Exforge (Amlodipine and Valsartan) - Oral

Warning:

Exforge (amlodipine and valsartan) should be stopped as soon as one becomes pregnant. Using this medication while pregnant can be toxic to the fetus.  

What Is Exforge?

Exforge (amlodipine and valsartan) is an oral prescription medication used to treat high blood pressure (hypertension). It is a combination of the blood pressure-lowering medications amlodipine and valsartan, which work by relaxing the blood vessels.

Amlodipine belongs to a drug class called calcium channel blockers. Calcium channel blockers can treat high blood pressure and heart arrhythmias (irregular heartbeat) by reducing the amount of calcium that enters the arteries and cells of the heart. Calcium reduction prevents the blood vessels from tightening, increasing blood pressure.

Valsartan is an angiotensin II receptor blocker (ARB). ARBs block the action of the hormone angiotensin II, which can directly narrow (constrict) the blood vessels and increase blood pressure.

Exforge is available in tablet form to take by mouth.

Drug Facts

Generic Name: Amlodipine and valsartan

Brand Name(s): Exforge

Drug Availability: Prescription

Administration Route: Oral

Therapeutic Classification: Antihypertensive 

Available Generically: Yes 

Controlled Substance: N/A

Active Ingredient: Amlodipine and valsartan 

Dosage Form(s): Tablet

What Is Exforge Used For?

The Food and Drug Administration (FDA) approved Exforge for hypertension (high blood pressure) treatment. It is commonly used in people with high blood pressure that is not well controlled with only one medication.

High blood pressure is a blood pressure measurement where the top number (systolic) is higher than 130 millimeters of mercury (mmHg) or the bottom number (diastolic) is higher than 80 millimeters of mercury. High blood pressure can cause damage to the walls of the blood vessels, which increases one’s risk of heart attack, stroke, and kidney damage.

Blood pressure-lowering medications reduce your blood pressure and prevent these complications.

How to Use Exforge

As with all medications, Exforge must be taken as directed by your healthcare provider. This oral medication is taken once per day with or without food. It is best to take your dose at the same time each day. Doses start at five milligrams (mg) of amlodipine and 160 milligrams of valsartan and can increase to 10 milligrams of amlodipine and 320 milligrams of valsartan.

Storage

Store Exforge at room temperature (between 68 F and 77 F) in a dry area. Do not store it in the bathroom or the kitchen. Keep your medication secure and out of reach of children or pets.

Off-Label Uses

There are situations where medications are used for reasons other than what is approved by the FDA. This is known as off-label use. Exforge does not have any reported off-label uses.

How Long Does Exforge Take to Work?

Exforge does not immediately decrease your blood pressure. It may take up to two weeks to see any improvement. Your healthcare provider will monitor your blood pressure and may increase your dose if needed.

What Are the Side Effects of Exforge?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at www.fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

The most common side effects of Exforge include the following:

  • Dizziness
  • Peripheral edema (swelling in the lower legs or hands)
  • Sore throat 
  • Runny nose 
  • Upper respiratory tract infection

Other side effects may occur that have not been mentioned. Contact your healthcare provider for any further advice or concerns about side effects.

Severe Side Effects

Life-threatening side effects from Exforge are rare. However, some side effects are severe and should not be taken lightly. Seek medical help right away if you experience:

  • Symptoms of kidney problems, such as the inability to pass urine, blood in the urine, change in the amount of urine passed, and weight gain
  • Symptoms of high potassium levels, such as a heartbeat that feels abnormal, confusion, weakness, lightheadedness, dizziness, and shortness of breath
  • Symptoms of liver problems, such as dark urine, lack of appetite, nausea, abdominal pain, vomiting, and yellowing skin
  • Signs of urinary tract infection (UTI), such as blood in the urine, burning pain when passing urine, feeling the need to urinate often or urgently, and lower stomach pain
  • Weakness on one side of the body
  • Dizziness 
  • Passing out 
  • Stiff muscles 
  • Swelling of the arms or legs 
  • Tremors 
  • Gingival hyperplasia (overgrowth of the gum tissue) is a potential effect associated with calcium channel blockers, like amlodipine, that resolves upon stopping. There are fewer reports of this with amlodipine than others within its class.

Call your healthcare provider immediately if you experience serious side effects. This is not a list of all potential side effects. Call 911 if your symptoms feel life-threatening or if you think you are having a medical emergency.

Long-Term Side Effects

Long-term use of Exforge should only occur with the approval of your healthcare team. It is not uncommon to use Exforge or any other blood pressure medication for long-term control.

Inappropriate use of this medication can result in low blood pressure. Proper usage and follow-up with your healthcare provider are essential to monitor unwanted side effects and ensure the medicine works correctly.

Report Side Effects

Exforge may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Exforge Should I Take?

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The dose of this medicine 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 amount of medicine 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 using the medicine.

  • For oral dosage form (tablets):
    • For high blood pressure:
      • Adults—One tablet once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than amlodipine 10 milligrams (mg) and valsartan 320 mg per day.
      • Children—Use and dose must be determined by your doctor.

Modifications

Due to the possible effects of this medication, there may be changes in how it is used in certain situations. Examples include: 

  • Pregnancy: Using Exforge during the second or third trimester of pregnancy can potentially harm the fetus. If you are pregnant or trying to conceive, let your healthcare provider know so that alternative blood pressure medication is used. 
  • Breastfeeding: It is currently unknown if there is a transfer of amlodipine or valsartan into breast milk. The decision to discontinue this medication or stop nursing will require a discussion between you and your healthcare provider to determine what is best for you and your baby. 
  • Advanced age: Your body may respond to medications differently as you age. Your healthcare provider may prescribe lower doses of this medication at the start of treatment. This is to prevent unwanted side effects and protect the kidneys.

Missed Dose

For effective treatment, it is important to take this medication as directed by your healthcare provider. If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue your recommended schedule. Do not take extra doses or multiple doses at the same time.

Overdose: What Happens if I Take Too Much Exforge?

An overdose of Exforge can lower your blood pressure beyond what the body needs. In the event of an overdose, you may experience excessive peripheral vasodilation (blood vessel widening) and symptoms of low blood pressure (hypotension), such as:

  • Lightheadedness or dizziness
  • Nausea
  • Fainting
  • Dehydration and unusual thirst
  • Cold, clammy, and pale skin
  • Blurry vision
  • Rapid, shallow breathing

What Happens If I Overdose on Exforge?

If you think you or someone else may have overdosed on Exforge, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Exforge, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.

Dizziness, lightheadedness, or fainting may also occur, especially when you get up from a lying or sitting position or if you have been taking a diuretic (water pill). Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or not alert. If you feel dizzy, lie down so you do not faint. Then sit for a few moments before standing to prevent the dizziness from returning.

Check with your doctor right away if you become sick while taking this medicine, especially with severe or continuing nausea, vomiting, or diarrhea. These conditions may cause you to lose too much water or salt which may cause low blood pressure. You can also lose water by sweating, so drink plenty of water during exercise or in hot weather.

This medicine may worsen the symptoms of angina (chest pain) or cause a heart attack in certain patients with severe heart or blood vessel disease. Check with your doctor right away if you are having chest pain or discomfort, fast or uneven heartbeat, nausea or vomiting, pain or discomfort in the arms, jaw, back, or neck, shortness of breath, or sweating.

Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests.

Hyperkalemia (high potassium in the blood) may occur in certain people receiving this medicine. Check with your doctor right away if you have the following symptoms: abdominal or stomach pain, confusion, difficulty with breathing, irregular heartbeat, nausea or vomiting, nervousness, numbness or tingling in the hands, feet, or lips, shortness of breath, or weakness or heaviness of the legs. Ask your doctor before you use any medicines, supplements, or salt substitutes that contain potassium.

Do not take other medicines unless they have been discussed with your doctor. This especially includes over-the-counter (nonprescription) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may tend to increase your blood pressure.

What Are Reasons I Shouldn't Use Exforge?

Exforge may not be the right medication for you. Do not take it if you are hypersensitive to any of its ingredients (allergic reaction). Some examples of allergic reactions include hives, fever, and swelling.

What Other Medications Interact With Exforge?

To avoid potential interactions, tell your healthcare provider about any other medicines you take or plan to take, including over-the-counter (OTC) nonprescription products, vitamins, herbs, supplements, and plant-based medicines.

It is possible that the use of other medications with Exforge can negatively affect its ability to work correctly. Exforge has a few drug interactions. Medications that may interact with Exforge include: 

  • Tekturna (aliskiren): Aliskiren may increase the potential for high blood potassium, low blood pressure, and kidney toxicity. People with diabetes should not combine Exforge and aliskiren.
  • Amphetamines, such as Adderall (dextroamphetamine and amphetamine): Taking Exforge with amphetamines may reduce its blood pressure-lowering effects.
  • Plavix (clopidogrel): Amlodipine may decrease the effect of clopidogrel. 
  • Nonsteroidal anti-inflammatory agents (NSAIDs): These include Advil (ibuprofen) and Celebrex (celecoxib)
  • Potassium-sparing diuretics and potassium salts, such as Inspra (eplerenone) and Aldactone (spironolactone): Both potassium-sparing diuretics, salts, and ARBs may result in hyperkalemia, also known as high blood potassium. This can increase the risk of abnormal heartbeat and shortness of breath.
  • Zocor (simvastatin): Amlodipine may increase the amount of simvastatin in the body, which can lead to unwanted side effects. Simvastatin doses should not exceed 20 milligrams if taken with this medication.

What Medications Are Similar?

Many other medications are used to lower blood pressure. This includes other calcium channel blockers and ARBs. Other blood pressure-lowering therapies include:

  • Procardia (nifedipine), a calcium channel blocker used for high blood pressure and angina (chest pain)
  • Cardene (nicardipine), another calcium channel blocker used for high blood pressure and angina
  • Lotrel (amlodipine and benazepril), a combination of a calcium channel blocker (amlodipine) and an angiotensin converting enzyme inhibitor (benazepril)
  • Benicar (olmesartan), an angiotensin II receptor antagonist used for high blood pressure in adults and children six years and older
  • Cozaar (losartan), an ARB used to treat high blood pressure

Frequently Asked Questions

  • Can I drive while taking Exforge?

    Exforge can cause tiredness, dizziness, and lightheadedness when starting this medication. It is important to see how your body reacts to it before driving or doing any activity that requires your full attention. Eventually, your body will adjust to the medication.

  • Can Exforge cause damage to my kidneys?

    Exforge is safe to take if you have healthy kidney function. However, it should not be used in individuals with severe kidney problems, as it can worsen the disease. Your healthcare provider will test your kidney function before starting the medication.

  • How long do I need to take Exforge?

    It is not uncommon to take blood pressure-lowering medications for a long time, even if your blood pressure has improved. Do not discontinue this medication unless your healthcare provider tells you to.

How Can I Stay Healthy While Taking Exforge?

If you've been prescribed Exforge, you are likely having difficulty with blood pressure control. Taking your medication as directed is important to improving your health and lowering the risk of severe hypertension-related complications, such as heart attack and stroke.

In addition to taking your prescribed treatments, try to make healthier lifestyle choices. Get adequate sleep, develop an exercise plan, and stick to heart-healthy foods. Consider buying a blood pressure monitor to check your measurements regularly. This information can also be helpful to your healthcare provider when managing your medication regimen.

Other steps you can take to improve your health if you have hypertension include:

  • Getting to and maintaining a healthy weight
  • Quitting smoking
  • Eating low-fat dairy, fruits, and vegetables, and foods low in saturated fat
  • Limiting sodium (salt) intake
  • Getting regular aerobic exercise
  • Limiting alcohol consumption

Talk to your healthcare provider about an appropriate exercise and eating plan for your condition.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

Acknowledgement:

I would like to recognize and thank Faith Awoniyi for contributing to this article.


9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. DailyMed. Label: Exforge- amlodipine besylate and valsartan tablet, film coated.

  2. U.S. Food and Drug Administration. Norvasc label.

  3. U.S. Food and Drug Administration. Diovan label.

  4. Allemann Y. Efficacy of the combination of amlodipine and valsartan in patients with hypertension uncontrolled with previous monotherapy: the exforge in failure after single therapy (EX-FAST) study. J Clin Hypertens (Greenwich). 2008;10(3):185-194. doi:10.1111/j.1751-7176.2008.07516.x

  5. American Heart Association. Understanding blood pressure readings.

  6. Lauritano D. Drug-induced gingival hyperplasia: an in vitro study using amlodipine and human gingival fibroblasts. Int J Immunopathol Pharmacol. 2019;33:2058738419827746. doi:10.1177/2058738419827746

  7. American Heart Association. Low blood pressure - when blood pressure is too low.

  8. Prescribers' Digital Reference. Amlodipine/valsartan - drug summary.

  9. Mann JFE. Patient education: high blood pressure treatment in adults (beyond the basics). UpToDate.