Blokatens (5/160-10/160)

Generic Name:
Amlodipine 5mg + Valsartan 160mg.
Amlodipine 10mg + Valsartan 160mg.
Company Name: Medizen Pharmaceuticals Industries.
Pharmaceutical Form: Film-coated tablets.
Composition:
Each film-coated tablet contains:
Active Ingredients:
Amlodipine besylate 6.4mg equivalent to amlodipine 5 mg free base or amlodipine besylate 12.8mg
equivalent to amlodipine 10mg free base + Valsartan 160mg.
Inactive Ingredients:
Magnesium stearate - microcrystalline cellulose - lactose monohydrate crospovidone - sodium starch
glycolate - colloidal silicon dioxide - polyethylene glycol - titanium dioxide.
Pharmacological Action:
Amlodipine is a dihydropyridine calcium channel blocker that inhibits the transmembrane influx of
calcium ions into vascular smooth muscle and cardiac muscle. Amlodipine inhibits calcium ion influx
across cell membranes selectively with a greater effect on vascular smooth muscle cells than on cardiac
muscle cells. Serum calcium concentration is not affected by amlodipine.
Amlodipine is a peripheral arterial vasodilator that acts directly on vascular smooth muscle to cause a
reduction in peripheral vascular resistance and reduction in blood pressure.
Valsartan: Angiotensin II is formed from angiotensin I in a reaction catalyzed by angiotensinconverting enzyme (ACE, kininase II.) Angiotensin II is the principal pressor agent of the reninangiotensin system with effects that include vasoconstriction, stimulation of synthesis and release of
aldosterone, cardiac stimulation, and renal reabsorption of sodium. Valsartan blocks the vasoconstrictor
and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II
to the AT1 receptor in many tissues, such as vascular smooth muscle and the adrenal gland.
Pharmacokinetics:
Peak plasma concentrations of amlodipine are reached 6 - 12 hours after administration. Absolute
bioavailability has been estimated to be between 64% and 90%. The bioavailability of amlodipine is
not altered by the presence of food. Amlodipine is converted to inactive metabolites via hepatic
metabolism and 60% of the metabolites excreted in the urine. Elimination half-life is about 30-50
hours. Steady state plasma levels of amlodipine are reached after 7 to 8 days of consecutive daily
dosing. Following oral administration of valsartan alone peak plasma concentrations of valsartan are
reached in 2 to 4 hours. Absolute bioavailability is about 25%. Food decreases the exposure to
valsartan by about 40%. The recovery is mainly as unchanged drug with only about 20% of dose
recovered
as
metabolites.
Following
oral
administration
of
Blokatens (amlodipine and valsartan), peak plasma concentrations of valsartan is 3 hours and
amlodipine are reached in 6-8 hours. The rate and extent of absorption of valsartan and amlodipine
from Blokatens are the same as when administered as individual tablets. No dosage adjustment is
needed in patients with mild-to-moderate liver or kidney diseases.
Indications and Usage:
Blokatens (amlodipine and valsartan) is indicated for the treatment of hypertension.
Dosage and Administration:
Using amlodipine doses of 5mg -10mg and valsartan doses of 160mg - 320mg, the antihypertensive
effects increased with increasing doses. The clinical response to Blokatens should be subsequently
evaluated and if blood pressure remains uncontrolled after 3-4 weeks of therapy, the dose may be
titrated up.
Contraindications:
Blokatens (amlodipine and valsartan) is contraindicated in patients who are hypersensitive to any
components of this product.
Warnings:
Hypotension: Excessive hypotension was seen in 0.4% of patients with uncomplicated hypertension
treated with Blokatens. Caution should be observed when initiating therapy in patients with heart
failure or recent myocardial infarction and in patients undergoing surgery or dialysis. Since the
vasodilation induced by amlodipine is gradual in onset, acute hypotension has rarely been reported

after oral administration. If excessive hypotension occurs with Blokatens, the patient should be placed
in a supine position and, if necessary, given an intravenous infusion of normal saline.
Increased Angina and/or Myocardial Infarction: Rarely, patients, particularly those with severe
obstructive coronary artery disease, have developed documented increased frequency, duration and/or
severity of angina or acute myocardial infarction on starting calcium channel blocker therapy or at the
time of dosage increase. The mechanism of this effect has not been elucidated. This fixed combination
drug is not indicated for the initial therapy of hypertension.
Precautions:
Impaired Hepatic Function: Caution should be exercised when administering amlodipine to patients
with severe hepatic impairment. As the majority of valsartan is eliminated in the bile, patients with
mild-to-moderate hepatic impairment, including patients with biliary obstructive disorders, showed
lower valsartan clearance. Care should be exercised in administering valsartan to these patients.
Impaired Renal Function: As a consequence of inhibiting the renin-angiotensin-aldosterone system,
changes in renal function may be anticipated in susceptible individuals.
Congestive Heart Failure: In general, calcium channel blockers should be used with caution in
patients with heart failure. Some patients with heart failure have developed increases in blood urea
nitrogen, serum creatinine and potassium on valsartan. These effects are usually minor and transient,
and they are more likely to occur in patients with pre-existing renal impairment. Dosage reduction
and/or discontinuation of the diuretic and/or valsartan may be required.
Beta-Blocker Withdrawal: should be by gradual reduction of the dose of beta-blocker.
Pregnancy and Nursing Mothers;
When pregnancy is detected, valsartan should be discontinued as soon as possible. Because of the
potential for adverse effects on the nursing infant, a decision should be made whether to discontinue
nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Drug Interactions:
When amlodipine and sildenafil were used in combination, each agent independently exerted its own
blood pressure lowering effect. Interactions were observed when valsartan was co-administered with
amlodipine, cimetidine, digoxin, furosemide, glyburide, hydrochlorothiazide or indomethacin.
Concomitant use of potassium sparing diuretics (e.g., spironolactone, triamterene, amiloride),
potassium supplements, or salt substitutes containing potassium may lead to increases in serum
potassium and in heart failure patients to increases in serum creatinine.
Adverse reactions
Peripheral edema (0.4%), vertigo (0.2%), nasopharyngitis and orthostatic hypotension.
Blokatens rarely causes palpitations, tachycardia, ear pain, diarrhea, nausea, constipation, dyspepsia,
abdominal pain, gastritis, vomiting, flatulence, hemorrhoids, dry mouth, toothache, colitis, fatigue,
chest pain, asthenia, pitting edema, pyrexia, pain, seasonal allergies, sinusitis, influenza, bronchitis,
pharyngitis, urinary tract infections, gastroenteritis, bronchitis acute, viral infection, tooth abscesses,
cystitis, gout, non-insulin dependent diabetes mellitus, hypercholesterolemia, arthralgia, back pain,
muscle spasms, pain in extremities, myalgia, osteoarthritis, joint swelling, musculoskeletal chest pain,
headache, sciatica, parasthesia, cerviocobrachial syndrome, carpal tunnel syndrome, hypoaesthesia,
sinus headache, somnolence, insomnia, anxiety, depression, hematuria, nephrolithiasis, pollakiuria,
erectile dysfunction, cough, pharyngolaryngeal pain and sinusitis.
Package:
Blokatens 5/160: Carton box containing 2 Aluminum/Aluminum strips; each strip contains 14 film
coated tablets with the insert leaflet.
Blokatens10/160: Carton box containing 2 Aluminum/Aluminum strips; each strip contains 14 film
coated tablets with the insert leaflet.
Storage:
Keep out of reach of children.
Keep at a temperature not exceeding 30C in a dry place.
Instructions for Patients:
-Keep this leaflet. You may need to read it again.
-If you have any further questions, ask your doctor or pharmacist.
-This medicine has been prescribed for you. Do not pass it on to others, it may harm them, even if their
symptoms are the same as yours.

-If any of the side effects gets serious or if you notice any side effects not listed in this leaflet, please
tell your doctor or pharmacist.