This medicine works best if there is a constant amount in the blood. To help keep this amount constant, do not miss any doses and take the medicine at the same time each day.

In addition to the use of the medicine your doctor has prescribed, treatment for your high blood pressure may include weight control and care in the types of foods you eat, especially foods high in sodium. Your doctor will tell you which of these is most important for you. You should check with your doctor before changing your diet.

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.

Remember that this medicine will not cure your high blood pressure but it does help control it. Therefore, you must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life . If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

Dosing

The dose of these medicines will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The number of tablets that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking valsartan and hydrochlorothiazide .

• For oral dosage form (tablets):
  • For high blood pressure:
    • Adults 1 tablet once a day. Your doctor may increase your dose if needed.
    • Children Use and dose must be determined by your doctor.

Missed dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Keep the medicine from freezing. Do not refrigerate.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For valsartan and hydrochlorothiazide, the following should be considered:

Allergies Tell your doctor if you have ever had any unusual or allergic reaction to valsartan, sulfonamides (sulfa drugs), bumetanide, furosemide, acetazolamide, dichlorphenamide, or methazolamide or to hydrochlorothiazide or any of the other thiazide diuretics (water pills). Also tell your health care professional if you are allergic to any other substances, such as foods, sulfites or other preservatives, or dyes.

Pregnancy Use of valsartan during pregnancy, especially after the first three months, can cause low blood pressure, kidney failure, too much potassium, or death in newborns. Additionally, when hydrochlorothiazide is used during pregnancy, it may cause jaundice, blood problems, and other side effects in the newborn baby. Therefore, it is important that you check with your doctor immediately if you think that you may be pregnant .

Breast-feeding It is not known whether valsartan passes into breast milk. However, it does pass into the milk of lactating rats. Hydrochlorothiazide does pass into breast milk. Be sure that you discuss this with your doctor if you decide to breast feed while taking these medicines.

Children Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of valsartan and hydrochlorothiazide combination in children with use in other age groups.

Older adults Elderly patients may be more sensitive than younger adults to the effects of this medicine.

Other medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

• Diabetes mellitus (sugar diabetes) Hydrochlorothiazide may raise blood sugar levels

• Fluid or electrolyte (e.g., potassium, chloride, sodium) imbalance (due to excessive perspiration, vomiting, diarrhea, etc.) The side effects of valsartan and hydrochlorothiazide may be increased

• Gout Hydrochlorothiazide may increase the amount of uric acid in the body, which may activate or aggravate this condition

• Heart failure, severe Lowering of blood pressure by these medicines may make this condition worse

• Kidney disease or
• Liver disease These conditions may be aggravated by valsartan and hydrochlorothiazide