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Diovan HCT (Valsartan / Hydrochlorothiazide) - Side Effects and Adverse Reactions



Clinical Trials Experience

Because clinical studies are conducted under widely varying conditions, adverse reactions rates observed in the clinical studies of a drug cannot be directly compared to rates in the clinical studies of another drug and may not reflect the rates observed in practice. The adverse reaction information from clinical trials does, however, provide a basis for identifying the adverse events that appear to be related to drug use and for approximating rates.


Diovan HCT (valsartan and hydrochlorothiazide, USP) has been evaluated for safety in more than 5,700 patients, including over 990 treated for over 6 months, and over 370 for over 1 year. Adverse experiences have generally been mild and transient in nature and have only infrequently required discontinuation of therapy. The overall incidence of adverse reactions with Diovan HCT was comparable to placebo.

The overall frequency of adverse reactions was neither dose-related nor related to gender, age, or race. In controlled clinical trials, discontinuation of therapy due to side effects was required in 2.3% of valsartan-hydrochlorothiazide patients and 3.1% of placebo patients. The most common reasons for discontinuation of therapy with Diovan HCT were headache and dizziness.

The only adverse reaction that occurred in controlled clinical trials in at least 2% of patients treated with Diovan HCT and at a higher incidence in valsartan-hydrochlorothiazide (n=4372) than placebo (n=262) patients was nasopharyngitis (2.4% vs. 1.9%).

Dose-related orthostatic effects were seen in fewer than 1% of patients. In individual trials, a dose-related increase in the incidence of dizziness was observed in patients treated with Diovan HCT.

Other adverse reactions that have been reported with valsartan-hydrochlorothiazide (>0.2% of valsartan-hydrochlorothiazide patients in controlled clinical trials) without regard to causality, are listed below:

Cardiovascular : Palpitations and tachycardia

Ear and L abyrinth : Tinnitus and vertigo

Gastrointestinal : Dyspepsia, diarrhea, flatulence, dry mouth, nausea, abdominal pain, abdominal pain upper, and vomiting

General and A dministration S ite C onditions : Asthenia, chest pain, fatigue, peripheral edema and pyrexia

Infections and I nfestations : Bronchitis, bronchitis acute, influenza, gastroenteritis, sinusitis, upper respiratory tract infection and urinary tract infection

Investigations : Blood urea increased

Musculoskeletal : Arthralgia, back pain, muscle cramps, myalgia, and pain in extremity

Nervous S ystem : Dizziness postural, paresthesia, and somnolence

Psychiatric : Anxiety and insomnia

Renal and U rinary : Pollakiuria

Reproductive S ystem : Erectile dysfunction

Respiratory, T horacic and M ediastinal : Dyspnea, cough, nasal congestion, pharyngolaryngeal pain and sinus congestion

Skin and S ubcutaneous T issue : Hyperhidrosis and rash

Vascular : Hypotension

Other reported reactions seen less frequently in clinical trials included abnormal vision, anaphylaxis, bronchospasm, constipation, depression, dehydration, decreased libido, dysuria, epistaxis, flushing, gout, increased appetite, muscle weakness, pharyngitis, pruritus, sunburn, syncope, and viral infection.

Valsartan : In trials in which valsartan was compared to an ACE inhibitor with or without placebo, the incidence of dry cough was significantly greater in the ACE inhibitor group (7.9%) than in the groups who received valsartan (2.6%) or placebo (1.5%). In a 129-patient trial limited to patients who had had dry cough when they had previously received ACE inhibitors, the incidences of cough in patients who received valsartan, hydrochlorothiazide, or lisinopril were 20%, 19%, 69% respectively (p <0.001).

Other reported reactions seen less frequently in clinical trials included chest pain, syncope, anorexia, vomiting, and angioedema.

Hydrochlorothiazide : Other adverse reactions that have been reported with hydrochlorothiazide, without regard to causality, are listed below:

Body As A Whole : weakness;

Digestive : pancreatitis, jaundice (intrahepatic cholestatic jaundice), sialadenitis, cramping, gastric irritation;

Hematologic : aplastic anemia, agranulocytosis, leukopenia, hemolytic anemia, thrombocytopenia;

Hypersensitivity : purpura, photosensitivity, urticaria, necrotizing angiitis (vasculitis and cutaneous vasculitis), fever, respiratory distress including pneumonitis and pulmonary edema, anaphylactic reactions;

Metabolic : hyperglycemia, glycosuria, hyperuricemia;

Musculoskeletal : muscle spasm;

Nervous System/Psychiatric : restlessness;

Renal : renal failure, renal dysfunction, interstitial nephritis;

Skin : erythema multiforme including Stevens-Johnson syndrome, exfoliative dermatitis including toxic epidermal necrolysis;

Special Senses : transient blurred vision, xanthopsia.

Initial T herapy - Hypertension

In a clinical study in patients with severe hypertension (diastolic blood pressure ≥110 mmHg and systolic blood pressure ≥140 mmHg), the overall pattern of adverse reactions reported through six weeks of follow-up was similar in patients treated with Diovan HCT as initial therapy and in patients treated with valsartan as initial therapy. Comparing the groups treated with Diovan HCT (force-titrated to 320/25 mg) and valsartan (force-titrated to 320 mg), dizziness was observed in 6% and 2% of patients, respectively. Hypotension was observed in 1% of those patients receiving Diovan HCT and 0% of patients receiving valsartan. There were no reported cases of syncope in either treatment group. Laboratory changes with Diovan HCT as initial therapy in patients with severe hypertension were similar to those reported with Diovan HCT in patients with less severe hypertension [see Clinical Studies (14.2) and Drug Interactions   (7.3)].

Postmarketing Experience

The following additional adverse reactions have been reported in valsartan or valsartan/hydrochlorothiazide postmarketing experience:      

Hypersensitivity : There are rare reports of angioedema;

Digestive : Elevated liver enzymes and very rare reports of hepatitis;

Renal : Impaired renal function;

Clinical Laboratory Tests : Hyperkalemia;

Dermatologic : Alopecia;

Vascular: Vasculitis;

Nervous System: Syncope.

Rare cases of rhabdomyolysis have been reported in patients receiving angiotensin II receptor blockers.

Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.


Below is a sample of reports where side effects / adverse reactions may be related to Diovan HCT. The information is not vetted and should not be considered as verified clinical evidence.

Possible Diovan HCT side effects / adverse reactions in 65 year old female

Reported by a consumer/non-health professional from Brazil on 2011-10-03

Patient: 65 year old female

Reactions: Meniscus Lesion, Weight Decreased, Osteoarthritis, Tendon Disorder, Fall, Hypertension, Inflammation

Adverse event resulted in: hospitalization

Suspect drug(s):
    Dosage: 1 df, 160 mg in the morning
    Administration route: Oral
    Indication: Hypertension
    Start date: 2010-02-01

Diovan HCT
    Dosage: 1 df, qd (1 tablet at night)
    Administration route: Oral
    Indication: Hypertension

Other drugs received by patient: Atenolol; Prelone; Glucosamine Sulfate W/chondroitin Sulfate /msm; Nisulid; Atensine; Lisinopril

Possible Diovan HCT side effects / adverse reactions in 56 year old female

Reported by a individual with unspecified qualification from United States on 2011-10-03

Patient: 56 year old female

Reactions: Blood Pressure Increased, Malaise, Cerebrovascular Accident

Adverse event resulted in: hospitalization

Suspect drug(s):
Diovan HCT

Other drugs received by patient: Cymbalta; Norvasc; Potassium; Atenolol

Possible Diovan HCT side effects / adverse reactions in 59 year old male

Reported by a physician from Japan on 2011-10-04

Patient: 59 year old male

Reactions: Glycosylated Haemoglobin Increased, Gamma-Glutamyltransferase Increased, Diabetes Mellitus, Alanine Aminotransferase Increased, Aspartate Aminotransferase Increased

Suspect drug(s):
Diovan HCT

Other drugs received by patient: Warfarin Sodium

See index of all Diovan HCT side effect reports >>

Drug label data at the top of this Page last updated: 2011-02-11

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