The flexibility to customize dosing
for your patients
From the EXFORGE Prescribing Information2
EXFORGE Dosage Information – General Considerations
- Amlodipine is an effective treatment of hypertension in once-daily dosages of 2.5 mg to 10 mg while valsartan is effective in dosages of 80 mg to 320 mg. In clinical trials with once-daily EXFORGE using amlodipine dosages of 5 mg to 10 mg and valsartan dosages of 160 mg to 320 mg, the antihypertensive effects increased with increasing dosages.
- The hazards of valsartan are generally independent of dose; those of amlodipine are a mixture of dose-dependent phenomena (primarily peripheral edema) and dose-independent phenomena, the former much more common than the latter.
- The majority of the antihypertensive effect is attained within 2 weeks after initiation of therapy or a change in dosage. The dosage can be increased after 1 to 2 weeks of therapy to a maximum of one 10/320-mg tablet once daily as needed to control blood pressure.
- EXFORGE may be administered with or without food.
- EXFORGE may be administered with other antihypertensive agents.
- Elderly patients: Because of decreased clearance of amlodipine, therapy should usually be initiated at 2.5 mg.
- Renal Impairment: No initial dosage adjustment is required for patients with mild or moderate renal impairment. Titrate slowly in patients with severe renal impairment.
- Hepatic Impairment: No initial dosage adjustment is required for patients with mild or moderate liver insufficiency. Titrate slowly in patients with hepatic impairment.
- A patient whose blood pressure is not adequately controlled with amlodipine (or another dihydropyridine calcium channel blocker) alone or with valsartan (or another angiotensin II receptor blocker) alone may be switched to combination therapy with EXFORGE.
- A patient who experiences dose-limiting adverse reactions on either component alone may be switched to EXFORGE containing a lower dose of that component in combination with the other to achieve similar blood pressure reductions. The clinical response to EXFORGE should be subsequently evaluated and if blood pressure remains uncontrolled after 3 to 4 weeks of therapy, the dosage may be titrated up to a maximum of 10/320 mg.
- For convenience, patients receiving amlodipine and valsartan from separate tablets may instead wish to receive tablets of EXFORGE containing the same component doses.
- A patient may be initiated on EXFORGE if it is unlikely that control of blood pressure would be achieved with a single agent. The usual starting dosage is EXFORGE 5/160 mg once daily in patients who are not volume-depleted.
From the EXFORGE HCT Prescribing Information3
Exforge HCT Dosage Information – General Considerations
- Dose once daily. The dosage may be increased after 2 weeks of therapy. The full blood pressure-lowering effect was achieved 2 weeks after being on the maximal dosage of EXFORGE HCT. The maximum recommended dose of EXFORGE HCT is 10/320/25 mg.
- EXFORGE HCT may be administered with or without food.
- No initial dosage adjustment is required for elderly patients.
- Renal impairment: The usual regimens of therapy with EXFORGE HCT may be followed if the patient's creatinine clearance is >30 mL/min. In patients with more severe renal impairment, loop diuretics are preferred to thiazides, so avoid use of
- Hepatic impairment: Avoid EXFORGE HCT in patients with severe hepatic impairment. In patients with lesser degrees of hepatic impairment, monitor for worsening of hepatic or renal function and adverse reactions.
- EXFORGE HCT is not indicated for the initial therapy of hypertension.
- EXFORGE HCT may be used for patients not adequately controlled on any two of the following antihypertensive classes: calcium channel blockers, angiotensin receptor blockers, and diuretics.
- A patient who experiences dose-limiting adverse reactions to an individual component while on any dual combination of the components of EXFORGE HCT may be switched to EXFORGE HCT containing a lower dose of that component to achieve similar blood pressure reductions.
- EXFORGE HCT may be substituted for the individually titrated components.