorothiazide, sulfonamide-derived drugs, or any component of the formulation; concomitant use with aliskiren in patients with diabetes mellitus; anuria

Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Note: Although the FDA-approved product labeling states this medication is contraindicated in patients with hypersensitivity to sulfonamide-containing drugs, the scientific basis of this cross-sensitivity has been challenged. See “Warnings/Precautions” for more detail.

Canadian labeling: Additional contraindications (not in US labeling): Severe progressive renal disease and if increasing azotemia and oliguria occur during treatment; pregnancy; breastfeeding; concomitant use with aliskiren in patients with moderate to severe renal impairment (GFR <60 mL/minute/1.73 m²); hyponatremia; hypercalcemia; symptomatic hyperuricemia; conditions involving enhanced potassium loss

Warnings/Precautions

Concerns related to adverse effects:

• Angioedema: Angiotensin II receptor antagonists (ARBs) do not appear to elevate the risk of angioedema (Rasmussen 2019; Toh 2012). Patients with a history of angioedema due to an angiotensin-converting enzyme inhibitor must be educated that sometimes there can be recurrence within months following discontinuation (Beltrami 2011). No matter the cause of angioedema, prolonged frequent monitoring is required, especially if tongue, glottis, or larynx is involved, as they are associated with airway obstruction. Discontinue therapy immediately if angioedema occurs. Aggressive, early management is critical. IM administration of epinephrine may be necessary. Do not readminister the ARB to patients who experience angioedema from this medication.

• Electrolyte disturbances: Hyperkalemia may occur with ARBs; risk factors include renal dysfunction, diabetes mellitus, and concomitant use of potassium-sparing diuretics, potassium supplements, and/or potassium-containing salts. Use cautiously, if at all, with these agents and monitor potassium closely. Thiazide diuretics may cause hypokalemia, hypochloremic alkalosis, hypomagnesemia, and hyponatremia.

• Gout: In certain patients with a history of gout, a familial predisposition to gout, or chronic renal failure, gout can be precipitated by hydrochlorothiazide. This risk may be increased with doses ≥25 mg (Gurwitz 1997).

• Hypersensitivity reactions: Hypersensitivity reactions may occur with hydrochlorothiazide. Risk is increased in patients with a history of allergy or bronchial asthma.

• Hypotension: Symptomatic hypotension may occur upon initiation in patients who are salt- or volume-depleted (eg, those treated with high-dose diuretics); correct volume depletion prior to administration. This transient hypotensive response is not a contraindication to further treatment with valsartan/hydrochlorothiazide.

• Ocular effects: Hydrochlorothiazide may cause acute transient myopia and acute angle-closure glaucoma, typically occurring within hours to weeks following initiation; discontinue therapy immediately in patients with acute decreases in visual acuity or ocular pain. Additional treatments may be needed if uncontrolled intraocular pressure persists. Risk factors may include a history of sulfonamide or penicillin allergy.

• Photosensitivity: Photosensitization may occur.

• Renal function deterioration: May be associated with deterioration of renal function and/or increases in serum creatinine, particularly in patients with low renal blood flow (eg, renal artery stenosis, heart failure) whose glomerular filtration rate (GFR) is dependent on efferent arteriolar vasoconstriction by angiotensin II; deterioration may result in oliguria, acute renal failure, and progressive azotemia. Small increases in serum creatinine may occur following initiation; consider discontinuation only in patients with progressive and/or significant deterioration in renal function.

• Skin cancer, nonmelanoma: Prolonged use (≥3 years) may increase the risk for squamous cell carcinoma up to 4 times and increase the risk for basal cell carcinoma up to 1.25 times compared to patients not treated with hydrochlorothiazide (Pedersen 2018; Pottegård 2017).

• Sulfonamide (“sulfa”) allergy: The FDA-approved product labeling for many medications containing a sulfonamide chemical group includes a broad contraindication in patients with a prior allergic reaction to sulfonamides. There is a potential for cross-reactivity between members of a specific class (eg, two antibiotic sulfonamides). However, concerns for cross-reactivity have previously extended to all compounds containing the sulfonamide structure (SO₂NH₂). An expanded understanding of allergic mechanisms indicates cross-reactivity between antibiotic sulfonamides and nonantibiotic sulfonamides may not occur or at the very least this potential is extremely low (Brackett 2004; Johnson 2005; Slatore 2004; Tornero 2004). In particular, mechanisms of cross-reaction due to antibody production (anaphylaxis) are unlikely to occur with nonantibiotic sulfonamides. T-cell-mediated (type IV) reactions (eg, maculopapular rash) are less well understood and it is not possible to completely exclude this potential based on current insights. In cases where prior reactions were severe (Stevens-Johnson syndrome/TEN), some clinicians choose to avoid exposure to these classes.

Disease-related concerns:

• Aortic/mitral stenosis: Use with caution in patients with significant aortic/mitral stenosis.

• Bariatric surgery: Dehydration: Avoid diuretics in the immediate postoperative period after bariatric surgery; electrolyte disturbances and dehydration may occur. Diuretics may be resumed, if indicated, once oral fluid intake goals are met (Ziegler 2009).

• Diabetes: Use hydrochlorothiazide with caution in patients with prediabetes or diabetes mellitus; may see a change in glucose control.

• Hepatic impairment: Use caution in patients with biliary obstructive disorders or severe hepatic impairment. In progressive or severe liver disease, avoid electrolyte and acid/base imbalances that might lead to hepatic encephalopathy/coma.

• Hypercalcemia: Thiazide diuretics may decrease renal calcium excretion; consider avoiding use in patients with hypercalcemia.

• Hypercholesterolemia: Use with caution in patients with moderate or high cholesterol concentrations; increased cholesterol and triglyceride levels have been reported with thiazides.

• Parathyroid disease: Thiazide diuretics reduce calcium excretion; pathologic changes in the parathyroid glands with hypercalcemia and hypophosphatemia have been observed with prolonged use; should be discontinued prior to testing for parathyroid function.

• Renal artery stenosis: Use valsartan with caution in patients with unstented unilateral/bilateral renal artery stenosis. When unstented bilateral renal artery stenosis is present, use is generally avoided due to the elevated risk of deterioration in renal function unless possible benefits outweigh risks.

• Renal impairment: Use valsartan with caution with pre-existing renal insufficiency, and severe renal impairment. Avoid hydrochlorothiazide in severe renal disease (ineffective); may precipitate azotemia; discontinue or consider withholding if renal impairment occurs. Contraindicated in patients with anuria.

• Systemic lupus erythematosus (SLE): Hydrochlorothiazide can cause SLE exacerbation or activation.

Special populations:

• Pregnancy: [US Boxed Warning]: Drugs that act on the renin-angiotensin system can cause injury and death to the developing fetus. Discontinue as soon as possible once pregnancy is detected.

• Surgical patients: In patients on chronic angiotensin receptor blocker (ARB) therapy, intraoperative hypotension may occur with induction and maintenance of general anesthesia; however, discontinuation of therapy prior to surgery is controversial. If continued preoperatively, avoidance of hypotensive agents during surgery is prudent (Hillis 2011).

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Tablet, oral: 80 mg/12.5 mg: Valsartan 80 mg and hydrochlorothiazide 12.5 mg; 160 mg/12.5 mg: Valsartan 160 mg and hydrochlorothiazide 12.5 mg; 160 mg/25 mg: Valsartan 160 mg and hydrochlorothiazide 25 mg; 320 mg/12.5 mg: Valsartan 320 mg and hydrochlorothiazide 12.5 mg; 320 mg/25 mg: Valsartan 320 mg and hydrochlorothiazide 25 mg

Diovan HCT 80 mg/12.5 mg: Valsartan 80 mg and hydrochlorothiazide 12.5 mg

Diovan HCT 160 mg/12.5 mg: Valsartan 160 mg and hydrochlorothiazide 12.5 mg

Diovan HCT 160 mg/25 mg: Valsartan 160 mg and hydrochlorothiazide 25 mg

Diovan HCT 320 mg/12.5 mg: Valsartan 320 mg and hydrochlorothiazide 12.5 mg

Diovan HCT 320 mg/25 mg: Valsartan 320 mg and hydrochlorothiazide 25 mg

Generic Equivalent Available: US

Yes

Pricing: US

Tablets (Diovan HCT Oral)

80-12.5 mg (per each): $12.48

160-12.5 mg (per each): $13.57

160-25 mg (per each): $15.39

320-12.5 mg (per each): $17.20

320-25 mg (per each): $19.51

Tablets (Valsartan-hydroCHLOROthiazide Oral)

80-12.5 mg (per each): $3.69 - $3.93

160-12.5 mg (per each): $4.00 - $4.28

160-25 mg (per each): $4.49 - $4.85

320-12.5 mg (per each): $4.99 - $5.42

320-25 mg (per each): $5.64 - $6.15

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Administration: Adult

Oral: Administer with or without food.

Use: Labeled Indications

Hypertension: Management of hypertension.

Medication Safety Issues

Sound-alike/look-alike issues:

Diovan may be confused with Zyban

Older Adult: High-risk medication:

Beers Criteria: Diuretics (hydrochlorothiazide) are identified in the Beers Criteria as potentially inappropriate medications to be used with caution in patients 65 years and older due to the potential to cause or exacerbate syndrome of inappropriate antidiuretic hormone secretion (SIADH) or hyponatremia; monitor sodium concentration closely when initiating or adjusting the dose in older adults (Beers Criteria [AGS 2023]).

Metabolism/Transport Effects

Refer to individual components.

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

Ajmaline: Sulfonamides may enhance the adverse/toxic effect of Ajmaline. Specifically, the risk for cholestasis may be increased. Risk C: Monitor therapy

Alcohol (Ethyl): May enhance the orthostatic hypotensive effect of Thiazide and Thiazide-Like Diuretics. Risk C: Monitor therapy

Alfuzosin: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Aliskiren: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Aliskiren may enhance the hypotensive effect of Angiotensin II Receptor Blockers. Aliskiren may enhance the nephrotoxic effect of Angiotensin II Receptor Blockers. Management: Aliskiren use with ACEIs or ARBs in patients with diabetes is contraindicated. Combined use in other patients should be avoided, particularly when CrCl is less than 60 mL/min. If combined, monitor potassium, creatinine, and blood pressure closely. Risk D: Consider therapy modification

Allopurinol: Thiazide and Thiazide-Like Diuretics may enhance the potential for allergic or hypersensitivity reactions to Allopurinol. Risk C: Monitor therapy

Amifostine: Blood Pressure Lowering Agents may enhance the hypotensive effect of Amifostine. Management: When used at chemotherapy doses, hold blood pressure lowering medications for 24 hours before amifostine administration. If blood pressure lowering therapy cannot be held, do not administer amifostine. Use caution with radiotherapy doses of amifostine. Risk D: Consider therapy modification

Aminolevulinic Acid (Systemic): Photosensitizing Agents may enhance the photosensitizing effect of Aminolevulinic Acid (Systemic). Risk X: Avoid combination

Aminolevulinic Acid (Topical): Photosensitizing Agents may enhance the photosensitizing effect of Aminolevulinic Acid (Topical). Risk C: Monitor therapy

Amphetamines: May diminish the antihypertensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Angiotensin II: Receptor Blockers may diminish the therapeutic effect of Angiotensin II. Risk C: Monitor therapy

Angiotensin-Converting Enzyme Inhibitors: Angiotensin II Receptor Blockers may enhance the adverse/toxic effect of Angiotensin-Converting Enzyme Inhibitors. Angiotensin II Receptor Blockers may increase the serum concentration of Angiotensin-Converting Enzyme Inhibitors. Management: Use of telmisartan and ramipril is not recommended. It is not clear if any other combination of an ACE inhibitor and an ARB would be any safer. Consider alternatives when possible. Monitor blood pressure, renal function, and potassium if combined. Risk D: Consider therapy modification

Anticholinergic Agents: May increase the serum concentration of Thiazide and Thiazide-Like Diuretics. Risk C: Monitor therapy

Antidiabetic Agents: Thiazide and Thiazide-Like Diuretics may diminish the therapeutic effect of Antidiabetic Agents. Risk C: Monitor therapy

Antidiabetic Agents: Hyperglycemia-Associated Agents may diminish the therapeutic effect of Antidiabetic Agents. Risk C: Monitor therapy

Antihepaciviral Combination Products: May increase the serum concentration of Valsartan. Management: Consider decreasing the valsartan dose and monitoring for evidence of hypotension and worsening renal function if these agents are used in combination. Risk D: Consider therapy modification

Antipsychotic Agents (Second Generation [Atypical]): Blood Pressure Lowering Agents may enhance the hypotensive effect of Antipsychotic Agents (Second Generation [Atypical]). Risk C: Monitor therapy

Arginine: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Arsenic Trioxide: Thiazide and Thiazide-Like Diuretics may enhance the hypotensive effect of Arsenic Trioxide. Thiazide and Thiazide-Like Diuretics may enhance the QTc-prolonging effect of Arsenic Trioxide. Management: When possible, avoid concurrent use of arsenic trioxide with drugs that can cause electrolyte abnormalities, such as the thiazide and thiazide-like diuretics. Risk D: Consider therapy modification

Asciminib: May increase the serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates (Clinically Relevant with Inhibitors). Risk C: Monitor therapy

Barbiturates: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Benperidol: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Beta2-Agonists: May enhance the hypokalemic effect of Thiazide and Thiazide-Like Diuretics. Risk C: Monitor therapy

Bile Acid Sequestrants: May decrease the absorption of Thiazide and Thiazide-Like Diuretics. The diuretic response is likewise decreased. Management: Consider separating administraton of bile acid sequestrants and thiazide diuretics by at least 4 hours. Monitor for decreased therapeutic effects of thiazide diuretics if coadministered with a bile acid sequestrant. Risk D: Consider therapy modification

Brigatinib: May diminish the antihypertensive effect of Antihypertensive Agents. Brigatinib may enhance the bradycardic effect of Antihypertensive Agents. Risk C: Monitor therapy

Brimonidine (Topical): May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Bromperidol: May diminish the hypotensive effect of Blood Pressure Lowering Agents. Blood Pressure Lowering Agents may enhance the hypotensive effect of Bromperidol. Risk X: Avoid combination

Calcium Salts: Thiazide and Thiazide-Like Diuretics may increase the serum concentration of Calcium Salts. Risk C: Monitor therapy

Cardiac Glycosides: Thiazide and Thiazide-Like Diuretics may enhance the adverse/toxic effect of Cardiac Glycosides. Specifically, cardiac glycoside toxicity may be enhanced by the hypokalemic and hypomagnesemic effect of thiazide diuretics. Risk C: Monitor therapy

Corticosteroids (Systemic): May enhance the hypokalemic effect of Thiazide and Thiazide-Like Diuretics. Risk C: Monitor therapy

CycloPHOSphamide: Thiazide and Thiazide-Like Diuretics may enhance the adverse/toxic effect of CycloPHOSphamide. Specifically, granulocytopenia may be enhanced. Risk C: Monitor therapy

Dapoxetine: May enhance the orthostatic hypotensive effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Darolutamide: May increase the serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates (Clinically Relevant with Inhibitors). Risk C: Monitor therapy

Desmopressin: Hyponatremia-Associated Agents may enhance the hyponatremic effect of Desmopressin. Risk C: Monitor therapy

Dexketoprofen: May enhance the adverse/toxic effect of Sulfonamides. Risk C: Monitor therapy

Dexmethylphenidate: May diminish the therapeutic effect of Antihypertensive Agents. Risk C: Monitor therapy

Diacerein: May enhance the therapeutic effect of Diuretics. Specifically, the risk for dehydration or hypokalemia may be increased. Risk C: Monitor therapy

Diazoxide: Thiazide and Thiazide-Like Diuretics may enhance the adverse/toxic effect of Diazoxide. Risk C: Monitor therapy

Diazoxide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Dichlorphenamide: Thiazide and Thiazide-Like Diuretics may enhance the hypokalemic effect of Dichlorphenamide. Risk C: Monitor therapy

Dofetilide: HydroCHLOROthiazide may enhance the QTc-prolonging effect of Dofetilide. HydroCHLOROthiazide may increase the serum concentration of Dofetilide. Risk X: Avoid combination

Drospirenone-Containing Products: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

DULoxetine: Blood Pressure Lowering Agents may enhance the hypotensive effect of DULoxetine. Risk C: Monitor therapy

Eltrombopag: May increase the serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates (Clinically Relevant with Inhibitors). Risk C: Monitor therapy

Encorafenib: May increase the serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates (Clinically Relevant with Inhibitors). Risk C: Monitor therapy

Eplerenone: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Finerenone: Angiotensin II Receptor Blockers may enhance the hyperkalemic effect of Finerenone. Risk C: Monitor therapy

Flunarizine: May enhance the therapeutic effect of Antihypertensive Agents. Risk C: Monitor therapy

Gemfibrozil: May increase the serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates (Clinically Relevant with Inhibitors). Risk C: Monitor therapy

Heparin: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Heparins (Low Molecular Weight): May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Herbal Products with Blood Pressure Increasing Effects: May diminish the antihypertensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Herbal Products with Blood Pressure Lowering Effects: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Hypotension-Associated Agents: Blood Pressure Lowering Agents may enhance the hypotensive effect of Hypotension-Associated Agents. Risk C: Monitor therapy

Indoramin: May enhance the hypotensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Ipragliflozin: May enhance the adverse/toxic effect of Thiazide and Thiazide-Like Diuretics. Specifically, the risk for intravascular volume depletion may be increased. Risk C: Monitor therapy

Ivabradine: Thiazide and Thiazide-Like Diuretics may enhance the arrhythmogenic effect of Ivabradine. Risk C: Monitor therapy

Leflunomide: May increase the serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates (Clinically Relevant with Inhibitors). Risk C: Monitor therapy

Leniolisib: May increase the serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates (Clinically Relevant with Inhibitors). Risk X: Avoid combination

Levodopa-Foslevodopa: Blood Pressure Lowering Agents may enhance the hypotensive effect of Levodopa-Foslevodopa. Risk C: Monitor therapy

Levosulpiride: Thiazide and Thiazide-Like Diuretics may enhance the adverse/toxic effect of Levosulpiride. Risk X: Avoid combination

Licorice: May enhance the hypokalemic effect of Thiazide and Thiazide-Like Diuretics. Risk C: Monitor therapy

Lithium: Thiazide and Thiazide-Like Diuretics may decrease the excretion of Lithium. Management: Reduce the lithium dose if coadministered with thiazide or thiazide-like diuretics. Monitor serum lithium levels during coadministration with thiazide and thiazide-like diuretics. Risk D: Consider therapy modification

Lithium: Angiotensin II Receptor Blockers may increase the serum concentration of Lithium. Management: Initiate lithium at lower doses in patients receiving an angiotensin II receptor blocker (ARB). Consider lithium dose reductions in patients stable on lithium therapy who are initiating an ARB. Monitor lithium concentrations closely when combined. Risk D: Consider therapy modification

Loop Diuretics: May enhance the hypotensive effect of Angiotensin II Receptor Blockers. Loop Diuretics may enhance the nephrotoxic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Loop Diuretics: May enhance the hypotensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Lormetazepam: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Mecamylamine: Thiazide and Thiazide-Like Diuretics may enhance the adverse/toxic effect of Mecamylamine. Management: Consider avoiding the use of mecamylamine and thiazide diuretics. If combined, mecamylamine prescribing information suggests reducing the mecamylamine dose by 50% in order to avoid excessive hypotension. Risk D: Consider therapy modification

Methenamine: Thiazide and Thiazide-Like Diuretics may diminish the therapeutic effect of Methenamine. Risk C: Monitor therapy

Methotrexate: HydroCHLOROthiazide may enhance the nephrotoxic effect of Methotrexate. Risk C: Monitor therapy

Methoxsalen (Systemic): Photosensitizing Agents may enhance the photosensitizing effect of Methoxsalen (Systemic). Risk C: Monitor therapy

Methylphenidate: May diminish the antihypertensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Molsidomine: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Multivitamins/Fluoride (with ADE): May enhance the hypercalcemic effect of Thiazide and Thiazide-Like Diuretics. Risk C: Monitor therapy

Multivitamins/Minerals (with ADEK, Folate, Iron): Thiazide and Thiazide-Like Diuretics may enhance the hypercalcemic effect of Multivitamins/Minerals (with ADEK, Folate, Iron). Risk C: Monitor therapy

Multivitamins/Minerals (with AE, No Iron): Thiazide and Thiazide-Like Diuretics may increase the serum concentration of Multivitamins/Minerals (with AE, No Iron). Specifically, thiazide diuretics may decrease the excretion of calcium, and continued concomitant use can also result in metabolic alkalosis. Risk C: Monitor therapy

Naftopidil: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Neuromuscular-Blocking Agents (Nondepolarizing): Thiazide and Thiazide-Like Diuretics may enhance the neuromuscular-blocking effect of Neuromuscular-Blocking Agents (Nondepolarizing). Risk C: Monitor therapy

Nicergoline: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Nicorandil: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Nicorandil: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Nitroprusside: Blood Pressure Lowering Agents may enhance the hypotensive effect of Nitroprusside. Risk C: Monitor therapy

Nonsteroidal Anti-Inflammatory Agents: Thiazide and Thiazide-Like Diuretics may enhance the nephrotoxic effect of Nonsteroidal Anti-Inflammatory Agents. Nonsteroidal Anti-Inflammatory Agents may diminish the therapeutic effect of Thiazide and Thiazide-Like Diuretics. Risk C: Monitor therapy

Nonsteroidal Anti-Inflammatory Agents: Angiotensin II Receptor Blockers may enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents. Specifically, the combination may result in a significant decrease in renal function. Nonsteroidal Anti-Inflammatory Agents may diminish the therapeutic effect of Angiotensin II Receptor Blockers. The combination of these two agents may also significantly decrease glomerular filtration and renal function. Risk C: Monitor therapy

Nonsteroidal Anti-Inflammatory Agents (Topical): May diminish the therapeutic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Nonsteroidal Anti-Inflammatory Agents (Topical): May diminish the therapeutic effect of Thiazide and Thiazide-Like Diuretics. Risk C: Monitor therapy

Obinutuzumab: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Management: Consider temporarily withholding blood pressure lowering medications beginning 12 hours prior to obinutuzumab infusion and continuing until 1 hour after the end of the infusion. Risk D: Consider therapy modification

Opioid Agonists: May enhance the adverse/toxic effect of Diuretics. Opioid Agonists may diminish the therapeutic effect of Diuretics. Risk C: Monitor therapy

Pentoxifylline: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Pholcodine: Blood Pressure Lowering Agents may enhance the hypotensive effect of Pholcodine. Risk C: Monitor therapy

Phosphodiesterase 5 Inhibitors: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Polyethylene Glycol-Electrolyte Solution: Angiotensin II Receptor Blockers may enhance the nephrotoxic effect of Polyethylene Glycol-Electrolyte Solution. Risk C: Monitor therapy

Polyethylene Glycol-Electrolyte Solution: Diuretics may enhance the nephrotoxic effect of Polyethylene Glycol-Electrolyte Solution. Risk C: Monitor therapy

Porfimer: Photosensitizing Agents may enhance the photosensitizing effect of Porfimer. Risk C: Monitor therapy

Potassium Salts: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Potassium-Sparing Diuretics: Angiotensin II Receptor Blockers may enhance the hyperkalemic effect of Potassium-Sparing Diuretics. Risk C: Monitor therapy

Prazosin: Antihypertensive Agents may enhance the hypotensive effect of Prazosin. Risk C: Monitor therapy

Pretomanid: May increase the serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates (Clinically Relevant with Inhibitors). Risk C: Monitor therapy

Promazine: Thiazide and Thiazide-Like Diuretics may enhance the QTc-prolonging effect of Promazine. Risk X: Avoid combination

Prostacyclin Analogues: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Quinagolide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Ranolazine: May enhance the adverse/toxic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Reboxetine: May enhance the hypokalemic effect of Thiazide and Thiazide-Like Diuretics. Risk C: Monitor therapy

Selective Serotonin Reuptake Inhibitors: May enhance the hyponatremic effect of Thiazide and Thiazide-Like Diuretics. Risk C: Monitor therapy

Silodosin: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Sodium Phosphates: Angiotensin II Receptor Blockers may enhance the nephrotoxic effect of Sodium Phosphates. Specifically, the risk of acute phosphate nephropathy may be enhanced. Risk C: Monitor therapy

Sodium Phosphates: Diuretics may enhance the nephrotoxic effect of Sodium Phosphates. Specifically, the risk of acute phosphate nephropathy may be enhanced. Risk C: Monitor therapy

Sparsentan: May enhance the adverse/toxic effect of Angiotensin II Receptor Blockers. Risk X: Avoid combination

Tacrolimus (Systemic): Angiotensin II Receptor Blockers may enhance the hyperkalemic effect of Tacrolimus (Systemic). Risk C: Monitor therapy

Terazosin: Antihypertensive Agents may enhance the hypotensive effect of Terazosin. Risk C: Monitor therapy

Teriflunomide: May increase the serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates (Clinically Relevant with Inhibitors). Risk C: Monitor therapy

Tolvaptan: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Topiramate: Thiazide and Thiazide-Like Diuretics may enhance the hypokalemic effect of Topiramate. Thiazide and Thiazide-Like Diuretics may increase the serum concentration of Topiramate. Risk C: Monitor therapy

Toremifene: Thiazide and Thiazide-Like Diuretics may enhance the hypercalcemic effect of Toremifene. Risk C: Monitor therapy

Trimethoprim: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Trofinetide: May increase the serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates (Clinically Relevant with Inhibitors). Management: Avoid concurrent use with OATP1B1/1B3 substrates for which small changes in exposure may be associated with serious toxicities. Monitor for evidence of an altered response to any OATP1B1/1B3 substrate if used together with trofinetide. Risk D: Consider therapy modification

Urapidil: Antihypertensive Agents may enhance the hypotensive effect of Urapidil. Risk C: Monitor therapy

Verteporfin: Photosensitizing Agents may enhance the photosensitizing effect of Verteporfin. Risk C: Monitor therapy

Vitamin D Analogs: Thiazide and Thiazide-Like Diuretics may enhance the hypercalcemic effect of Vitamin D Analogs. Risk C: Monitor therapy

Voclosporin: May increase the serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates (Clinically Relevant with Inhibitors). Risk C: Monitor therapy

Food Interactions

See individual agents.

Pregnancy Considerations

[US Boxed Warning]: Drugs that act on the renin-angiotensin system can cause injury and death to the developing fetus. Discontinue as soon as possible once pregnancy is detected. Also see individual agents.

Breastfeeding Considerations

Hydrochlorothiazide is present in breast milk. Excretion of valsartan in breast milk is not known.

Due to the potential for serious adverse reactions in the breastfeeding infant, breastfeeding is not recommended by the manufacturer. See individual agents.

Dietary Considerations

Avoid salt substitutes which contain potassium. May be taken with or without food.

Monitoring Parameters

Blood pressure, heart rate; serum electrolytes, renal function

Mechanism of Action

Valsartan produces direct antagonism of the angiotensin II (AT2) receptors, unlike the ACE inhibitors. It displaces angiotensin II from the AT1 receptor and produces its blood pressure-lowering effects by antagonizing AT1-induced vasoconstriction, aldosterone release, catecholamine release, arginine vasopressin release, water intake, and hypertrophic responses. This action results in more efficient blockade of the cardiovascular effects of angiotensin II and fewer side effects than the ACE inhibitors.

Hydrochlorothiazide inhibits sodium reabsorption in the distal tubules causing increased excretion of sodium and water as well as potassium and hydrogen ions

Pharmacokinetics (Adult Data Unless Noted)

See individual agents.

Brand Names: International

International Brand Names by Country

For country code abbreviations (show table)

(AE) United Arab Emirates: Arbaval plus | Co diovan | Co tabuvan | Joltan plus | Lova plus | Vanguard plus;
(AR) Argentina: Alpertan D | Co valsapress | Corosan d | Diapresan d | Dilcoran d | Diovan d | Nicorvas diur | Paliax d | Racorval d | Sarval d | Simultan d | Valsarfec d;
(AT) Austria: Co diovan | Co Valsax | Valsarcomp | Valsartan HCT G.L. | Valsartan/hct | Valsartan/HCT 1A Pharma | Valsartan/hct actavis | Valsartan/HCT Sandoz | Valsartan/hct stada | Valsartan/hydrochlorothiazid krka;
(AU) Australia: Apo valsartan hctz | Co diovan | Dilart hct;
(BD) Bangladesh: Cardovan plus | Co diovan;
(BE) Belgium: Co diovane | Co valsartan | Co Valsartan Abdi | Co valsartan eg | Valsartan hct;
(BF) Burkina Faso: Covalsar | Covalsar denk;
(BG) Bulgaria: Co diovan | Co sartoval | Co valsacor | Co Valsator | Co valstor | Sarteg HCT | Suvartar H | Valsalen h | Valsarcon co | Valsavil comp | Valsol plus | Valtensin Plus | Valzap h | Vanatex HCT;
(BR) Brazil: Aracor hct | Brasart hct | Brator H | Bravan hct | Co-tareg | Cosartan HCT | Diovan hct | Dopcor hct | Valsartan + hidroclorotiazida | Valsartana + hidroclorotiazida;
(CH) Switzerland: Co diovan | Co valsartan | Co valsartan spirig hc | Co Valtan | Provas comp | Provas maxx | Valsartan hct | Valsartan HCT Actavis | Valsartan hct axapharm | Valsartan HCT Streuli | Valsartan HCT Zentiva;
(CI) Côte d'Ivoire: Co dopcor | Co valex | Starval hct | Valmac h;
(CL) Chile: Dosara D | Micten D | Tareg-d | Valacor D | Valaplex-d | Valax d | Valkem d | Valvitae plus | Vartalan d | Vartalan d plus | Veralpres d;
(CN) China: Co diovan | Feng hai tan | Fu tan | Fu xin | Jin xie ke | Valsartan and hydrochlorothiazid | Valsartan and hydrochlorothiazide | Xie sai ping;
(CO) Colombia: Bratenzil h | Cardiotan H | Clembroxol plus | Diovan hct | Racorval d | Salvara hct | Valsaprex h | Valsartan / hidroclorotiazida | Valsartan hct | Valsartan+hidroclorotiazida | Valsarvitae plus | Valtan h | Vartalan d plus;
(CZ) Czech Republic: Blessin Plus H | Kylotan Plus H | Valsacombi | Valzap Combi | Vanatex HCT;
(DE) Germany: Co diovan | Codiovan | Cordinate plus | Cosamson | Cotareg | Provas comp | Provas maxx | Valsacor Comp | Valsargamma HCT | Valsartan + hct denk | Valsartan comp | Valsartan comp. | Valsartan HCT Aaa | Valsartan hennig plus hct | Valsartan Hexal Comp | Valsartan plus | Valsartan Q comp. | Valsartan/hct al | Valsartan/hct dura | Valsartan/hct mylan | Valsartan/hct stada | Valsartan/Hctz Fair Med Healthcare;
(DK) Denmark: Valsavil HCT;
(DO) Dominican Republic: Acrovan d | Alsartan D | Atdos h | Balsartec H | Cardio-Kd | Co diovan | Gioten hct | Lodelip H | Lysamol d | Pexabrel h | Terapres H | Valaplex d | Valchem D | Valdiber h | Valsacor D | Valsapress Plus | Valsar H | Valsartan + hidroclorotiazida sued | Valsartan hct | Valsartec h | Valscard hct | Valtan h;
(EC) Ecuador: Covalsapress | Diapresan d | Europres d | Hiperval h | Inixia hct | Pertena hc | Valaplex-d | Valopral d | Valsartan + hidroclorotiazida | Valsartan + Hidroclorotiazida Genfar;
(EE) Estonia: Co diovan | Suvartar hct | Valsacombi | Valzap h;
(EG) Egypt: Adwivalsar co | Alfabetex | Co diovan | Co valsartan | Co vasotec | Co-tareg | Idisartan co | Pressothioval | Pressval plus | Sarangiot plus | Valsarcard comb | Valsatens plus | Valthiazide;
(ES) Spain: Aralter Plus | Co diovan | Co vals | Co vals forte | Kalpress plus | Miten plus | Valsartan + hidroclorotiazida krka | Valsartan/hidroclorotiazida | Valsartan/Hidroclorotiazida actavis | Valsartan/hidroclorotiazida alter | Valsartan/Hidroclorotiazida Apotex | Valsartan/Hidroclorotiazida aurobindo | Valsartan/Hidroclorotiazida Cantabria | Valsartan/Hidroclorotiazida cinfa | Valsartan/Hidroclorotiazida Combix | Valsartan/Hidroclorotiazida Kern pharma | Valsartan/hidroclorotiazida Mabo | Valsartan/Hidroclorotiazida mylan | Valsartan/Hidroclorotiazida normon | Valsartan/Hidroclorotiazida Pharmagenus | Valsartan/Hidroclorotiazida Qualigen | Valsartan/hidroclorotiazida ranbaxy | Valsartan/Hidroclorotiazida Ratiopharm | Valsartan/Hidroclorotiazida Sandoz | Valsartan/Hidroclorotiazida Stada | Valsartan/Hidroclorotiazida teva;
(ET) Ethiopia: Co anginet | Co diovan | Co tabuvan | Covalsar denk | Diostar plus | Valsartan and hydrochlorothiazide;
(FI) Finland: Diovan comp | Valsarstad Comp | Valsartan hydrochlorothiazide krka | Valsartan/hydrochlorothiazide | Valsartan/hydrochlorothiazide orion | Valsartan/hydrochlorothiazide ratiopharm | Valsartan/hydrochlorthiazid | Valsartore comp;
(FR) France: Cotareg | Nisisco | Valsartan/hydrochlorothazide zydus | Valsartan/hydrochlorothiazide | Valsartan/hydrochlorothiazide actavis | Valsartan/hydrochlorothiazide ahcl | Valsartan/hydrochlorothiazide arrow | Valsartan/hydrochlorothiazide biogaran | Valsartan/hydrochlorothiazide cristers | Valsartan/hydrochlorothiazide eg | Valsartan/hydrochlorothiazide evolugen | Valsartan/hydrochlorothiazide krka | Valsartan/hydrochlorothiazide mylan | Valsartan/Hydrochlorothiazide Phr lab | Valsartan/hydrochlorothiazide ranbaxy | Valsartan/hydrochlorothiazide sandoz | Valsartan/hydrochlorothiazide teva;
(GB) United Kingdom: Co diovan | Valsartan/hydrochlorothiazide;
(GR) Greece: Avalsan plus | Co dalzad | Co diovan | Co valsareta | Valpressol plus | Valsaben plus | Valsartan + hctz/sandoz | Valsartan/Hctz Teva | Zakodian plus | Zencil;
(HK) Hong Kong: Apo valsartan/hctz | Co diovan | Valsartan | Valtensin HCT;
(HR) Croatia: Co diovan | Val plus | Valnorm H | Valsacombi;
(HU) Hungary: Alvastran hct | Co valsacor | Diovan hct | Nortivan HCT | Tensart HCT | Valsartan hct sandoz | Valsartan hct teva | Valsartan/hydrochlorothiazide krka | Valsocard HCT | Valsotens HCT | Vezuran plus;
(IE) Ireland: Co diovan | Co Vatan | Valsartan Hctz KRKA | Valtan Comp;
(IL) Israel: Co diovan | Vector plus;
(IN) India: Co diovan | Valent h | Valfect H | Valzaar h;
(IQ) Iraq: Diosartan plus;
(IS) Iceland: Valpress comp;
(IT) Italy: Arterpress | Combisartan | Corixil | Cotareg | Valbacomp | Validroc | Valsacombi | Valsartan e idroclorothiazide teva italia | Valsartan e idroclorotiazide actavis | Valsartan e idroclorotiazide aurobindo | Valsartan e idroclorotiazide eg | Valsartan e idroclorotiazide mylan generics | Valsartan e idroclorotiazide sandoz | Valsartan e Idroclorotiazide Tecnigen | Valsartan e idroclorotiazide zentiva | Valsartan e idroclorotiaziode ranbaxy | Valsartan idroclorotiazide doc generici | Valsartan idroclorotiazide pensa | Valsodiur;
(JO) Jordan: Arbiten Plus | Co anginet | Co diovan | Co tabuvan | Diostar plus | Tenstar plus;
(JP) Japan: Co Dio Combination | Co dio ex | Valhydio;
(KE) Kenya: Co diovan | Cotroval | Covalsar denk | Starval hct | Valzaar h;
(KR) Korea, Republic of: Angiovan Plus | Auskovan plus | C rtan plus | Casartan plus | Cirtan plus | Co diocan | Co diosartan | Co diovan | Co divad | Co-tareg | Cobarovan | Codetension | Codiopass | Codiortan | Codiorvan | Codiovaltan | Codiovan | Codiozartan | Codiqvan | Codirtan | Codisar | Codizantan | Codizantin | Coplex | Covalosartan | Covalsan | Covalsar | Covalsarbell | Covalsarect | Covalsat | Covaltaran | Covaratan | Covasotan | Dio v plus | Diotan Plus | Dioten plus | Dirotan plus | Divaltan Plus | Duosartan | Duotan | Exvan plus | Hipoten | Hyden plus | Hydnplus | Klovan plus | Kotarec | Maxdio plus | Maxdioplus | Newvaltan plus | Samsung dio | Sarvaltan plus | Selectan Plus | Selectan plus f | V van plus | Valdesar plus | Valmitan | Valsanin plus | Valsaone Plus | Valsaor Plus | Valsar plus | Valsartan plus | Valsartel Plus | Valsatan plus | Valtan plus | Valtrep Plus | Vaotan plus | Varban plus | Varetan plus | Vartan pro | Vasatanplus | Vzatan plus;
(KW) Kuwait: Co anginet | Co diovan;
(LB) Lebanon: Arbiten Plus | Co anginet | Co diotens | Co diovan | Co tabuvan | Retazid | Valpress plus | Valustar plus | Valzap hct | Viostan plus;
(LT) Lithuania: Co diovan | Suvartar hct | Tensart HCT | Valsacombi | Valsartan HCT Actavis | Valsartan hctz | Valsartan/hct bijon | Valsartan/hydrochloorthiazide sandoz | Valzap h | Vanatex HCT;
(LU) Luxembourg: Co valsartan | Co valsartan eg | Co valsartan mylan | Codiovan | Valsartan ratiopharm comp;
(LV) Latvia: Co diovan | Tensart HCT | Valsacombi | Valzap h | Vanatex HCT;
(MA) Morocco: Co valsartan win | Co vartex | Co zenovan | Co-tareg | Costarval | Valphi plus;
(MX) Mexico: Antelan | Carvals hct | Co diovan | Di tanvlur | Efnithin | Vivendal hid | Vzar cda;
(MY) Malaysia: Co diovan | Valzaar h;
(NG) Nigeria: Co anginet | Co diovan | Codiolad plus | Covalsar denk | Dony valsartan and hydrochlorothiazide | Joltan plus | Lastavin htz | Valsartan hct;
(NL) Netherlands: Co diovan | Codiovan | Cotareg | Valsartan/hct | Valsartan/HCTZ Fair-Med | Valsartan/hydrochloorthiazide | Valsartan/Hydrochloorthiazide Aurobindo | Valsartan/hydrochloorthiazide krka;
(NO) Norway: Co diovan | Codiovan | Cotareg | Diovan comp | Valsartan/hct | Valsartan/hydrochlorothiazide krka | Valsartan/hydrochlorthiazid actavis;
(PE) Peru: Avan hct | Diovan hct | Europres d | Starval hct | Valatren h | Valsartan + hidroclorotiazida | Valsiprel hct;
(PH) Philippines: Co diovan | Co dizant | Co-tareg | Dizantin plus | Duoval max | Valazyd h;
(PK) Pakistan: Angiotan H | Biosartan hct | C val plus | Co diovan | Co vals | Co valseta | Co Valstar | Co Valtec | Co-valid | Cova h | Exval h | Listan ht | Nuval D | Sevia H | Valdipine h | Valken h | Valtan plus | Velker plus;
(PL) Poland: Anartan HCT | Apovalsart hct | Awalten | Axudan hct | Co bespres | Co diovan | Co dipper | Co nortivan | Co valsacor | Tensart HCT | Valsartan + hct arrow | Valsartan hct mylan | Valsartan+HCT Genoptim | Valsartan+hydrochlorothiazide aurobindo | Valsotens HCT | Valtap HCT | Vanatex HCT | Zelvartancombo;
(PR) Puerto Rico: Diovan hct | Valsartan & hctz | Valsartan and hydrochlorothiazide | Valsartan hctz;
(PT) Portugal: Co diovan | Co-tareg | Valsartan + Hidroclorotiazida Actavis | Valsartan + Hidroclorotiazida Alter Genericos | Valsartan + Hidroclorotiazida Aurobindo | Valsartan + hidroclorotiazida baldacci | Valsartan + Hidroclorotiazida ciclum | Valsartan + Hidroclorotiazida Farmoz | Valsartan + hidroclorotiazida generis | Valsartan + hidroclorotiazida limeg | Valsartan + hidroclorotiazida mylan | Valsartan + Hidroclorotiazida Pentafarma | Valsartan + hidroclorotiazida pharmacons | Valsartan + hidroclorotiazida pharmakern | Valsartan + Hidroclorotiazida Pressiter | Valsartan + Hidroclorotiazida ratiopharm | Valsartan + hidroclorotiazida ritisca | Valsartan + Hidroclorotiazida Sandoz | Valsartan + hidroclorotiazida tecnilor | Valsartan + hidroclorotiazida tetrafarma | Valsartan + hidroclorotiazida teva | Valsartan + Hidroclorotiazida toLife | Valsartan + hidroclorotiazida zentiva;
(PY) Paraguay: Diovan d | Diusartan plus | Diusartan plus forte | Europres d | Valaplex d forte | Valaplex-d | Vartalan d | Vartalan d forte;
(QA) Qatar: Arbiten Plus | Co-Anginet | Co-Cinfaval | Co-Diovan | Co-Tabuvan | Co-Valor | Diostar Plus;
(RO) Romania: Co diovan | Valsartan hidroclorotiazida torrent;
(RU) Russian Federation: Co diovan | Duopress | Valsacor h | Valsacor h160 | Valsacor h320 | Valsacor h80 | Valsacor hd | Valsartan hydrochlorothiazide akrikhin | Valsartan+hydrochlorothiazide | Valz h | Vanatex combi;
(SA) Saudi Arabia: Arbaval plus | Arbiten Plus | Co anginet | Co diovan | Co tabuvan | Co valista | Diostar plus | Valtense plus;
(SE) Sweden: Diovan comp | Rocaval | Valsartan/Hydrochlorothiazide 2care4 | Valsartan/hydrochlorothiazide abacus medicine | Valsartan/hydrochlorothiazide krka | Valsartan/hydrochlorothiazide sandoz | Valsartan/hydrochlorothiazide teva | Valsartan/hydroklortiazid | Valsartan/hydroklortiazid actavis | Valsartore comp | Valtsu comp;
(SG) Singapore: Co diovan;
(SI) Slovenia: Co diovan | Valsaden | Zelvartancombo;
(SK) Slovakia: Co diovan | Co valsacor | Valsartan/hydrochlorotiazid krka | Valtan HCT | Valtensin HCT | Valzap hct | Vasopentol HCT | Zelvartancombo;
(TH) Thailand: Co diovan | Co-tareg;
(TN) Tunisia: Bival | Co tazar | Co valsartan winthrop | Cotareg | Diostar plus | Retazid;
(TR) Turkey: Cardopan Plus | Co diovan | Co Tamgard | Limiten plus | Premium plus | Valcor plus | Valtan plus | Valtensin Plus | Venaton Plus | Wansaar plus;
(TW) Taiwan: Co diovan | Co vosaa | Co-tareg | Kovan plus;
(UA) Ukraine: Adeniz h | Corsar h | Diocor | Sacord n | Tiara duo | Valmisar h | Valsartan+hydrochlorothiazide | Vasar h;
(UG) Uganda: Co anginet | Valazyd h;
(UY) Uruguay: Diovan d | Simultan d | Valdix D | Valsacor D | Valsartan D;
(VE) Venezuela, Bolivarian Republic of: Bicol | Diovan hct | Valsan HCT | Valsartan hct | Valsartan hidroclorotiazida | Vasaten hct;
(VN) Viet Nam: Dembele | Midatoren | Valsgim h | Vasartim plus;
(ZA) South Africa: Co diovan | Co migroben | Co zomevek | Diolo co | Dynaval co | Regoval co;
(ZM) Zambia: Co diovan | Starval hct;
(ZW) Zimbabwe: Cardisar ht | Co diovan | Co dopcor | Dynaval co | Valzaar h

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Valsartan and hydrochlorothiazide: Drug information