Drug Class: Calcium Channel Blocker + ARB Combination | Form: Oral Tablet | Prescription Status: Prescription Only (Rx) — DRAP Registered
What is Exval-A 5/160mg Tablet?
Exval-A 5/160mg is the mid-strength formulation of the Amlodipine-Valsartan combination — containing a standard Amlodipine dose of 5mg paired with a full therapeutic Valsartan dose of 160mg. It is prescribed when the 5/80mg starting strength does not achieve blood pressure targets, or when stronger ARB blockade is needed alongside the standard Amlodipine dose. Amlodipine relaxes arterial walls directly through calcium channel blockade while Valsartan at its full 160mg dose provides maximum angiotensin II receptor blockade — delivering stronger neurohormonal blood pressure control than the lower Valsartan strength, with the added kidney and cardiovascular protection characteristic of full-dose ARB therapy.
What is Exval-A 5/160mg Used For?
- Hypertension (high blood pressure) — when 5/80mg is insufficient or full-dose Valsartan is clinically indicated (ہائی بلڈ پریشر)
- Cardiovascular risk reduction — long-term blood pressure control to reduce risk of heart attack, stroke, and kidney damage
- Step-up therapy — for patients previously on Exval-A 5/80mg requiring stronger Valsartan-component blood pressure control
- Simplified treatment — replacing separate Amlodipine and Valsartan tablets with one convenient daily combination
How Does Exval-A 5/160mg Work?
Amlodipine 5mg — Calcium Channel Blocker: Blocks L-type calcium channels in peripheral arterial smooth muscle cells — preventing calcium entry that drives vessel constriction. Arterial walls relax and widen, reducing peripheral vascular resistance and lowering blood pressure. Amlodipine's long half-life provides smooth, consistent 24-hour blood pressure control without peaks and troughs from a single daily dose.
Valsartan 160mg — Angiotensin II Receptor Blocker (ARB): At the full 160mg dose, Valsartan provides maximum selective blockade of AT1 receptors — completely preventing angiotensin II from constricting blood vessels and stimulating aldosterone-driven fluid and sodium retention. This stronger hormonal blockade compared to the 80mg dose delivers more potent blood pressure reduction and greater kidney and cardiovascular protective benefits — particularly valuable for patients with diabetes, proteinuria, or established cardiovascular disease.
Combined Effect: Standard-dose Amlodipine provides direct arterial relaxation while maximum-dose Valsartan comprehensively blocks the renin-angiotensin-aldosterone system — two complementary pathways delivering additive blood pressure control with meaningful organ protection beyond simple antihypertensive effect.
Dosage and Administration
⚠️ Take exactly as prescribed. Never stop suddenly — abrupt discontinuation can cause rebound hypertension. Blood pressure must be monitored regularly throughout treatment.
| Indication | Usual Dose | Frequency |
|---|---|---|
| Hypertension (step-up or standard combination therapy) | 1 tablet (5mg/160mg) | Once daily |
- Take once daily at the same time each day — with or without food
- Swallow whole with a full glass of water
- Maintain adequate fluid intake — particularly important during hot weather, illness, or exercise
- Your doctor may further titrate to 10/160mg if blood pressure targets remain unmet
Active Ingredients
| Ingredient | Strength per Tablet |
|---|---|
| Amlodipine Besilate | 5mg |
| Valsartan | 160mg |
Who Should NOT Take Exval-A 5/160mg?
- Known allergy to Amlodipine, Valsartan, or any calcium channel blocker or ARB
- Pregnancy — ARBs are absolutely contraindicated in pregnancy; can cause serious foetal harm
- Severe liver disease — Valsartan is primarily hepatically metabolised
- Severe aortic stenosis — Amlodipine requires caution in significant valve disease
- Concomitant use with Aliskiren in diabetic patients — contraindicated combination
Consult your doctor before use if you have: kidney or liver disease, heart failure, low blood pressure, electrolyte imbalances, or are taking ACE inhibitors, potassium-sparing diuretics, or potassium supplements.
Side Effects
Common:
- Ankle or leg swelling (oedema) — common Amlodipine class effect (پاؤں کی سوجن)
- Dizziness or lightheadedness — particularly on standing up quickly
- Flushing or facial warmth — Amlodipine-related arterial dilation effect
- Headache — particularly during the first few weeks of treatment
- Fatigue or mild nausea
Serious — seek medical attention immediately:
- Severe hypotension — sudden fainting or collapse, particularly with dehydration or illness (یہ طبی ہنگامی صورتحال ہے)
- Elevated potassium (hyperkalaemia) — muscle weakness, irregular heartbeat — risk increases at full 160mg Valsartan dose
- Kidney function deterioration — reduced urination, ankle swelling, unexplained weight gain
- Severe allergic reaction — facial swelling, difficulty breathing, widespread rash
- Worsening chest pain — rare paradoxical effect at start of Amlodipine in severe coronary disease
Drug Interactions
| Medicine | Interaction |
|---|---|
| ACE inhibitors (e.g., Enalapril, Ramipril) | Double renin-angiotensin blockade — increased hypotension and kidney failure risk; avoid combination |
| Aliskiren | Contraindicated in diabetic patients — increased hypotension, kidney failure, and hyperkalaemia risk |
| Potassium-sparing diuretics / Potassium supplements | Valsartan raises potassium — combined use significantly increases hyperkalaemia risk at 160mg dose |
| NSAIDs (e.g., Ibuprofen, Diclofenac) | Reduce Valsartan's antihypertensive effect and increase kidney damage risk |
| Simvastatin | Amlodipine increases Simvastatin exposure — muscle damage risk; dose cap of 20mg Simvastatin applies |
| Cyclosporine / Tacrolimus | Increases Valsartan blood levels — kidney toxicity monitoring required |
| Alcohol (شراب) | Worsens blood pressure lowering and dizziness — avoid excessive alcohol |
Storage Instructions
- Store below 25°C away from moisture and direct sunlight
- Keep in original packaging until use
- Keep out of reach of children (بچوں کی پہنچ سے دور رکھیں)
- Do not use after expiry date on the pack
Frequently Asked Questions (FAQs)
Q: What is the difference between Exval-A 5/80mg and 5/160mg? The 5/160mg contains a doubled Valsartan dose — prescribed when the 80mg Valsartan strength is not achieving blood pressure targets or when full ARB dosing is needed for additional kidney or cardiovascular protection.
Q: Why does Valsartan 160mg provide extra kidney protection compared to 80mg? Higher Valsartan doses provide more complete AT1 receptor blockade — reducing intraglomerular pressure and protein leakage more effectively, which is particularly beneficial for diabetic patients or those with early kidney disease.
Q: Can I take Exval-A 5/160mg during pregnancy? No — Valsartan is absolutely contraindicated in pregnancy and causes serious foetal kidney damage. Use reliable contraception and inform your doctor immediately if pregnancy occurs during treatment.
Q: Can I stop Exval-A if my blood pressure reads normal? No — normal readings confirm the medicine is working. Stopping suddenly causes rebound hypertension and significantly increases stroke and heart attack risk. Only stop under your doctor's direct supervision.
⚕️ Medical Disclaimer: This description is for general information only and does not replace professional medical advice. Always consult your doctor or pharmacist before starting or stopping this medicine. Never stop blood pressure treatment without medical guidance.
DRAP Registered | Prescription Required (Rx) | Take once daily — never stop without doctor's advice — avoid in pregnancy — monitor blood pressure and kidney function regularly