VALSARTAN/HYDROCHLOROTHIAZIDE TEVA-RATIOPHARM 160mg/25mg FILM-COATED TABLETS

2. What you need to know before you take Valsartan/Hydrochlorothiazide Teva-ratiopharm

Do not take Valsartan/Hydrochlorothiazide Teva-ratiopharm

• If you are allergic to valsartan, hydrochlorothiazide, sulfonamide derivatives (chemically related substances to hydrochlorothiazide) or to any of the other components of this medicine (listed in section 6).
• If you are pregnant for more than 3 months(it is also best to avoid the use of Valsartan/Hydrochlorothiazide Teva-ratiopharm during the first months of pregnancy, see section 2. Pregnancy and Breastfeeding)
• If you have a severe liver disease, destruction of the small bile ducts in the liver (biliary cirrhosis) leading to bile accumulation in the liver (cholestasis)
• If you have a severe kidney disease
• If you cannot produce urine (anuria)
• If you are undergoing dialysis
• If you have low potassium or sodium levels in your blood or if your blood calcium levels are higher than normal despite treatment.
• If you have gout.
• If you have diabetes mellitus or kidney failure and are being treated with a blood pressure-lowering medicine that contains aliskiren.

If any of these situations apply to you, inform your doctor and do not take Valsartan/Hydrochlorothiazide.

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

Warnings and precautions

Consult your doctor or pharmacist before starting to take Valsartan/Hydrochlorothiazide

• If you are taking potassium-sparing medicines, potassium supplements, salt substitutes that contain potassium, or other medicines that increase the amount of potassium in your blood, such as heparin. Your doctor may consider it necessary to regularly check your potassium levels.
• If you have low potassium levels in your blood.
• If you experience severe diarrhea or vomiting.
• If you are taking high doses of a diuretic.
• If you have severe heart disease.
• If you suffer from heart failure or have had a heart attack. Follow your doctor's instructions carefully when starting treatment. Your doctor may also check your kidney function.
• If you have narrowing of the kidney artery.
• If you have recently undergone a kidney transplant.
• If you have hyperaldosteronism, a disease in which the adrenal glands produce too much aldosterone hormone. In this case, Valsartan/Hydrochlorothiazide is not recommended.
• If you have kidney or liver disease.
• If you have ever experienced swelling of the tongue and face, caused by an allergic reaction called angioedema when taking another medicine (including ACE inhibitors), tell your doctor. If these symptoms occur when you are taking Valsartan/Hydrochlorothiazide, stop taking Valsartan/Hydrochlorothiazide immediately and do not take it again. See section 4 “Possible side effects”
• If you have fever, skin rash, and joint pain, which can be signs of systemic lupus erythematosus (SLE, a known autoimmune disease).
• If you have diabetes, gout, high cholesterol or triglyceride levels in your blood.
• If you have previously had an allergic reaction with the use of another medicine in this class to lower blood pressure (angiotensin II receptor antagonists), or if you suffer from any type of allergy or asthma.
• If you experience decreased vision or eye pain. This could be a symptom of fluid accumulation in the vascular layer of the eye (choroidal effusion) or an increase in pressure in your eyes and can occur from a few hours to weeks after taking Valsartan/Hydrochlorothiazide. If left untreated, it can lead to vision loss. If you have previously been allergic to penicillin or sulfonamides, you may be at higher risk of developing this.

• If you are taking any of the following medicines used to treat high blood pressure (high blood pressure)
• • an angiotensin-converting enzyme inhibitor (ACE inhibitor) (such as enalapril, lisinopril, ramipril), particularly if you have kidney problems related to diabetes.
  • aliskiren
• If you have had skin cancer or if you develop an unexpected skin lesion during treatment. Treatment with hydrochlorothiazide, especially long-term use at high doses, may increase the risk of certain types of skin and lip cancer (non-melanoma skin cancer). Protect your skin from sun exposure and UV rays while taking Valsartan/Hydrochlorothiazide Teva-ratiopharm.
• If you have experienced respiratory or lung problems (including inflammation or fluid in the lungs) after taking hydrochlorothiazide in the past. If you experience severe shortness of breath or difficulty breathing after taking this medicine, seek medical attention immediately.

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

See also the information under the heading “Do not take Valsartan/Hydrochlorothiazide”

Valsartan/Hydrochlorothiazide Teva-ratiopharm may cause increased sensitivity of the skin to the sun.

Tell your doctor if you are pregnant (or think you may be). It is not recommended to use Valsartan/Hydrochlorothiazide Teva-ratiopharm at the start of pregnancy, and in no case should it be administered if you are pregnant for more than 3 months, as it may cause serious harm to your baby when administered from that time on (see section “Pregnancy and Breastfeeding”).

Children and adolescents

The use of Valsartan/Hydrochlorothiazide Teva-ratiopharm is not recommended in children and adolescents (under 18 years of age).

Taking Valsartan/Hydrochlorothiazide with other medicines

Tell your doctor or pharmacist if you are using, have recently used, or might use any other medicines.

The effect of treatment with Valsartan/Hydrochlorothiazide Teva-ratiopharm may be altered if taken with certain medicines. It may be necessary to change the dose, take other precautions, or, in some cases, stop treatment with one of the medicines. This is especially applicable to the following medicines:

• lithium, a medicine used to treat certain psychiatric disorders

psychiatric disorders

• medicines or substances that can increase the amount of potassium in your blood. These include potassium supplements or salt substitutes that contain potassium, potassium-sparing medicines, and heparin

include potassium supplements or salt substitutes that contain potassium, potassium-sparing medicines, and heparin

• medicines that can reduce the amount of potassium in your blood, such as diuretics, corticosteroids, laxatives, ACTH (a hormone), carbenoxolone, amphotericin, penicillin G, salicylic acid, and derivatives.

• certain antibiotics (rifampicin group), a medicine used to protect against transplant rejection (cyclosporin) or an antiretroviral medicine used to treat HIV/AIDS (ritonavir). These medicines may increase the effect of Valsartan/Hydrochlorothiazide.

These medicines may increase the effect of Valsartan/Hydrochlorothiazide.

• medicines that can induce “torsades de pointes” (irregular heart rhythm), such as antiarrhythmics (medicines used to treat heart problems) and some antipsychotics.

and some antipsychotics.

• medicines that can reduce the amount of sodium in your blood, such as antidepressants, antipsychotics, antiepileptics.

antiepileptics.

• medicines for the treatment of gout, such as allopurinol, probenecid, sulfinpyrazone.
• therapeutic vitamin D and calcium supplements.
• medicines for the treatment of diabetes (oral antidiabetics such as metformin or insulins)

insulins)

• other medicines for lowering blood pressure, including methyldopa, angiotensin-converting enzyme inhibitors (ACE inhibitors) (such as enalapril, lisinopril, etc.) or aliskiren (see also the information under the headings “Do not take Valsartan/Hydrochlorothiazide” and “Warnings and precautions”).
• medicines that increase blood pressure, such as noradrenaline or adrenaline
• digoxin or other digitalis glycosides (medicines for treating heart problems).
• medicines that can increase blood sugar levels, such as diazoxide or beta blockers

beta blockers

• cytotoxic medicines (used to treat cancer), such as methotrexate or cyclophosphamide

cyclophosphamide

• medicines for pain such as non-steroidal anti-inflammatory agents (NSAIDs), including selective cyclooxygenase-2 (COX-2) inhibitors and acetylsalicylic acid >3g.

acetylsalicylic acid >3g.

• muscle relaxants, such as tubocurarine
• anticholinergic medicines (medicines used to treat a variety of disorders such as gastrointestinal cramps, bladder spasms, asthma, dizziness, muscle spasms, Parkinson's disease, and anesthetic aids), such as atropine or biperiden.

anesthetic aids), such as atropine or biperiden.

• amantadine (a medicine used to treat Parkinson's disease and also used to treat or prevent certain viral diseases)

viral diseases)

• cholestyramine and colestipol (medicines used primarily to treat high lipid levels in the blood).

high lipid levels in the blood).

• cyclosporin, a medicine used for organ transplantation to prevent organ rejection.
• alcohol, sleeping medicines, and anesthetics (sleeping medicines or painkillers, used, for example, during surgery)

used, for example, during surgery)

• iodine-containing contrast media (agents used for imaging tests).

Valsartan/Hydrochlorothiazide Teva-ratiopharm with food, drinks, and alcohol

You can take Valsartan/Hydrochlorothiazide with or without food.

Avoid drinking alcohol until you have consulted your doctor. Alcohol can further lower your blood pressure and/or increase the risk of dizziness and weakness.

Pregnancy and Breastfeeding

If you are pregnant or breastfeeding, think you may be pregnant, or plan to become pregnant, consult your doctor before using this medicine.

Pregnancy

• Tell your doctor if you are pregnant (or think you may be)

Your doctor will usually advise you to stop taking Valsartan/Hydrochlorothiazide Teva-ratiopharm before you become pregnant or as soon as you know you are pregnant and will recommend that you take another medicine instead of Valsartan/Hydrochlorothiazide Teva-ratiopharm. It is not recommended to use Valsartan/Hydrochlorothiazide Teva-ratiopharm at the start of pregnancy, and in no case should it be administered from the third month of pregnancy onwards, as it may cause serious harm to your baby when administered from that time on.

Breastfeeding

• Tell your doctor if you are breastfeeding or plan to start breastfeeding.

The use of Valsartan/Hydrochlorothiazide Teva-ratiopharm is not recommended during breastfeeding, and your doctor will choose another treatment for you if you want to breastfeed, especially if your baby is newborn or premature.

Driving and using machines

Before driving a vehicle, using tools, or operating machines, or carrying out other activities that require concentration, make sure you know how you react to the effects of Valsartan/Hydrochlorothiazide Teva-ratiopharm. Like many other medicines used to treat high blood pressure, Valsartan/Hydrochlorothiazide Teva-ratiopharm can cause, in rare cases, dizziness and affect your ability to concentrate.

This medicine contains less than 1 mmol of sodium (23 mg) per film-coated tablet, i.e., it is essentially “sodium-free”.

Use in athletes:

This medicine contains hydrochlorothiazide, which can produce a positive result in doping tests.

3. How to take Valsartan/Hydrochlorothiazide Teva-ratiopharm

Follow the instructions for administration of this medicine exactly as indicated by your doctor. This will help you achieve the best results and reduce the risk of side effects. If you are in doubt, consult your doctor or pharmacist again.

People with high blood pressure often do not notice any signs of the disease. Many feel normal. This makes it very important to attend your appointments with your doctor, even if you feel well.

Your doctor will tell you exactly how many Valsartan/Hydrochlorothiazide Teva-ratiopharm tablets you should take. Depending on how you respond to treatment, your doctor may suggest increasing or decreasing the dose.

• The recommended dose of Valsartan/Hydrochlorothiazide Teva-ratiopharm is one tablet per day.
• Do not change the dose or interrupt treatment without consulting your doctor.
• This medicine should be taken at the same time every day, usually in the morning.

morning.

• You can take Valsartan/Hydrochlorothiazide Teva-ratiopharm with or without food.
• Swallow the tablet with a glass of water.

If you take more Valsartan/Hydrochlorothiazide Teva-ratiopharm than you should

If you notice a strong dizziness and/or fainting, lie down and contact your doctor immediately. If you have accidentally taken too many tablets, contact your doctor, pharmacist, or hospital. You can also contact the Toxicology Information Service, phone: 91 562 04 20, indicating the medicine and the amount taken.

If you forget to take Valsartan/Hydrochlorothiazide Teva-ratiopharm

If you forget to take a dose, take it as soon as you remember. However, if it is almost time for the next dose, skip the missed dose.

Do not take a double dose to make up for missed doses.

If you stop taking Valsartan/Hydrochlorothiazide Teva-ratiopharm

If you stop your treatment with Valsartan/Hydrochlorothiazide Teva-ratiopharm, your hypertension may worsen. Do not stop taking the medicine unless your doctor tells you to.

If you have any doubts about the use of this medicine, ask your doctor or pharmacist.

4. Possible Adverse Effects

Like all medications, this medication can produce adverse effects, although not all people suffer from them.

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

• You should visit your doctor immediately if you notice symptoms of angioedema, such as:

• swelling in the face, tongue, or pharynx
• difficulty swallowing
• hives and difficulty breathing.

• decrease in vision or eye pain due to high pressure (possible signs of fluid accumulation in the vascular layer of the eye (choroidal effusion) or acute angle-closure glaucoma)

The frequency of these adverse effects is "unknown" (the frequency cannot be estimated from the available data)

• severe skin disease that causes skin rash, skin redness, blisters on the lips, eyes, or mouth, skin peeling, fever (toxic epidermal necrolysis)
• fever, sore throat, higher frequency of infections (agranulocytosis)
• acute respiratory distress (signs include severe difficulty breathing, fever, weakness, and confusion)

These adverse effects are very rare (may affect up to 1 in 10,000 people)

If you experience any of these symptoms, stop taking Valsartan/Hydrochlorothiazide and contact your doctor directly (see also section 2 "Warnings and Precautions")

Other adverse effects include:

Uncommon (may affect up to 1 in 100 people)

• cough
• low blood pressure
• dizziness
• dehydration (with symptoms of thirst, dry mouth and tongue, reduced frequency of

urination, dark-colored urine, dry skin)

• muscle pain
• fatigue
• tingling or numbness
• blurred vision
• noises (e.g., ringing or buzzing) in the ears

Rare (may affect up to 1 in 10,000 people)

• dizziness
• diarrhea
• joint pain

Frequency not known (cannot be estimated from the available data)

• breathing difficulties
• severe decrease in diuresis
• low sodium levels in the blood (which can trigger fatigue, confusion, muscle spasms, and/or severe convulsions)

• low potassium levels in the blood (sometimes with muscle weakness, muscle spasms, irregular heartbeat)

The following adverse effects have been observed in medications that contain valsartan or hydrochlorothiazide separately:

Valsartan

Uncommon (may affect up to 1 in 100 people)

• feeling of rotation
• abdominal pain

Rare (may affect up to 1 in 10,000 people)

• Intestinal angioedema: swelling in the intestine that presents symptoms such as abdominal pain, nausea, vomiting, and diarrhea

Frequency not known (cannot be estimated from the available data)

• blisters on the skin (sign of bullous dermatitis)
• skin rash with or without itching along with any of the following signs or symptoms:

fever, joint pain, muscle pain, lymph node inflammation, and/or flu-like symptoms

• skin rash, red-purple spots, fever, itching (symptoms of blood vessel inflammation)

Hydrochlorothiazide

Very common (may affect more than 1 in 10 people)

• low potassium levels in the blood
• increased lipids in the blood

Common (may affect up to 1 in 10 people)

• low sodium levels in the blood
• low magnesium levels in the blood
• high uric acid levels in the blood
• skin rash with itching and other types of rash
• loss of appetite
• mild vomiting and nausea
• dizziness, dizziness when standing up
• inability to achieve or maintain an erection

Rare (may affect up to 1 in 1,000 people)

• swelling and blisters on the skin (due to increased sensitivity to the sun)
• high calcium levels in the blood
• high blood sugar levels
• sugar in the urine
• worsening of diabetes mellitus.
• constipation, diarrhea, stomach or intestinal discomfort, liver disorders that may occur along with yellowing of the skin and eyes

Very rare (may affect up to 1 in 10,000 people)

• inflammation of blood vessels with symptoms such as skin rash, red-purple spots, fever (vasculitis)

Unknown frequency (cannot be estimated from the available data)

• weakness, bruising, and frequent infections (aplastic anemia)

• severe decrease in urine output (possible sign of kidney disorders or kidney failure)
• skin rash, redness, blisters on the lips, eyes, or mouth, skin peeling, fever (possible signs of erythema multiforme)

• muscle spasms
• fever (pyrexia)
• weakness (asthenia)
• skin and lip cancer (non-melanoma skin cancer)

Reporting of adverse effects:

If you experience any type of adverse effect, consult your doctor or pharmacist, even if it is a possible adverse effect that is not listed in this prospectus. You can also report them directly through the Spanish Pharmacovigilance System for Human Use Medicines: https://www.notificaram.es. By reporting adverse effects, you can contribute to providing more information on the safety of this medication.

5. Conservation of Valsartan/Hydrochlorothiazide Teva-ratiopharm

Keep this medication out of sight and reach of children.

Do not use this medication after the expiration date that appears on the packaging and blister pack after CAD. The expiration date is the last day of the month indicated.

Do not store at a temperature above 30°C.

Do not use Valsartan/Hydrochlorothiazide Teva-ratiopharm if you observe that the packaging is damaged or shows signs of deterioration.

Medications should not be thrown down the drain or into the trash. Deposit the packaging and medications you no longer need at the SIGRE point of your usual pharmacy. In case of doubt, ask your pharmacist how to dispose of the packaging and medications you no longer need. This way, you will help protect the environment.

6. Package contents and additional information

Composition of Valsartan/Hydrochlorothiazide Teva-ratiopharm

The active ingredients are valsartan and hydrochlorothiazide. Each tablet contains 160 mg of valsartan and 25 mg of hydrochlorothiazide.

The other components are: anhydrous colloidal silica, sodium starch glycolate, crospovidone, microcrystalline cellulose, cornstarch, and magnesium stearate.

The coating contains: hypromellose, macrogol 8000, talc, titanium dioxide (E171), red iron oxide (E172), black iron oxide (E172), yellow iron oxide (E172).

Appearance of Valsartan/Hydrochlorothiazide Teva-ratiopharm and package contents

Coated tablets, round, brown, engraved with "93" on one side and "7430" on the other side of the tablet.

The product is available in package sizes of 1, 14, 15, 28, 30, 50, 56, 60, 84, 90, 98, and 100 tablets.

Not all package sizes may be marketed.

Marketing authorization holder

TEVA PHARMA S.L.U.

C/ Anabel Segura, 11

Edificio Albatros B, 1ª planta

28108 Alcobendas (MADRID)

Manufacturer

Pharmachemie B.V.

Swensweg 5, Postbus 552,

2003 RN Haarlem

Netherlands

TEVA Pharmaceutical Works Private Limited Company

Pallagi út 13, 4042 Debrecen

Hungary

Teva Czech Industries s.r.o.

Ostravská 29, c.p. 305, 747 70 Opava -Komárov

Czech Republic

Teva Operations Poland Sp. z o.o.,

Mogilska 80 Str.

31-546 Kraków

Poland

Date of the last revision of this prospectus:March 2025

Detailed and updated information about this medication is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es/

You can access detailed and updated information about this medication by scanning the QR code included in the packaging with your mobile phone (smartphone). You can also access this information at the following internet address: https://cima.aemps.es/cima/dochtml/p/71149/P_71149.html

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