Warnings and Precautions With Valsartan and Hydrochlorothiazide

• There are several medicines that valsartan and hydrochlorothiazide can interact with (see Drug Interactions With Valsartan and Hydrochlorothiazide).

• Valsartan and hydrochlorothiazide may cause extremely low blood pressure in some people. Extremely low blood pressure is more likely to happen when the medicine is first started or the dosage is changed. It is also more likely to happen in people who are taking a diuretic, who are on dialysis, who have congestive heart failure, who have diarrhea or vomiting, or who have excessive sweating. This is why it is important to drink fluids regularly while taking valsartan and hydrochlorothiazide. If you have any possible symptoms of low blood pressure, such as dizziness, lightheadedness, or fainting, contact your healthcare provider. If you have fainted, stop taking valsartan and hydrochlorothiazide until you have talked with your healthcare provider.
   

Also, make sure not to drive, operate any heavy machinery, or perform any other tasks that require alertness before you know how valsartan and hydrochlorothiazide affects you.

• Valsartan and hydrochlorothiazide is a pregnancy Category C medicine for the first trimester and a pregnancy Category D medicine for the second and third trimesters, meaning that valsartan and hydrochlorothiazide has health risks to your unborn child. Prior to taking valsartan and hydrochlorothiazide, let your healthcare provider know if you are pregnant or thinking of becoming pregnant. If you become pregnant while taking valsartan and hydrochlorothiazide, contact your healthcare provider immediately (see Diovan HCT and Pregnancy for more information).
   
• While taking valsartan and hydrochlorothiazide, do not use potassium supplements or salt substitutes with potassium unless you have discussed this with your doctor. This is because in some people taking valsartan and hydrochlorothiazide, potassium in the blood can increase or decrease to dangerous levels.
   
• Valsartan and hydrochlorothiazide may affect electrolytes in the blood (including sodium, potassium, magnesium, and chloride). Therefore, during treatment with valsartan and hydrochlorothiazide, your healthcare provider will regularly check these levels. If you notice any symptoms of a possible electrolyte imbalance, contact your healthcare provider. These symptoms may include a dry mouth, increased thirst, weakness, tiredness, restlessness, seizures, confusion, muscle pain or cramps, a decrease in urine output, a weak or irregular heartbeat, nausea, or vomiting.
   
• Medicines like valsartan and hydrochlorothiazide have been known to cause a decrease in kidney function, especially in certain groups such as those with severe congestive heart failure. Let your healthcare provider know if you have symptoms such as a decrease in urine output, drowsiness, headache, or back pain. Your healthcare provider will also regularly check your kidney function with a blood test.
   
• If you have moderate to severe liver disease (such as cirrhosis), gallstones, or other gallbladder problems, your body may metabolize the valsartan and hydrochlorothiazide differently than intended. Therefore, your healthcare provider may start you on a lower dose of valsartan and hydrochlorothiazide and will monitor your situation more closely, or may recommend another blood pressure medicine.
   
• Because of the hydrochlorothiazide, valsartan and hydrochlorothiazide is more likely than other drugs to cause allergic reactions. This is more common in people with a history of allergies or asthma. Make sure to discuss this risk with your healthcare provider. Also, seek emergency medical attention immediately if you notice things such as hives, an unexplained rash, difficulty breathing, or swelling of the face or throat.
   
• Because of the hydrochlorothiazide, valsartan and hydrochlorothiazide is more likely to worsen systemic lupus erythematosus or, in some cases, even cause the condition.
   
• Because of the hydrochlorothiazide, valsartan and hydrochlorothiazide is also known to worsen gout.
   
• Valsartan and hydrochlorothiazide may cause high blood sugar (hyperglycemia) in diabetics or, in some cases, even cause diabetes in people without a history of the condition.
   
• Valsartan and hydrochlorothiazide may increase levels of cholesterol and triglycerides in the blood.
   
• It is not known whether or not valsartan and hydrochlorothiazide passes through breast milk. Therefore, if you are nursing and taking valsartan and hydrochlorothiazide, talk with your healthcare provider about whether you should stop taking valsartan and hydrochlorothiazide or stop breastfeeding.
   

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