Saudi Arabia - English - SFDA (Saudi Food and Drug Authority)- الهيئة العامة للغذاء والدواء

novartis - aliskiren, hydrochlorothiazide - film-coated tablet - 300, 25 mg

Singapore - English - HSA (Health Sciences Authority)

novartis (singapore) pte ltd - aliskiren - tablet, film coated - 150mg

Singapore - English - HSA (Health Sciences Authority)

novartis (singapore) pte ltd - aliskiren - tablet, film coated - 300mg

United States - English - NLM (National Library of Medicine)

par pharmaceutical inc. - candesartan cilexetil (unii: r85m2x0d68) (candesartan - unii:s8q36md2xx) - candesartan cilexetil 4 mg - candesartan cilexetil is indicated for the treatment of hypertension in adults and in children 1 to <17 years of age, to lower blood pressure. lowering blood pressure reduces the risk of fatal and non-fatal cardiovascular events, primarily strokes and myocardial infarctions. these benefits have been seen in controlled trials of antihypertensive drugs from a wide variety of pharmacologic classes including the class to which this drug principally belongs. control of high blood pressure should be part of comprehensive cardiovascular risk management, including, as appropriate, lipid control, diabetes management, antithrombotic therapy, smoking cessation, exercise, and limited sodium intake. many patients will require more than one drug to achieve blood pressure goals. for specific advice on goals and management, see published guidelines, such as those of the national high blood pressure education program’s joint national committee on prevention, detection, evaluation, and treatment of high blood pressure (jnc). numerous antihypertensive drugs, from a variety of pharmacologic classes and with different mechanisms of action, have been shown in randomized controlled trials to reduce cardiovascular morbidity and mortality, and it can be concluded that it is blood pressure reduction, and not some other pharmacologic property of the drugs, that is largely responsible for those benefits. the largest and most consistent cardiovascular outcome benefit has been a reduction in the risk of stroke, but reductions in myocardial infarction and cardiovascular mortality also have been seen regularly. elevated systolic or diastolic pressure causes increased cardiovascular risk, and the absolute risk increase per mmhg is greater at higher blood pressures, so that even modest reductions of severe hypertension can provide substantial benefit. relative risk reduction from blood pressure reduction is similar across populations with varying absolute risk, so the absolute benefit is greater in patients who are at higher risk independent of their hypertension (for example, patients with diabetes or hyperlipidemia), and such patients would be expected to benefit from more aggressive treatment to a lower blood pressure goal. some antihypertensive drugs have smaller blood pressure effects (as monotherapy) in black patients, and many antihypertensive drugs have additional approved indications and effects (e.g., on angina, heart failure, or diabetic kidney disease). these considerations may guide selection of therapy. candesartan cilexetil may be used alone or in combination with other antihypertensive agents. candesartan cilexetil is indicated for the treatment of heart failure (nyha class ii-iv) in adults with left ventricular systolic dysfunction (ejection fraction ≤ 40%) to reduce cardiovascular death and to reduce heart failure hospitalizations [see clinical studies (14.2) ] . candesartan cilexetil also has an added effect on these outcomes when used with an ace inhibitor [see drug interactions (7.4)] . candesartan cilexetil is contraindicated in patients who are hypersensitive to candesartan. do not co-administer aliskiren with candesartan cilexetil in patients with diabetes [see drug interactions (7.4)] . pregnancy category d use of drugs that act on the renin-angiotensin system during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death. resulting oligohydramnios can be associated with fetal lung hypoplasia and skeletal deformations. potential neonatal adverse effects include skull hypoplasia, anuria, hypotension, renal failure, and death. when pregnancy is detected, discontinue candesartan cilexetil as soon as possible. these adverse outcomes are usually associated with use of these drugs in the second and third trimester of pregnancy. most epidemiologic studies examining fetal abnormalities after exposure to antihypertensive use in the first trimester have not distinguished drugs affecting the renin-angiotensin system from other antihypertensive agents. appropriate management of maternal hypertension during pregnancy is important to optimize outcomes for both mother and fetus. in the unusual case that there is no appropriate alternative to therapy with drugs affecting the renin-angiotensin system for a particular patient, apprise the mother of the potential risk to the fetus. perform serial ultrasound examinations to assess the intra-amniotic environment. if oligohydramnios is observed, discontinue candesartan cilexetil, unless it is considered lifesaving for the mother. fetal testing may be appropriate, based on the week of pregnancy. patients and physicians should be aware, however, that oligohydramnios may not appear until after the fetus has sustained irreversible injury. closely observe infants with histories of in utero exposure to candesartan cilexetil for hypotension, oliguria, and hyperkalemia [see use in specific populations (8.4) ] . the effect of candesartan cilexetil on labor and delivery in humans is unknown [see warnings and precautions (5.1) ]. it is not known whether candesartan is excreted in human milk, but candesartan has been shown to be present in rat milk. because of the potential for adverse effects on the nursing infant, a decision should be made whether to discontinue nursing or discontinue candesartan cilexetil, taking into account the importance of the drug to the mother. neonates with a history of in utero exposure to candesartan cilexetil : if oliguria or hypotension occurs, direct attention toward support of blood pressure and renal perfusion. exchange transfusions or dialysis may be required as a means of reversing hypotension and/or substituting for disordered renal function. the antihypertensive effects of candesartan cilexetil were evaluated in hypertensive children 1 to < 17 years of age in randomized, double-blind clinical studies [see clinical studies (14.1) ] . the pharmacokinetics of candesartan cilexetil have been evaluated in pediatric patients 1 to < 17 years of age [see clinical pharmacology (12.3) ] . children < 1 year of age must not receive candesartan cilexetil for hypertension [see warnings and precautions (5.2) ].

United States - English - NLM (National Library of Medicine)

nucare pharmaceuticals, inc. - amlodipine besylate (unii: 864v2q084h) (amlodipine - unii:1j444qc288), benazepril hydrochloride (unii: n1sn99t69t) (benazeprilat - unii:jrm708l703) - amlodipine 5 mg - amlodipine besylate and benazepril hydrochloride capsules, usp are indicated for the treatment of hypertension in patients not adequately controlled on monotherapy with either agent.  - do not coadminister aliskiren with angiotensin receptor blockers, ace inhibitors, including amlodipine besylate and benazepril hydrochloride capsules in patients with diabetes. - amlodipine besylate and benazepril hydrochloride capsules are contraindicated in patients with a history of angioedema, with or without previous ace inhibitor treatment, or patients who are hypersensitive to benazepril, to any other ace inhibitor, to amlodipine, or to any of the excipients of amlodipine besylate and benazepril hydrochloride capsules. pregnancy category d use of drugs that act on the renin-angiotensin system during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death.  resulting oligohydramnios can be associated with fetal lung hypoplasia and skeletal deformati

United States - English - NLM (National Library of Medicine)

nucare pharmaceuticals, inc. - amlodipine besylate (unii: 864v2q084h) (amlodipine - unii:1j444qc288), benazepril hydrochloride (unii: n1sn99t69t) (benazeprilat - unii:jrm708l703) - amlodipine 5 mg - amlodipine besylate and benazepril hydrochloride capsules, usp are indicated for the treatment of hypertension in patients not adequately controlled on monotherapy with either agent.  - do not coadminister aliskiren with angiotensin receptor blockers, ace inhibitors, including amlodipine besylate and benazepril hydrochloride capsules in patients with diabetes. - amlodipine besylate and benazepril hydrochloride capsules are contraindicated in patients with a history of angioedema, with or without previous ace inhibitor treatment, or patients who are hypersensitive to benazepril, to any other ace inhibitor, to amlodipine, or to any of the excipients of amlodipine besylate and benazepril hydrochloride capsules. pregnancy category d use of drugs that act on the renin-angiotensin system during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death.  resulting oligohydramnios can be associated with fetal lung hypoplasia and skeletal deformati

United States - English - NLM (National Library of Medicine)

actavis pharma, inc. - amlodipine besylate (unii: 864v2q084h) (amlodipine - unii:1j444qc288), benazepril hydrochloride (unii: n1sn99t69t) (benazeprilat - unii:jrm708l703) - amlodipine 5 mg - amlodipine and benazepril hydrochloride capsules are indicated for the treatment of hypertension in patients not adequately controlled on monotherapy with either agent. - do not coadminister aliskiren with angiotensin receptor blockers (arbs), ace inhibitors, including amlodipine and benazepril hydrochloride capsules in patients with diabetes. - amlodipine and benazepril hydrochloride capsules are contraindicated in patients with a history of angioedema, with or without previous ace inhibitor treatment, or patients who are hypersensitive to benazepril, to any other ace inhibitor, to amlodipine, or to any of the excipients of amlodipine and benazepril hydrochloride capsules. pregnancy category d use of drugs that act on the ras during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death. resulting oligohydramnios can be associated with fetal lung hypoplasia and skeletal deformations. potential neonatal adverse effects include skull hypop

United States - English - NLM (National Library of Medicine)

actavis pharma, inc. - amlodipine besylate (unii: 864v2q084h) (amlodipine - unii:1j444qc288), benazepril hydrochloride (unii: n1sn99t69t) (benazeprilat - unii:jrm708l703) - amlodipine 5 mg - amlodipine and benazepril hydrochloride capsules are indicated for the treatment of hypertension in patients not adequately controlled on monotherapy with either agent. - do not coadminister aliskiren with angiotensin receptor blockers (arbs), ace inhibitors, including amlodipine and benazepril hydrochloride capsules in patients with diabetes. - amlodipine and benazepril hydrochloride capsules are contraindicated in patients with a history of angioedema, with or without previous ace inhibitor treatment, or patients who are hypersensitive to benazepril, to any other ace inhibitor, to amlodipine, or to any of the excipients of amlodipine and benazepril hydrochloride capsules. pregnancy category d use of drugs that act on the ras during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death. resulting oligohydramnios can be associated with fetal lung hypoplasia and skeletal deformations. potential neonatal adverse effects include skull hypop

United States - English - NLM (National Library of Medicine)

mylan pharmaceuticals inc. - eprosartan mesylate (unii: 8n2l1nx8s3) (eprosartan - unii:2kh13z0s0y) - eprosartan 600 mg - eprosartan mesylate tablets are indicated for the treatment of hypertension. they may be used alone or in combination with other antihypertensives such as diuretics and calcium channel blockers. eprosartan mesylate tablets are contraindicated in patients who are hypersensitive to this product or any of its components. do not co-administer aliskiren with eprosartan in patients with diabetes (see precautions: drug interactions).

United States - English - NLM (National Library of Medicine)

novartis pharmaceuticals corporation - sacubitril (unii: 17erj0mkgi) (sacubitrilat - unii:spi5pbf81s), valsartan (unii: 80m03yxj7i) (valsartan - unii:80m03yxj7i) - sacubitril 24 mg - entresto is indicated to reduce the risk of cardiovascular death and hospitalization for heart failure in adult patients with chronic heart failure. benefits are most clearly evident in patients with left ventricular ejection fraction (lvef) below normal. lvef is a variable measure, so use clinical judgment in deciding whom to treat [see clinical studies (14.1)] . entresto is indicated for the treatment of symptomatic heart failure with systemic left ventricular systolic dysfunction in pediatric patients aged one year and older. entresto reduces nt-probnp and is expected to improve cardiovascular outcomes. entresto is contraindicated: - in patients with hypersensitivity to any component - in patients with a history of angioedema related to previous ace inhibitor or arb therapy [see warnings and precautions (5.2)] - with concomitant use of ace inhibitors. do not administer within 36 hours of switching from or to an ace inhibitor [see drug interactions (7.1)] - with concomitant use of aliskiren in patients with diabetes [see drug interactions (7.1)] risk summary entresto can cause fetal harm when administered to a pregnant woman. use of drugs that act on the renin-angiotensin system during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death. most epidemiologic studies examining fetal abnormalities after exposure to antihypertensive use in the first trimester have not distinguished drugs affecting the renin-angiotensin system from other antihypertensive agents. in animal reproduction studies, entresto treatment during organogenesis resulted in increased embryo-fetal lethality in rats and rabbits and teratogenicity in rabbits. when pregnancy is detected, consider alternative drug treatment and discontinue entresto. however, if there is no appropriate alternative to therapy with drugs affecting the renin-angiotensin system, and if the drug is considered lifesaving for the mother, advise a pregnant woman of the potential risk to the fetus. the estimated background risk of major birth defects and miscarriage for the indicated population is unknown. in the u.s. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2-4% and 15-20%, respectively. clinical considerations fetal/neonatal adverse reactions oligohydramnios in pregnant women who use drugs affecting the renin-angiotensin system in the second and third trimesters of pregnancy can result in the following: reduced fetal renal function leading to anuria and renal failure, fetal lung hypoplasia, skeletal deformations, including skull hypoplasia, hypotension, and death. perform serial ultrasound examinations to assess the intra-amniotic environment. fetal testing may be appropriate, based on the week of gestation. patients and physicians should be aware, however, that oligohydramnios may not appear until after the fetus has sustained irreversible injury. if oligohydramnios is observed, consider alternative drug treatment. closely observe neonates with histories of in utero exposure to entresto for hypotension, oliguria, and hyperkalemia. in neonates with a history of in utero exposure to entresto, if oliguria or hypotension occurs, support blood pressure and renal perfusion. exchange transfusions or dialysis may be required as a means of reversing hypotension and replacing renal function. data animal data entresto treatment during organogenesis resulted in increased embryo-fetal lethality in rats at doses ≥ 49 mg sacubitril/51 mg valsartan/kg/day (≤ 0.06 [lbq657, the active metabolite] and 0.72 [valsartan]-fold the maximum recommended human dose [mrhd] of 97/103 mg twice-daily on the basis of the area under the plasma drug concentration-time curve [auc]) and rabbits at doses ≥ 5 mg sacubitril/5 mg valsartan/kg/day (2-fold and 0.03-fold the mrhd on the basis of valsartan and lbq657 auc, respectively). entresto is teratogenic based on a low incidence of fetal hydrocephaly, associated with maternally toxic doses, which was observed in rabbits at an entresto dose of ≥ 5 mg sacubitril/5 mg valsartan/kg/day. the adverse embryo-fetal effects of entresto are attributed to the angiotensin receptor antagonist activity. pre- and postnatal development studies in rats at sacubitril doses up to 750 mg/kg/day (2.2-fold the mrhd on the basis of lbq657 auc) and valsartan at doses up to 600 mg/kg/day (0.86-fold the mrhd on the basis of auc) indicate that treatment with entresto during organogenesis, gestation and lactation may affect pup development and survival. risk summary there is no information regarding the presence of sacubitril/valsartan in human milk, the effects on the breastfed infant, or the effects on milk production. sacubitril/valsartan is present in rat milk. because of the potential for serious adverse reactions in breastfed infants from exposure to sacubitril/valsartan, advise a nursing woman that breastfeeding is not recommended during treatment with entresto. data following an oral dose (15 mg sacubitril/15 mg valsartan/kg) of [14 c] entresto to lactating rats, transfer of lbq657 into milk was observed. after a single oral administration of 3 mg/kg [14 c] valsartan to lactating rats, transfer of valsartan into milk was observed. the safety and effectiveness of entresto in pediatric heart failure patients 1 to < 18 years old are supported by the reduction from baseline to 12 weeks in nt-probnp in a randomized, double-blind clinical study [see clinical studies (14.2)] . the analysis of nt-probnp included 90 patients age 6 to 18 years and 20 patients age 1 to 6 years. safety and effectiveness have not been established in pediatric patients less than 1 year of age. animal data sacubitril given orally to juvenile rats from postnatal day (pnd) 7 to pnd 35 or pnd 70 (an age approximately equivalent to neonatal through pre-pubertal development or adulthood in humans) at doses ≥ 400 mg/kg/day (approximately 2-fold the auc exposure to the active metabolite of sacubitril, lbq657, at an entresto pediatric clinical dose of 3.1 mg/kg twice daily) resulted in decreases in body weight, bone length, and bone mass. the decrease in body weight was transient from pnd 10 to pnd 20 and the effects for most bone parameters were reversible after treatment stopped. exposure at the no-observed-adverse-effect-level (noael) of 100 mg/kg/day was approximately 0.5-fold the auc exposure to lbq657 at the 3.1 mg/kg twice daily dose of entresto. the mechanism underlying bone effects in rats and the translatability to pediatric patients are unknown. valsartan given orally to juvenile rats from pnd 7 to pnd 70 (an age approximately equivalent to neonatal through adulthood in humans) produced persistent, irreversible kidney damage at all dose levels. exposure at the lowest tested dose of 1 mg/kg/day was approximately 0.2-fold the exposure at 3.1 mg/kg twice daily dose of entresto based on auc. these kidney effects in neonatal rats represent expected exaggerated pharmacological effects that are observed if rats are treated during the first 13 days of life. no relevant pharmacokinetic differences have been observed in elderly (≥ 65 years) or very elderly (≥ 75 years) patients compared to the overall population [see clinical pharmacology (12.3)] . no dose adjustment is required when administering entresto to patients with mild hepatic impairment (child-pugh a classification). the recommended starting dose in patients with moderate hepatic impairment (child-pugh b classification) is 24/26 mg twice daily. the use of entresto in patients with severe hepatic impairment (child-pugh c classification) is not recommended, as no studies have been conducted in these patients [see dosage and administration (2.6), clinical pharmacology (12.3)] . no dose adjustment is required in patients with mild (egfr 60 to 90 ml/min/1.73 m2 ) to moderate (egfr 30 to 60 ml/min/1.73 m2 ) renal impairment. the recommended starting dose in patients with severe renal impairment (egfr < 30 ml/min/1.73 m2 ) is 24/26 mg twice daily [see dosage and administration (2.5), warnings and precautions (5.4), and clinical pharmacology (12.3)] .