AMLODIPINE/VALSARTAN KRKA 5 mg/160 mg FILM-COATED TABLETS

2. What you need to know before you take Amlodipine/Valsartan Krka

Do not take Amlodipine/Valsartan Krka:

• if you are allergic to amlodipine or any other calcium channel blocker. This may include itching, redness of the skin, or difficulty breathing.
• if you are allergic to valsartan or any of the other ingredients of this medicine (listed in section 6). If you think you may be allergic, inform your doctor before taking Amlodipine/Valsartan Krka.
• if you have severe liver problems or biliary problems such as biliary cirrhosis or cholestasis.
• if you are more than 3 months pregnant. (In any case, it is recommended to avoid taking this medicine also at the start of your pregnancy, see section Pregnancy).
• if you have severe low blood pressure (hypotension).
• if you have narrowing of the aortic valve (aortic stenosis) or cardiogenic shock (a situation where your heart is unable to supply enough blood to your body).
• if you have heart failure after a heart attack.
• if you have high blood sugar levels and have diabetes type 2 (also called non-insulin-dependent diabetes mellitus) or have a kidney function disorder and are being treated with a blood pressure-lowering medicine that contains aliskiren.

Do not take Amlodipine/Valsartan Krka and inform your doctor if any of the above applies to you.

Warnings and precautions

Consult your doctor before starting to take Amlodipine/Valsartan Krka:

• if you have been ill (with vomiting or diarrhea).
• if you have liver or kidney problems.
• if you have had a kidney transplant or if you have been told that you have narrowing of the arteries to your kidneys.
• if you have a disease that affects the adrenal glands called “primary hyperaldosteronism”.
• if you have had heart failure or have had a heart attack. Follow your doctor's instructions carefully to start the dosage. Your doctor may also check your kidney function.
• if your doctor has informed you that you have narrowing of the heart valves (so-called “aortic or mitral stenosis”) or that the thickness of your heart muscle has increased abnormally (so-called “hypertrophic obstructive cardiomyopathy”).
• if you have experienced swelling, particularly in the face and throat, while taking other medicines (including ACE inhibitors). If you have these symptoms, stop taking Amlodipine/Valsartan Krka and contact your doctor immediately. You should never take Amlodipine/Valsartan Krka again.
• if you are taking any of the following medicines used to treat high blood pressure:
• • an ACE inhibitor (e.g., enalapril, lisinopril, ramipril), especially if you have kidney problems related to diabetes.
  • aliskiren.

Your doctor may check your kidney function, blood pressure, and electrolyte levels (e.g., potassium) in your blood at regular intervals.

Consult your doctor if you experience abdominal pain, nausea, vomiting, or diarrhea after taking Amlodipine/Valsartan Krka. Your doctor will decide whether to continue treatment. Do not stop taking Amlodipine/Valsartan Krka on your own.

See also the information under the heading “Do not take Amlodipine/Valsartan Krka”.

Tell your doctor before taking Amlodipine/Valsartan Krka if any of the above applies to you.

Children and adolescents

Amlodipine/Valsartan Krka is not recommended for use in children and adolescents (under 18 years).

Using Amlodipine/Valsartan Krka with other medicines

Tell your doctor or pharmacist if you are using, have recently used, or might use any other medicines. Your doctor may need to change your dose and/or take other precautions. In some cases, you may need to stop taking one of the medicines. This is especially applicable to the medicines listed below:

• an ACE inhibitor or aliskiren (see also the information under the headings “Do not take Amlodipine/Valsartan Krka” and “Warnings and precautions”);
• diuretics (a type of medicine that increases the amount of urine);
• lithium (a medicine used to treat certain types of depression);
• potassium-sparing diuretics, potassium supplements, salt substitutes containing potassium, and other substances that may increase potassium levels;

certain types of painkillers called non-steroidal anti-inflammatory drugs (NSAIDs) or selective cyclooxygenase-2 (COX-2) inhibitors. Your doctor may also check your kidney function;

• anticonvulsants (e.g., carbamazepine, phenobarbital, phenytoin, fosphenytoin, primidone);
• St. John's Wort;
• nitroglycerin and other nitrates, or other substances called “vasodilators”;
• medicines used to treat HIV/AIDS (e.g., ritonavir, indinavir, nelfinavir);
• medicines used to treat fungal infections (e.g., ketoconazole, itraconazole);
• antibiotics (medicines used to treat bacterial infections) such as rifampicin, erythromycin, clarithromycin, telithromycin;
• verapamil, diltiazem (heart medicines);
• simvastatin (a medicine used to control high cholesterol levels);
• dantrolene (in infusion for severe body temperature abnormalities);
• medicines used to protect against rejection in a transplant (cyclosporine, tacrolimus).

Taking Amlodipine/Valsartan Krka with food and drinks

People taking Amlodipine/Valsartan Krka should not consume grapefruit or grapefruit juice. This is because grapefruit and grapefruit juice can lead to an increase in the levels of the active substance amlodipine in the blood, which can cause an unpredictable increase in the blood pressure-lowering effect of Amlodipine/Valsartan Krka.

Pregnancy and breastfeeding

Pregnancy

You should inform your doctor if you are pregnant, think you may be pregnant, or plan to become pregnant. In general, your doctor will advise you to stop taking Amlodipine/Valsartan Krka before you become pregnant or as soon as you find out you are pregnant, and recommend that you take another blood pressure-lowering medicine instead. Amlodipine/Valsartan Krka is not recommended during the first 3 months of pregnancy and should not be used from the third month of pregnancy onwards, as it may cause serious harm to your baby when used after this point.

Breastfeeding

Amlodipine has been shown to pass into breast milk in small amounts. Inform your doctor if you are about to start or are already breastfeeding, as it is not recommended to take Amlodipine/Valsartan Krka during this time. Your doctor may decide to give you a treatment that is more suitable if you want to breastfeed, especially for newborns or premature babies.

Consult your doctor or pharmacist before using any medicine.

Driving and using machines

This medicine may make you feel dizzy. This may affect your ability to concentrate. If you are unsure how this medicine will affect you, do not drive, use machines, or perform other activities that require concentration.

Amlodipine/Valsartan Krka contains sodium

This medicine contains less than 23 mg of sodium (1 mmol) per tablet; this is essentially “sodium-free”.

3. How to take Amlodipine/Valsartan Krka

Always take this medicine exactly as your doctor has told you. If you are unsure, check with your doctor. This will help you get the best results and reduce the risk of side effects.

The usual dose of Amlodipine/Valsartan Krka is one tablet per day.

• It is preferable to take the medicine at the same time each day.
• Swallow the tablets with a glass of water.
• You can take Amlodipine/Valsartan Krka with or without food. Do not take Amlodipine/Valsartan Krka with grapefruit or grapefruit juice.

Depending on your response to treatment, your doctor may suggest a higher or lower dose. Do not exceed the prescribed dose.

Amlodipine/Valsartan Krka and elderly patients (65 years or older)

Your doctor should exercise caution when increasing your dose.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

If you take more Amlodipine/Valsartan Krka than you should

If you have taken too many Amlodipine/Valsartan Krka tablets, or if someone else has taken your tablets, contact a doctor immediately.

Excess fluid can accumulate in the lungs (pulmonary edema) causing difficulty breathing that can develop up to 24-48 hours after ingestion.

If you forget to take Amlodipine/Valsartan Krka

If you forget to take this medicine, take it as soon as you remember. Then take the next dose at the usual time. However, if it is almost time for the next dose, do not take the missed dose. Do not take a double dose to make up for forgotten doses.

If you stop taking Amlodipine/Valsartan Krka

Stopping your treatment with Amlodipine/Valsartan Krka may cause your illness to worsen. Do not stop taking your medicine unless your doctor tells you to.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

4. Possible side effects

Like all medicines, Amlodipine/Valsartan Krka can cause side effects, although not everybody gets them.

Some side effects can be serious and require immediate medical attention:

A few patients have experienced these serious side effects (may affect up to 1 in 1,000 patients).If you notice any of the following, tell your doctor immediately:

Allergic reaction with symptoms such as skin rash, itching, swelling of the face, lips, or tongue, difficulty breathing, low blood pressure (feeling of fainting, dizziness).

Other possible side effects of Amlodipine/Valsartan Krka:

Frequent (may affect up to 1 in 10 patients):Flu; blocked nose, sore throat, and discomfort when swallowing; headache; swelling in the arms, hands, legs, ankles, or feet; tiredness; weakness; flushing and warmth of the face and/or neck.

Uncommon (may affect up to 1 in 100 patients):Dizziness; nausea and abdominal pain; dry mouth; drowsiness, tingling, or numbness of the hands or feet; vertigo, rapid heartbeat including palpitations; dizziness when standing up; cough; diarrhea; constipation; skin rash, redness of the skin; joint inflammation, back pain; joint pain.

Rare (may affect up to 1 in 1,000 patients):Feeling anxious; ringing in the ears (tinnitus); fainting; increased urination or urgent need to urinate; inability to get or maintain an erection; feeling of heaviness; low blood pressure with symptoms such as dizziness, fainting; excessive sweating; skin rash all over the body, itching, muscle spasms. Tell your doctor if any of the above is severe.

Side effects reported with amlodipine or valsartan alone and not observed with Amlodipine/Valsartan Krka or observed with a higher frequency than with Amlodipine/Valsartan Krka:

Amlodipine

Consult your doctor immediately if you experience any of the following serious side effects, which are very rare when taking this medicine:

• Sudden wheezing, chest pain, shortness of breath, or difficulty breathing.
• Swelling of the eyelids, face, or lips.
• Swelling of the tongue and throat, which can cause great difficulty breathing.
• Severe skin reactions, including intense skin rash, hives, redness of the skin all over the body, severe itching, blistering, peeling, and inflammation of the skin, inflammation of the mucous membranes (Stevens-Johnson syndrome, toxic epidermal necrolysis), or other allergic reactions.
• Heart attack, abnormal heartbeat.
• Pancreatitis, which can cause severe abdominal pain and back pain, accompanied by a feeling of being very unwell.

The following side effects have been reported. If any of these cause problems or last more than a week, consult your doctor.

Frequent (may affect up to 1 in 10 patients):Dizziness, drowsiness; palpitations (feeling the heartbeat); flushing, swelling of the ankles (edema); abdominal pain, feeling unwell (nausea).

Uncommon (may affect up to 1 in 100 patients):Mood changes, anxiety, depression, drowsiness, tremor, changes in taste, fainting, loss of pain sensation; visual disturbances, impaired vision, ringing in the ears; decreased blood pressure; runny nose/nasal congestion caused by inflammation of the nasal mucosa (rhinitis); indigestion, vomiting (nausea); hair loss, increased sweating, itching of the skin, skin discoloration; urinary disorders, increased need to urinate at night, increased number of times urinating; inability to get an erection, discomfort or breast enlargement in men, pain, feeling unwell, muscle pain, muscle cramps; weight gain or weight loss.

Rare (may affect up to 1 in 1,000 patients):Confusion.

Very rare (may affect up to 1 in 10,000 patients):Decreased number of white blood cells, decreased platelet count, which can cause easy bruising or bleeding (damage to red blood cells); high blood sugar (hyperglycemia); gum inflammation, abdominal swelling (gastritis); abnormal liver function, liver inflammation (hepatitis), yellowing of the skin (jaundice), increased liver enzymes, which can affect some medical tests; increased muscle tension; inflammation of blood vessels, often with skin rash; disorders combining stiffness, tremor, and/or movement disorders.

Frequency not known(cannot be estimated from the available data): tremor, rigid posture, mask-like face, slow movements, and difficulty walking and maintaining balance.

Valsartan

Very rare (may affect up to 1 in 10,000 patients):Intestinal angioedema: swelling in the intestine that occurs with symptoms such as abdominal pain, nausea, vomiting, and diarrhea.

Frequency not known (frequency cannot be estimated from the available data):Decreased number of red blood cells, fever, sore throat, or mouth ulcers due to infection; spontaneous bleeding or bruising; high potassium levels in the blood; abnormal liver function test results; decreased kidney function and severely decreased kidney function; swelling, mainly of the face and throat; muscle pain; skin rash, purplish-red spots; fever; itching; allergic reaction, blistering skin disease (sign of a disease called bullous dermatitis).

If you experience any of the above, consult your doctor immediately.

Reporting of side effects

If you experience any side effects, talk to your doctor, pharmacist, or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Spanish Pharmacovigilance System for Human Use Medicines: https://www.notificaram.es. By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storage of Amlodipine/Valsartan Krka

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the carton and blister after EXP. The expiry date is the last day of the month shown.

Do not store above 30°C.

Medicines should not be disposed of via wastewater or household waste. Dispose of the packaging and any unused medicine in the pharmacy's SIGRE collection point. If in doubt, ask your pharmacist how to dispose of the packaging and unused medicine. This will help protect the environment.

6. Package Contents and Additional Information

Composition of Amlodipine/Valsartan Krka

• The active substances are Amlodipine and Valsartan 5mg / 160 mg film-coated tablets:

Each film-coated tablet contains 5 mg of amlodipine (as amlodipine besylate) and 160 mg of valsartan.

• The other ingredients are microcrystalline cellulose, magnesium stearate, sodium croscarmellose, povidone K25, sodium lauryl sulfate, mannitol, and anhydrous colloidal silica in the tablet core, and polyvinyl alcohol, titanium dioxide (E171), macrogol 3000, talc, and yellow iron oxide (E172) in the coating.

See section 2: "Amlodipine/Valsartan Krka contains sodium"

Appearance and Package Contents of the Product

Amlodipine/Valsartan Krka 5 mg/160 mg film-coated tablets (tablets): this medicine is presented as yellow-brown, oval, biconvex film-coated tablets with possible dark spots (tablet diameter: 13x8 mm, thickness: 3.8 mm-5.4 mm).

Tablets 5 mg/160 mg and 10 mg/160 mg: Blister (OPA/Alu/PVC-Alu sheets): 28, 30, 56, 90, 98, and 100 tablets, in a box.

Only some pack sizes may be marketed.

Marketing Authorization Holder

KRKA, d.d., Novo mesto, Šmarješka cesta 6, 8501 Novo mesto, Slovenia

Manufacturer

KRKA, d.d., Novo mesto, Šmarješka cesta 6, 8501 Novo mesto, Slovenia

TAD Pharma GmbH, Heinz-Lohmann-Str. 5, 27472 Cuxhaven, Germany

Krka-farma d.o.o., V. Holjevca 20/E, 10 450 Jastrebarsko, Croatia

Further information about this medicine can be obtained from the local representative of the marketing authorization holder:

KRKA Farmacéutica, S.L., C/ Anabel Segura 10, Pta. Baja, Oficina 1, 28108 Alcobendas, Madrid, Spain

This medicine is authorized in the EEA Member States with the following names:

Date of last revision of this leaflet:June 2025

Detailed and up-to-date information on this medicine is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) (http://www.aemps.gob.es/)