Prospect: information for the user

Co-Diován Forte 320mg/25mg film-coated tablets

Valsartan/hydrochlorothiazide

Read this prospect carefully before starting to take this medication,because it contains important information for you.

• Keep this prospect, as you may need to read it again.
• If you have any doubts, consult your doctor or pharmacist.
• This medication has been prescribedonlyto you, and you should not give it to other people even if they have the same symptomsas you, as it may harm them.
• Ifyou experienceadverse effects, consult your doctor or pharmacist, even if they do not appearin this prospect.See section 4.

1.What is Co-Diován Forte and for what it is used

2.What you need to know before starting to take Co-Diován Forte

3.How to take Co-Diován Forte

4.Possible adverse effects

5.Storage of Co-Diován Forte

6.Contents of the package andadditional information

Co-Diován Forte film-coated tablets contain two active ingredients known as valsartan and hydrochlorothiazide. These components help control high blood pressure (hypertension).

• Valsartanbelongs to a class of medications known as “angiotensin II receptor antagonists” that help control high blood pressure. Angiotensin II is a substance in the body that causes blood vessels to constrict, resulting in increased blood pressure. Valsartan acts by blocking the effect of angiotensin II. As a result, blood vessels relax and blood pressure decreases.
• Hydrochlorothiazidebelongs to a class of medications known as thiazide diuretics. Hydrochlorothiazide increases diuresis, which also decreases blood pressure.

Co-Diován Forte is used to treat high blood pressure that is not adequately controlled with the use of a single component.

Hypertension increases the workload of the heart and arteries. If left untreated, it can damage blood vessels in the brain, heart, and kidneys and may cause a stroke, heart failure, or kidney failure. High blood pressure increases the risk of heart attacks. Reducing blood pressure to normal values reduces the risk of developing these disorders.

Do not takeCo-Diován Forte

• if you are allergic (hypersensitive) to valsartan, hydrochlorothiazide, sulfonamide derivatives (substances chemically related to hydrochlorothiazide) or to any of the other components ofthis medicine (listed in section 6).

• if you are more than 3 months pregnant (in any case, it is better to avoid taking this medicine also at the beginning of your pregnancy – see Pregnancy section).
• if you have a severe liver disease, destruction of small bile ducts in the liver (biliary cirrhosis) leading to a buildup of bile in the liver (cholestasis).
• if you have a severe kidney disease.
• if you are unable to produce urine (anuria).
• if you are undergoing dialysis.
• if you have low levels of potassium or sodium in your blood, or if your blood calcium levels are higher than normal despite treatment.
• if you have gout.
• if you have diabetes or kidney insufficiency and are being treated with a blood pressure-lowering medicine containing aliskiren.

If any of these situations affect you, inform your doctor and do not take Co-Diován Forte.

Warnings and precautions

Consult your doctor

• if you are using potassium-sparing medicines, potassium supplements, salt substitutes containing potassium or other medicines that increase the amount of potassium in your blood, such as heparin. Your doctor may consider it necessary to regularly control your potassium levels.
• if you have low levels of potassium in your blood.
• if you experience severe diarrhea or vomiting.
• if you are taking high doses of a diuretic.
• if you have a severe heart disease.
• if you have heart failure or have had a heart attack. Follow your doctor's instructions carefully to start treatment. Your doctor may also monitor your kidney function.
• if you have a narrowing of the renal artery.
• if you have recently undergone a kidney transplant.
• if you have primary aldosteronism, a disease in which the adrenal glands produce too much aldosterone hormone. In this case, Co-Diován Forte is not recommended.
• if you have kidney or liver disease.
• if you have experienced swelling of the tongue and face caused by an allergic reaction called angioedema when taking other medicines (including ACE inhibitors), inform your doctor. If you have these symptoms when takingCo-Diován Forte, stop taking it immediately and never take it again. See also section 4 “Possible side effects”.
• if you have fever, skin rash and joint pain, which may be signs of systemic lupus erythematosus (a known autoimmune disease).
• if you have diabetes, gout, high levels of cholesterol or triglycerides in your blood.
• if you have previously experienced an allergic reaction with the use of another medicine of this class to lower blood pressure (angiotensin II receptor antagonists), or if you have any type of allergy or asthma.
• if you experience vision loss or eye pain. These may be symptoms of fluid accumulation in the vascular layer of the eye (choroidal effusion) or increased eye pressure, which can occur during a period of time ranging from several hours to weeks after taking Co-Diován Forte. If left untreated, thiscan lead to permanent vision loss. You may be at higher risk of developing it if you have previously been allergic to penicillin or sulfonamides.

• if you are taking any of the following medicines used to treat high blood pressure:
• • an ACE inhibitor (for example enalapril, lisinopril, ramipril), particularly if you have kidney problems related to diabetes.
  • aliskiren.
• if you have had skin cancer or if a skin lesion appears unexpectedly during treatment. The treatment with hydrochlorothiazide, particularly its 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 Co-Diován Forte.
• if you have had respiratory or pulmonary problems (such as inflammation or fluid in the lungs) after taking hydrochlorothiazide in the past. If you experience severe shortness of breath or difficulty breathing after taking Co-Diován Forte, see your doctor immediately.

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

See also the information under the heading “Do not take Co-Diován Forte”.

Co-DiovánForte may cause increased sensitivity to the sun.

Co-Diován Forte is not recommended for use in children and adolescents (under 18 years old).

If you are pregnant, if you suspect you may be pregnant, or if you plan to become pregnant, inform your doctor. Co-Diován Forte is not recommended for use at the beginning of pregnancy and should not be administered after the third month of pregnancy, as it may cause serious harm to your baby, see Pregnancy section.

Use of Co-Diován Forte withother medicines

Inform your doctor or pharmacist if you are using, have used recentlyor may need to useany other medicine.

The effect of treatment withCo-Diován Fortemay be altered if taken with certain medicines. Your doctor may need to modify your dose and/or take other precautions or, in some cases, discontinue treatment with one of the medicines. This is especially applicable to the following medicines:

• lithium, a medicine used to treat certain types of psychiatric diseases
• medicines or substances that may increase the amount of potassium in the blood. These include potassium supplements or salt substitutes containing potassium, potassium-sparing medicines, and heparin
• medicines that may decrease the amount of potassium in the blood, such as diuretics (urine-producing medicines), corticosteroids, laxatives, carbenoxolone, amphotericin or penicillin G
• some antibiotics (of the rifampicin group), a medicine used to protect against rejection in a transplant (ciclosporin) or an antiretroviral medicine used to treat HIV/AIDS (ritonavir). These medicines may increase the effect of Co-Diován Forte
• medicines that may induce “torsades de pointes” (irregular heartbeats), such as antiarrhythmics (medicines used to treat heart problems) and some antipsychotics
• medicines that may reduce the amount of sodium in the blood, such as antidepressants, antipsychotics, antiepileptics
• medicines used to treat gout, such as allopurinol, probenecid, sulfinpyrazone
• vitamin D therapy and calcium supplements
• medicines used to treat diabetes (insulin or oral antidiabetic medicines such as metformin)
• other medicines to lower blood pressure, including methyldopa, ACE inhibitors(such as enalapril, lisinopril, etc.,) or aliskiren(see also the information under the headings“Do not take Co-Diován Forte” and “Warnings and precautions”).
• medicines that increase blood pressure, such as noradrenaline or adrenaline
• digoxin or other digitalis glycosides (medicines used to treat heart problems)
• medicines that may increase blood sugar levels, such as diazoxide or beta-blockers
• cytotoxic medicines (used to treat cancer), such as methotrexate or cyclophosphamide
• pain medicines, such as non-steroidal anti-inflammatory drugs (NSAIDs), including selective COX-2 inhibitors and aspirin in doses above3 g
• muscle relaxants, such as tubocurarine
• anticholinergic medicines (medicines used to treat a wide range of disorders such as gastrointestinal cramps, bladder spasms, asthma, travel sickness, muscle spasms, Parkinson's disease, and as an aid to anesthesia)
• amantadine (a medicine used to treat Parkinson's disease and also to treat or prevent certain diseases caused by viruses)
• colestiramine and colestipol (medicines used mainly to treat high levels of lipids in the blood)
• ciclosporin, a medicine used to prevent organ rejection after transplant
• alcohol, sleep medicines, and anesthetics (medicines with sedative or pain-relieving effects used, for example, in surgery)
• contrast agents containing iodine (used for diagnostic imaging tests)

Co-Diován Forte with food, drinks, and alcohol

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

Pregnancy and breastfeeding

• You must inform your doctor if you are pregnant, if you suspect you may be pregnant, or if you plan to become pregnant.Generally, your doctor will advise you to stop taking Co-Diován Forte before becoming pregnant or as soon as you become pregnant, and recommend taking another antihypertensive medicine instead. Co-Diován Forte is not recommended for use at the beginning of pregnancy and should not be administered after the third month of pregnancy, as it may cause serious harm to your baby when administered from that point onwards.

• Inform your doctor if you are planning to start or are breastfeedingsince Co-Diován Forte is not recommended for use during this period. Your doctor may decide to administer a more suitable treatment if you want to breastfeed, especially for newborns or premature babies.

Driving and operating machinery

Before driving a vehicle, using tools, or operating machinery, or engaging in other activities that require concentration, make sure you know your reactions to the effects of Co-Diován Forte. Like many other medicines used to treat high blood pressure, Co-Diován Forte may cause, in rare cases, dizziness and affect concentration.

Always take this medication exactly as your doctor tells you to. This will help you get the best results and reduce the risk of side effects. If you are unsure, consult your doctor or pharmacist again.

People with high blood pressure often do not notice any symptoms 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 tablets of Co-Diován Forte you should take. Depending on how you respond to the treatment, your doctor may suggest increasing or decreasing the dose.

• The recommended dose of Co-Diován Forte is one tablet per day.
• Do not change the dose or stop treatment without consulting your doctor.
• This medication should be taken at the same time every day, usually in the morning.
• You can take Co-Diován Forte with or without food.
• Swallow the tablet with a glass of water.

If you take more Co-Diován Forte than you should

If you experience severe 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 medication and the amount taken.

If you forget to take Co-Diován Forte

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

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

If you interrupt treatment with Co-Diován Forte

If you stop taking Co-Diován Forte, your high blood pressure may worsen. Do not stop taking the medication unless your doctor tells you to.

If you have any other questions about the use of this medication, ask your doctor or pharmacist.

Like all medicines, this medicine can cause side effects, although not everyone will experience them.

Some side effects may 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 throat
• Difficulty swallowing
• Urticaria and difficulty breathing

• Severe skin disease that causes skin rash, skin redness, blisters on the lips, eyes, or mouth, skin peeling, fever (toxic epidermal necrolysis)
• Decreased vision or eye pain due to high blood pressure (possible signs of fluid accumulation in the vascular layer of the eye (choroidal hemorrhage) or acute angle-closure glaucoma)

• Fever, sore throat, increased frequency of infections (agranulocytosis)
• Severe respiratory difficulty, fever, weakness, and confusion (acute respiratory difficulty)

These side effects are very rare or of unknown frequency.

If you experience any of these symptoms, stop taking Co-Diován Forte and contact your doctor immediately (see also section 2 "Warnings and precautions").

Other side effects include:

Infrequent(may affect up to 1 in 10 people):

• Cough
• Low blood pressure
• Dizziness
• Dehydration (with symptoms of thirst, dry mouth and tongue, reduced urine frequency, dark urine, dry skin)
• Muscle pain
• Fatigue
• Tickling or numbness
• Blurred vision
• Ringing in the ears (e.g. tinnitus or buzzing)

Very rare(may affect fewer than 1 in 10,000 people):

• Dizziness
• Diarrhea
• Joint pain

Unknown frequency(cannot be estimated from available data):

• Severe difficulty breathing
• Severe decrease in urine production
• Low sodium levels in the blood (which, in severe cases, may cause fatigue, confusion, muscle fasciculations, and/or seizures)
• Low potassium levels in the blood (sometimes with muscle weakness, muscle spasms, abnormal heart rhythm)
• Low white blood cell count (with symptoms such as fever, skin infections, sore throat, or mouth ulcers due to infections, weakness)
• Increased bilirubin levels in the blood (which, in severe cases, may cause yellowing of the skin and eyes)
• Increased levels of urea nitrogen and creatinine in the blood (which may indicate abnormal kidney function)
• Increased levels of uric acid in the blood (which, in severe cases, may trigger a gout attack)
• Syncope (fainting)

The following side effects have been observed with valsartan or hydrochlorothiazide-containing medicines separately:

Valsartan

Infrequent(may affect up to 1 in 100 people):

• Sensation of rotation
• Abdominal pain

Unknown frequency(cannot be estimated from available data):

• Blisters on the skin (sign of dermatitis herpetiformis)
• Rash on the skin with or without itching, along with one or more of the following signs or symptoms: fever, joint pain, muscle pain, lymph node inflammation, and/or flu-like symptoms
• Rash on the skin, red-purple spots, fever, itching (signs of vasculitis)
• Low platelet count (sometimes with bleeding or bruising more frequently than usual)
• High potassium levels in the blood (sometimes with muscle spasms, abnormal heart rhythm)
• Allergic reactions (with symptoms such as rash, itching, urticaria, difficulty breathing or swallowing, dizziness)
• Swelling mainly of the face and throat; rash; itching
• Elevation of liver function values
• Decreased hemoglobin levels and reduced percentage of red blood cells in the blood (which, in severe cases, may cause anemia)
• Renal insufficiency
• Low sodium levels in the blood (which, in severe cases, may cause fatigue, confusion, muscle fasciculations, and/or seizures)

Hidroclorotiazida

Very frequent(may affect more than 1 in 10 people):

• Low potassium levels in the blood
• Increased levels of lipids in the blood

Frequent(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
• Rash on the skin with itching and other types of rash
• Decreased 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 diabetic metabolic state
• Constipation, diarrhea, stomach or intestinal discomfort, liver alterations that may appear with yellow skin and eyes
• Irregular heartbeat
• Headache
• Sleep disturbances
• Depression
• Low platelet count (sometimes with bleeding or bruising under the skin)
• Dizziness
• Tickling or numbness
• Visual disturbances

Very rare(may affect fewer than 1 in 10,000 people):

• Inflammation of blood vessels with symptoms such as rash, red-purple spots, fever (vasculitis)
• Rash, itching, urticaria, difficulty breathing or swallowing, dizziness (allergic reactions)
• Rash, joint pain, muscle disorders, fever (lupus erythematosus)
• Severe stomach pain (pancreatitis)
• Difficulty breathing with fever, cough, wheezing, shortness of breath (difficulty breathing that includes pneumonitis and pulmonary edema)
• Pale skin, fatigue, shortness of breath, dark urine (hemolytic anemia)
• Fever, sore throat, or mouth ulcers due to infections (leukopenia)
• Confusion, fatigue, muscle cramps, and spasms, rapid breathing (hypochloremic alkalosis)

Unknown frequency(cannot be estimated from available data):

• Weakness, bruising, and frequent infections (aplastic anemia)
• Severe decrease in urine production (possible signs of renal impairment or renal failure)
• Rash on the skin, skin redness, blisters on the lips, eyes, or mouth, skin peeling, fever (possible signs of erythema multiforme)
• Muscle spasms
• Fever (pyrexia)
• Weakness (asthenia)
• Skin cancer and lip cancer (non-melanoma skin cancer)

Reporting of side effects

If you experience any type of side effect, consult your doctor or pharmacist, even if it is a possible side effect that does not appear in this leaflet. You can also report them directly through theSpanish System for Pharmacovigilance of Medicines for Human Use (www.notificaRAM.es). By reporting side effects, you can contribute to providing more information on the safety of this medicine.

• Keep out of sight and reach of children.
• Do not usethis medicationafter the expiration date that appears on the packaging. The expiration date is the last day of the month indicated.
• Do not store at a temperature above30°C. Store in the original packaging to protect it from moisture.
• Do not usethis medicationif you observe that the packaging is damaged or shows signs of manipulation.
• Medicines should not be disposed of through drains or in the trash. Dispose of the packaging and unused medications at theSIGREcollection pointat the pharmacy. If in doubt, ask your pharmacist how to dispose of unused packaging and medications. By doing so, you will help protect the environment.

Composition ofCo-Diován Forte

• The active principles are valsartán and hidroclorotiazida. Each tablet contains 320 mg of valsartán and 25 mg of hidroclorotiazida.
• The other components are: celulosa microcristalina, crospovidona, sílice coloidal anhidra, estearato de magnesio.
• The coating of the tablet contains:hipromelosa, macrogol 4000, talco, óxido de hierro amarillo (E172), dióxido de titanio (E171).

Appearance of the product and contents of the package

The coated tablets of Co-Diován Forte 320 mg/25 mg are oval, with beveled edges, yellow in color, with the imprint mark “NVR” on one face and “CTI” on the other.

The tablets are presented in blister packs with 7 tablets, 14 tablets, 28 tablets in a calendar pack, 56 tablets, 98 tablets in a calendar pack or 280 tablets. Also available are pre-cut blister packs of 56x1, 98x1 or 280x1 tablets.

Only some package sizes may be marketed.

Marketing Authorization Holder

Novartis Farmacéutica, S.A.

Gran Via de les Corts Catalanes, 764

08013Barcelona

Spain

Responsible for manufacturing

Novartis Farma – Productos Farmacêuticos, S.A.

Avenida Professor Doutor Cavaco Silva, n.° 10E (Taguspark, Porto Salvo).

Oeiras Parish. 2740 255

Portugal

Novartis Farma S.p.A.

Via Provinciale, Schito131

IT-80058 Torre Annunziata / NA

Italy

Novartis Sverige AB

Torshamnsgatan 48

164 40 Kista

Sweden

Novartis Pharma GmbH

Roonstrasse 25

DE-90429 Nuremberg

Germany

Novartis Pharma GmbH

Jakov-Lind-Straße 5, Top 3.05

1020 Vienna

Austria

Novartis Pharma nv

Medialaan 40/Bus 1

BE-1800 Vilvoorde

Belgium

Novartis Farmacéutica S.A.

Gran Via de les Corts Catalanes, 764

08013 Barcelona

Spain

Novartis (Hellas) S.A.C.I.

12 km National Road

Atenas-Lamia.GR-14451. Metamorphoses

Greece

Novartis Pharma B.V.

Haaksbergweg 16,

1101 BX Amsterdam

Netherlands

Novartis Finland Oy

Metsäneidonkuja 10

FI-02130 Espoo

Finland

Novartis Hungária Kft.

Bartók Béla út 43-47.

1114 Budapest

Hungary

Novartis s.r.o.

Na Pankráci 1724/129

CZ-140 00 Prague 4, Nusle

Czech Republic

Novartis Poland Sp. zo.o.

ul. Marynarska 15

02-674 Warsaw

Poland

Novartis Pharma S.A.S.

8-10 rue Henri Sainte-Claire Deville

FR-92500 Rueil-Malmaison

France

Novartis Pharma GmbH

Sophie-Germain-Strasse 10

90443 Nuremberg

Germany

This medicinal product is authorized in themember states of the European Economic Area withthe following names:

Last revision date of this leaflet:02/2022

The detailed and updated information on this medicinal product is available on the website of the Spanish Agency for Medicines and Medical Devices (AEMPS) htpp://www.aemps.gob.es/