Exforge | Amlodipine Besylate And Valsartan Tablet Breastfeeding
Do you know that important immune protective proteins are present in breast milk? Breast milk also contains required vitamins, minerals, saturated and un saturated fats. These things are extremely important for development of healthy brain. If you are taking any medicine for short term or for the chronic reason then that passes in breast milk as well, that is why you should always check the drug with your health care provider. Here at DrLact we try to analyze drugs based on available researches and in this sheet we will present our analysis for Exforge | Amlodipine Besylate And Valsartan Tablet.

What is Exforge | Amlodipine Besylate And Valsartan Tablet used for?


Exforge is the combination tablet of amlodipine, a dihydropyridine calcium channel blocker (DHP CCB), and valsartan, an angiotensin II receptor blocker (ARB). Exforge is indicated for the treatment of hypertension: In patients not adequately controlled on monotherapy (1) As initial therapy in patients likely to need multiple drugs to achieve their blood pressure goals (1). Figure 1: Probability of Achieving Systolic Blood Pressure <140 mmHg at Week 8 Figure 2: Probability of Achieving Diastolic Blood Pressure <90 mmHg at Week 8 Figure 3: Probability of Achieving Systolic Blood Pressure <130 mmHg at Week 8 Figure 4: Probability of Achieving Diastolic Blood Pressure <80 mmHg at Week 8 1.1 Hypertension Exforge (amlodipine and valsartan) is indicated for the treatment of hypertension. Exforge may be used in patients whose blood pressure is not adequately controlled on either monotherapy. Exforge may also be used as initial therapy in patients who are likely to need multiple drugs to achieve their blood pressure goals. The choice of Exforge as initial therapy for hypertension should be based on an assessment of potential benefits and risks including whether the patient is likely to tolerate the lowest dose of Exforge. Patients with stage 2 hypertension (moderate or severe) are at a relatively higher risk for cardiovascular events (such as strokes, heart attacks, and heart failure), kidney failure and vision problems, so prompt treatment is clinically relevant. The decision to use a combination as initial therapy should be individualized and should be shaped by considerations such as baseline blood pressure, the target goal and the incremental likelihood of achieving goal with a combination compared to monotherapy. Individual blood pressure goals may vary based upon the patient’s risk. Data from the high-dose multifactorial study [see Clinical Studies (14)] provide estimates of the probability of reaching a blood pressure goal with Exforge compared to amlodipine or valsartan monotherapy. The figures below provide estimates of the likelihood of achieving systolic or diastolic blood pressure control with Exforge 10/320 mg, based upon baseline systolic or diastolic blood pressure. The curve of each treatment group was estimated by logistic regression modeling. The estimated likelihood at the right tail of each curve is less reliable due to small numbers of subjects with high baseline blood pressures. Figure 1: Probability of Achieving Systolic Blood Pressure <140 mmHg at Week 8 Figure 2: Probability of Achieving Diastolic Blood Pressure <90 mmHg at Week 8 Figure 3: Probability of Achieving Systolic Blood Pressure <130 mmHg at Week 8 Figure 4: Probability of Achieving Diastolic Blood Pressure <80 mmHg at Week 8 For example, a patient with a baseline blood pressure of 160/100 mmHg has about a 67% likelihood of achieving a goal of <140 mmHg (systolic) and 80% likelihood of achieving <90 mmHg (diastolic) on amlodipine alone, and the likelihood of achieving these goals on valsartan alone is about 47% (systolic) or 62% (diastolic). The likelihood of achieving these goals on Exforge rises to about 80% (systolic) or 85% (diastolic). The likelihood of achieving these goals on placebo is about 28% (systolic) or 37% (diastolic).

Is using Exforge | Amlodipine Besylate And Valsartan Tablet unsafe in breastfeeding? Can there be bad consequences for baby if I use it while breastfeeding?

Exforge | Amlodipine Besylate And Valsartan Tablet low risk for breastfeeding
Amlodipine and Valsartan are the two main ingredients of Exforge | Amlodipine Besylate And Valsartan Tablet. Based on our individual analysis of Amlodipine and Valsartan we can safely say that Exforge | Amlodipine Besylate And Valsartan Tablet has low risk while breastfeeding. Below we have summarized the usage of Amlodipine and Valsartan while breastfeeding, we recommend you to go through it for better understanding of your usage.

Statement of Manufacturer/Labeler about breastfeeding usage
8.3 Nursing Mothers It is not known whether amlodipine is excreted in human milk. In the absence of this information, it is recommended that nursing be discontinued while amlodipine is administered. It is not known whether valsartan is excreted in human milk. Valsartan was excreted into the milk of lactating rats; however, animal breast milk drug levels may not accurately reflect human breast milk levels. Because many drugs are excreted into human milk and because of the potential for adverse reactions in nursing infants from Exforge, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.

Exforge | Amlodipine Besylate And Valsartan Tablet Breastfeeding Analsys


Amlodipine while Breastfeeding

Low Risk

CAS Number: 111470-99-6

It is excreted into breast milk in small amount (less than 10% of relative dose) without problems observed in infants whose mothers were on treatment with this drug. (Naito 2015, Ahn 2007)When measured, the plasma levels of drug in these infants were undetectable (Vasa 2013). Because its drug elimination period is very prolonged, an alternative drug known to be safer should be used, especially during the neonatal period and in case of premature infant.

Valsartan while Breastfeeding

Low Risk

CAS Number: 137862-53-4

At latest update, relevant published data on excretion into breast milk were not found. A high protein-binding capacity makes excretion into breast milk unlikely. In addition, a low oral bioavailability makes difficult the absorption towards the infant's plasma from ingested milk, except in prematures or newborns who may show an increased absorption. Case report of kidney function impairment of a baby whose mother had taken Telmisartan in pregnancy. Until more data on this medication is available, safer alternative drugs are preferred, especially in premature babies or during the neonatal period. Should an ARA-II medication (Sartan type) be necessary, the associated risk may be decreased by choosing the one with a favorable pharmacokinetics (shorter half-life elimination time and lower bioavailability) like Eprosartan and Losartan


Exforge | Amlodipine Besylate And Valsartan Tablet Breastfeeding Analsys - 2


Amlodipine while Breastfeeding

CAS Number: 88150-42-9

Limited information indicates that milk levels of amlodipine are usually low and plasma levels in breastfed infants are undetectable. Maternal use of amlodipine during breastfeeding has not caused any adverse effects in breastfed infants. If amlodipine is required by the mother, it is not a reason to discontinue breastfeeding.

Valsartan while Breastfeeding

CAS Number: 137862-53-4

Because no information is available on the use of valsartan during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.


Exforge | Amlodipine Besylate And Valsartan Tablet and breastfeeding

I already used Exforge | Amlodipine Besylate And Valsartan Tablet and meanwhile I breastfed my baby should I be concerned?

During whole lactation period you shall first discuss with your doctor and then together you shall decide whether you shall take that drug or not however if you have already taken Exforge | Amlodipine Besylate And Valsartan Tablet then you shall inform your doctor, But you should not be worried too much as Exforge | Amlodipine Besylate And Valsartan Tablet comes in category of low risk drug.


My health care provider has asked me to use Exforge | Amlodipine Besylate And Valsartan Tablet, what to do?

Exforge | Amlodipine Besylate And Valsartan Tablet comes in category of low risk and if your doctor is aware that you are breastfeeding it should be ok to use without much concerns.


If I am using Exforge | Amlodipine Besylate And Valsartan Tablet, will my baby need extra monitoring?

Not much


Who can I talk to if I have questions about usage of Exforge | Amlodipine Besylate And Valsartan Tablet in breastfeeding?

US
National Womens Health and Breastfeeding Helpline: 800-994-9662 (TDD 888-220-5446) 9 a.m. and 6 p.m. ET, Monday through Friday

UK
National Breastfeeding Helpline: 0300-100-0212 9.30am to 9.30pm, daily
Association of Breastfeeding Mothers: 0300-330-5453
La Leche League: 0345-120-2918
The Breastfeeding Network supporter line in Bengali and Sylheti: 0300-456-2421
National Childbirth Trust (NCT): 0300-330-0700

Australia
National Breastfeeding Helpline: 1800-686-268 24 hours a day, 7 days a week

Canada
Telehealth Ontario for breastfeeding: 1-866-797-0000 24 hours a day, 7 days a week

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