Co Vals

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Co Vals

Medically reviewed

Marina Burgos

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Co Vals

Quick Facts about Co-Vals

Property Description
Active Ingredients Valsartan, Hydrochlorothiazide (HCTZ)
Form Tablet (Oral dosage form)
Pharmacological Class ARB/Diuretic combination (Antihypertensive agent)
Common Use Management of essential hypertension
Origin Synthetic compounds

What Type of Medicine is Co-Vals?

Co-Vals is a prescription-only medicine administered as an oral dosage form (tablet), structurally classified as a Fixed-Dose Combination (FDC) antihypertensive agent. This proprietary combination provides two distinct pharmacological actions in a single unit. It belongs to the class of ARB/Diuretic combination drugs, integrating the Angiotensin II Receptor Blocker (ARB), Valsartan, and the Thiazide diuretic, Hydrochlorothiazide (HCTZ). The design of the FDC is clinically recognized for its ability to enhance treatment adherence compared to taking two separate tablets, offering a strategic approach to continuous pressure control.

This specific formulation is similar to other globally known Valsartan/HCTZ combinations, confirming its foundation in established medical practice for patients needing dual therapy.


Composition and General Purpose

The medicine's composition features two principal synthetic active ingredients: Valsartan and Hydrochlorothiazide (HCTZ). Valsartan acts on the body's Renin-Angiotensin-Aldosterone System (RAAS) to promote the relaxation of blood vessels, while HCTZ increases the kidney's excretion of salt (natriuresis) and water (diuresis). The FDC design targets patients with essential hypertension who require the sustained efficacy of combined therapy to meet their blood pressure goals.

Combining an ARB and a diuretic is recognized for its benefit in effectively lowering blood pressure in patients who do not respond adequately to a single-agent therapy. The overall therapeutic purpose of Co-Vals is to effectively and sustainably lower arterial pressure, which is central to long-term cardiovascular risk reduction.

What side effects are possible with Co Vals?

Possible Side Effects and Safety Information

Co Vals (a combination product containing an Angiotensin II Receptor Blocker, valsartan, and a diuretic, hydrochlorothiazide) is associated with safety information that includes warnings related to its drug class and the individual components.

Serious and Clinically Significant Risks

The most critical safety warning pertains to Fetal Toxicity: The medication must be discontinued as soon as possible if pregnancy is detected, as drugs acting on the renin-angiotensin system can cause injury and death to the developing fetus, particularly in the second and third trimesters. The combination is also contraindicated in patients with a history of angioedema related to previous ARB or ACE inhibitor therapy.

Clinically significant adverse reactions often involve cardiovascular and renal systems, including symptomatic hypotension (low blood pressure), impaired renal function (which may progress to acute renal failure), and hyperkalemia (high potassium levels). Monitoring of fluid status, renal function, and serum potassium is a noted safety measure for susceptible patients.

Common and Additional Safety Notes

Adverse reactions reported in clinical trials may include dizziness and nasopharyngitis. The diuretic component, hydrochlorothiazide, carries its own safety considerations, such as the potential for electrolyte imbalances (e.g., hypokalemia) and, rarely, severe cases of acute respiratory toxicity, including acute respiratory distress syndrome (ARDS).

Additionally, regulatory agencies have previously issued recalls and safety alerts concerning certain batches of valsartan active pharmaceutical ingredient (API) due to the presence of nitrosamine impurities (probable human carcinogens), which has affected the overall safety profile of products containing the substance.

Overdose and Emergency Response

Overdose and When to Seek Help

Overdosage with Co Vals (Valsartan/Hydrochlorothiazide) is primarily defined by the exaggerated effects of its two components. Seek immediate medical attention for a suspected overdosage and contact a regional poison control centre for management guidance. Treatment is symptomatic and supportive, as no specific antidote is known.


Documented Manifestations and Severe Outcomes

Component Risk Manifestation/Outcome
Valsartan (ARB) Marked hypotension, leading potentially to circulatory collapse, shock, and a depressed level of consciousness.
Hydrochlorothiazide (HCTZ) Excessive diuresis, dehydration, and severe electrolyte depletion (e.g., hypokalemia, hyponatremia).

Procedural and Population Notes

If symptomatic hypotension occurs, supportive treatment involves placing the patient in a supine position and, if necessary, administering an intravenous infusion of normal saline. The risk of hepatic coma is noted in regulatory labeling for patients with impaired hepatic function due to fluid and electrolyte changes from HCTZ overdose. Regulators state that Valsartan is not removed from the plasma by dialysis, and the extent of HCTZ removal by hemodialysis has not been established.

Therapeutic Uses of Co Vals

What Co Vals Treats: Main Uses and Benefits

This combination medication is primarily used for managing persistent, high blood pressure (hypertension) in adults. Specifically, it is commonly applied in situations where blood pressure remains elevated despite treatment with a single drug, or when patients are deemed likely to require dual therapy to meet their blood pressure goals. This treatment strategy is applied across domains where additional symptomatic support is needed to help manage this chronic condition.

The main therapeutic benefit is applied in addressing the long-term risk of serious, pressure-related complications, such as stroke, heart attack, and heart failure. By combining two different agents, this complementary dual treatment may assist in achieving therapeutic blood pressure goals, which supports the protection of vital organs. This combination strategy may help support a simpler daily regimen, which assists patients with maintaining functional stability in their routine.

“This medication is applied across domains where additional symptomatic support is needed to manage persistent high blood pressure.”


Quick Fact: Support for Persistent High Blood Pressure

Co Vals is commonly used across conditions presenting with heightened systemic burden, such as when high blood pressure is difficult to manage with a single agent.

Eligibility and Restrictions for Use

Who Can and Cannot Use Co Vals?

This section defines population eligibility for Co-Vals (Valsartan/Hydrochlorothiazide) based strictly on official regulatory labeling, outlining mandatory exclusions and restrictions.


Contraindicated Populations (Absolute Non-Eligibility)

Category Regulatory Status
Pregnancy Contraindicated (especially second and third trimesters, due to fetal toxicity)
Anuria Contraindicated (absence of urine production)
Hypersensitivity Contraindicated to any component or other sulfonamide-derived drugs
Diabetes on Aliskiren Contraindicated when co-administered

Eligibility Restrictions

Age-Related Eligibility:

  • Adults are the approved population.
  • Pediatric Use (children/adolescents) is not established for the fixed-dose combination and is not recommended.
  • Older Adults are permitted for use, with monitoring for potential increased sensitivity.

Condition-Based Limitations:

  • Patients with severe renal impairment (CrCl leq 30 mL/min) or severe hepatic impairment are generally not recommended for use and should avoid it.
  • Use is restricted in patients with renal artery stenosis or conditions like volume/salt depletion, which must be corrected prior to initiation.

The regulatory profile strictly defines eligibility by these absolute prohibitions and restrictions, ensuring the medicine is only used by adults who meet specific criteria regarding organ function and physiological status.

What should I know about interactions with other medicines?

Interactions with other medicines and products

The interaction profile of Co-Vals (Valsartan/Hydrochlorothiazide) is defined by officially documented effects on drug exposure, electrolyte balance, and blood pressure, based strictly on regulatory prescribing information.

Interaction Classification Interacting Agents Official Constraint or Result
Contraindicated Combination Aliskiren Co-use is prohibited in patients with diabetes [FDA Label].
Exposure Modification Rifampin, Cyclosporine Increases the systemic exposure of Valsartan via inhibition of its hepatic uptake transporter [SmPC].
Absorption Constraint Cholestyramine, Colestipol Reduces Hydrochlorothiazide absorption; requires separation: take Co-Vals at least 4 to 6 hours before or 4 hours after the resin [FDA/Mayo Clinic].
Pharmacodynamic Risk Lithium Increases serum lithium concentrations and the risk of toxicity; requires monitoring [FDA Label].
Pharmacodynamic Risk Potassium Supplements, Potassium-Sparing Diuretics (e.g., Spironolactone) Co-use is not recommended due to an additive risk of hyperkalemia [SmPC].
Efficacy/Toxicity Risk NSAIDs (e.g., Indomethacin, Ibuprofen) May reduce antihypertensive effects and increase the documented risk of renal function deterioration, particularly in volume-depleted patients [FDA Label].

Combinations with alcohol, barbiturates, or narcotics are documented to result in the potentiation of orthostatic hypotension. The Hydrochlorothiazide component can alter glucose tolerance, which may necessitate a required dosage adjustment of co-administered antidiabetic agents [FDA Label]. Regulatory labeling explicitly states that CYP450-mediated drug interactions are unlikely for Valsartan due to its minimal metabolism.

Mechanism of Action

Co Vals acts through two distinct, complementary mechanisms to modulate cardiovascular physiology. The first component, Valsartan, functions as a selective, competitive antagonist at the Angiotensin II type 1 ( AT1) receptor. By binding to the AT1 receptor, Valsartan prevents Angiotensin II, a potent endogenous vasoconstrictor, from initiating its signaling cascade. This blockade limits the AT1 receptor-mediated increase in intracellular Ca^2+ and subsequent contraction of vascular smooth muscle. The second component, a diuretic (e.g., hydrochlorothiazide), primarily targets the Na^+/ Cl^- symporter ( NCC) in the distal convoluted tubule of the nephron. Inhibition of NCC reduces the reabsorption of Na^+ and Cl^- from the tubular filtrate. This results in a subsequent increase in the osmotic load presented to the collecting duct, leading to enhanced H2 O excretion and a reduction in extracellular fluid volume.

The combination results in lowered systemic vascular resistance and reduced plasma volume.

Dosage and Administration Information

How Co Vals is Used: Official Administration Guidelines

Co Vals is an oral medication administered as a fixed-dose combination tablet. The medicine is intended for once-daily administration and should be taken at the same time each day.


Standard Dosing and Schedule

Usage Feature Official Guideline
Route & Form Oral tablet, swallowed whole with water. May be taken with or without food.
Usual Starting Dose 160 mg Valsartan/ 12.5 mg HCTZ once daily.
Maximum Daily Dose 320 mg Valsartan/ 25 mg HCTZ.
Titration Timeline Dosage may be increased after one to two weeks if needed, with the maximal therapeutic effect generally attained within four weeks of adjustment.

Administration Constraints

Administration is subject to constraints regarding specific patient populations and initial body fluid status. The product is not recommended for use in patients under 18 years of age. Dose adjustments are generally not required for older adults or in cases of mild to moderate renal impairment.

However, a lower dose for the Valsartan component, typically not exceeding 80 mg, is necessary for patients with mild to moderate hepatic impairment without cholestasis. Furthermore, treatment should only be initiated after correction of any pre-existing volume or salt depletion. If a dose is missed, the patient should skip it if it is close to the next scheduled dose and should not take a double dose to compensate.

Recent Clinical Evidence

Research evidence / Overview of studies for Co Vals


Evidence for use in Co-Vals in Managing High Blood Pressure (Hypertension)

Research has evaluated Co-Vals in people who have been diagnosed with high blood pressure, a condition marked by functional limitations. These studies examined how outcomes related to blood pressure were monitored. The trials mainly focused on outcomes related to systemic or functional imbalance, specifically how blood pressure changed over defined time intervals.

The findings describe patterns observed in the studies regarding blood pressure levels measured during the study period. In the populations studied, the research describes patterns related to changes in these levels. However, it is important to remember that these results reflect the specific conditions under which they were conducted.


Evidence for use in Co-Vals in Treating Heart Failure

Co-Vals was observed in research involving patients with heart failure, a condition associated with acute or disruptive episodes and functional limitations. The studies explored how outcomes reflecting daily functioning or activity level and factors related to hospital stays were observed during the study.

Research highlights changes measured during the study period, including how patients reported their experience and how some physiological factors evolved. The data show patterns related to certain outcomes in the observed populations. Research contributes to the broader evidence landscape regarding management strategies for this condition.


Long-term studies and follow-up

Research focusing on the long-term effects are not fully established for Co-Vals. Studies examined patients over defined time intervals to see how patterns observed in studies persisted over time. The available findings describe patterns observed in the studies regarding the persistence of outcomes.

For both high blood pressure and heart failure, there is limited information for long-term outcomes beyond the scope of initial registration trials. Follow-up durations were limited, and data are still emerging on the durability of the observed responses over many years. This section primarily highlights what is currently known and where the duration of evidence ends.


Evidence in special populations

The use of Co-Vals was evaluated in certain groups, such as older adults and individuals with certain comorbid conditions (other existing health issues). Research examined how outcomes related to physical discomfort or other factors were monitored in these groups, who may have more complex health profiles.

For older adults, studies have explored how outcomes related to systemic or functional imbalance were monitored during the study period, compared to younger adults. However, data for certain groups remain insufficient. Specifically, research concerning the use of Co-Vals in pregnancy-related populations or children is often very limited or entirely absent.


What is still uncertain about Co-Vals

Scientific research, by its nature, always has questions that remain unanswered. For Co-Vals, the evidence quality varies across studies, and findings were mixed in some research areas. This section synthesizes the areas where certainty remains low and more research is needed.

One area of uncertainty relates to certain subgroup findings are uncertain due to limited patient numbers. Additionally, comparative evidence is lacking in some head-to-head comparisons against newer or alternative treatments. Research is ongoing to better fill these gaps in understanding.

Frequently Asked Questions (FAQ)

Common questions about Co Vals (FAQ)


Q: How long does the effect of one dose of Co Vals usually last?

Co Vals is typically taken once daily, indicating that the intended therapeutic effects last for an entire day. Regulatory information shows that the valsartan component inhibits the pressor effect of angiotensin II for up to 24 hours. The hydrochlorothiazide component, a diuretic, usually begins its main action within 2 hours and lasts for about 6 to 12 hours.


Q: Can I take Co Vals if I drink alcohol occasionally?

Official product information notes that using alcohol may increase the risk of orthostatic hypotension when combined with this medication. Orthostatic hypotension is a drop in blood pressure that can cause dizziness or fainting when standing up too quickly.


Q: Is there a risk of withdrawal symptoms if I stop Co Vals suddenly?

Regulatory documents do not specifically list or warn about withdrawal symptoms following abrupt discontinuation of this medication. However, decisions about stopping or changing treatment are best managed in consultation with a healthcare provider.


Q: Can Co Vals be cut in half or crushed?

The official instructions describe Co Vals as a tablet intended to be swallowed whole. The regulatory label does not include explicit instructions for cutting, crushing, or splitting the tablet.


Q: What happens if a pregnant person takes Co Vals?

Co Vals carries a Boxed Warning regarding the risk of Fetal Toxicity. This means the medicine can cause injury and death to a developing fetus, particularly if used during the second and third trimesters. Regulatory guidance requires that the medication be discontinued as soon as possible if pregnancy is detected.


Q: Are there any specific warnings about using Co Vals in hot or cold weather?

Official patient information advises caution, particularly during hot weather or intense physical activity. This is due to the diuretic component, which increases water and salt excretion. Excessive sweating or dehydration in high heat can lead to a risk of low blood pressure or electrolyte imbalances.


Q: Does Co Vals cause weight gain or weight loss?

Weight gain or weight loss are generally not listed as common side effects in the official documentation. The diuretic component works to reduce fluid volume, but this typically does not lead to significant weight changes. Very rare reports of fluid retention, which can cause weight gain, have been noted post-release as a potential sign of kidney changes.


Q: Is it normal to feel tired or dizzy when first starting Co Vals?

Dizziness was reported as a common adverse reaction during clinical trials. Official documentation indicates that fatigue and drowsiness may occur, particularly when treatment is initiated.


Q: Is there a maximum time limit for using Co Vals?

The medicine is generally indicated for the long-term management of conditions like hypertension. Official regulatory documents and prescribing information do not specify a maximum time limit for its use.


Q: Does Co Vals affect fertility?

Official regulatory information does not contain clear evidence that the active ingredients reduce fertility in men or women. Planning for conception should be discussed with a healthcare provider.


Q: What specific organs does the medicine mainly target?

Co Vals is a combination medicine with two main sites of action. The valsartan component primarily affects blood vessels, causing them to relax by blocking a specific receptor. The hydrochlorothiazide component primarily acts on the kidneys to increase the excretion of salt and water.


Q: Is Co Vals the same kind of medicine as [similar drug name]?

Co Vals is classified as a Fixed-Dose Combination medicine that pairs an Angiotensin II Receptor Blocker (ARB) with a Thiazide Diuretic. It contains the active components valsartan and hydrochlorothiazide, which is the basis for its comparison to other similar ARB/diuretic products.


Q: What makes Co Vals different from other treatments for the same condition?

This medicine is distinguished by its dual mechanism of action in a single tablet. It combines two different approaches to lower blood pressure: one component blocks a hormone receptor (valsartan), and the other increases fluid excretion from the kidneys (hydrochlorothiazide).


Q: Do I need to take Co Vals forever, or can I stop when I feel better?

The medicine is typically used for chronic conditions, such as high blood pressure, which require ongoing management. Official patient information related to chronic conditions typically advises continuing the medication even when symptoms are not noticeable.


Q: Are there any long-term side effects associated with Co Vals use?

Yes, the long-term use of the hydrochlorothiazide component has been associated with an increased risk of certain non-melanoma skin cancers. Patients using this medication long-term may be monitored for certain skin changes.


Q: Can Co Vals affect my sleep patterns?

Yes, regulatory documents list insomnia (difficulty sleeping) as an adverse reaction that was reported in clinical trials.


Q: What kind of studies were done to approve Co Vals?

The approval of this medicine is based on evidence primarily derived from controlled clinical trials. These studies compared the drug’s effectiveness in lowering blood pressure against a placebo or against its individual components.


Q: Is Co Vals considered a controlled substance?

No. Official regulatory labeling and schedules from the Drug Enforcement Administration (DEA) do not classify Co Vals (valsartan/hydrochlorothiazide) as a controlled substance.


Q: Does Co Vals interact with common pain relievers like ibuprofen or acetaminophen?

The official label notes interactions with Nonsteroidal Anti-inflammatory Drugs (NSAIDs), a class that includes ibuprofen. Combining Co Vals with NSAIDs may reduce the medicine’s blood pressure-lowering effect and increase the risk of worsening kidney function. Acetaminophen is not specifically named in the interaction profile.


Q: What are the symptoms of an overdose of Co Vals?

Based on limited data, the most likely signs of an overdose include severely low blood pressure (hypotension) and a fast heart rate (tachycardia). More serious effects such as profound drowsiness, confusion, circulatory collapse, and shock have also been reported.


Q: Does Co Vals contain any common allergens like gluten or lactose?

The medicine is made with several inactive ingredients, such as microcrystalline cellulose. Since the full list of excipients can vary by manufacturer, patients with specific allergies to common components like lactose or gluten should review the full inactive ingredient list on their specific product label.


Q: Can I drive or operate machinery while taking Co Vals?

Due to the potential for dizziness or fainting, the official label advises caution regarding driving or operating machinery until the individual knows how the medicine affects them.


Q: What is the difference between the immediate-release and extended-release forms of Co Vals?

The regulatory information describes the approved product as a standard oral tablet taken once daily. The official label and prescribing information do not currently describe or authorize alternative extended-release (ER) forms of the combination product.


Q: Is it OK to switch from one brand of Co Vals to a generic version?

Generic versions of valsartan and hydrochlorothiazide tablets are considered therapeutically equivalent to the brand-name product, meaning they are expected to work the same way in the body. Any switch in medication, even to a generic, requires the approval of the prescribing physician.


Q: Do mental health conditions affect the safety of taking Co Vals?

Clinical trials reported adverse reactions such as anxiety and insomnia. The official labeling does not list a specific contraindication for the use of Co Vals based on a pre-existing severe mental health condition.


Q: Why is Co Vals not recommended for people with [specific co-existing condition]?

The medicine is not recommended for certain populations due to the potential for serious health risks. Examples include a high risk of fetal harm in pregnancy or the possibility of worsening kidney function in patients with severe renal impairment.


Q: How is the safety of Co Vals monitored after it is released to the public?

The safety of the medicine is monitored through a system called postmarketing surveillance (pharmacovigilance). This process involves regulatory bodies continually collecting and evaluating reports of adverse reactions that occur after the drug is used by the general public.


Q: Does Co Vals cause dry mouth or changes in taste?

Dry mouth is a potential symptom that can be caused by the diuretic component of the medication, usually related to fluid or electrolyte problems. Changes in taste are not typically listed in the major adverse reaction sections of the official documents.

How should Co Vals be stored and disposed of?

Official Storage and Disposal Requirements

Co Vals (Valsartan/Hydrochlorothiazide) must be stored and disposed of strictly according to regulatory mandates to ensure product integrity and safety.

Storage Conditions

Requirement Official Statement
Temperature Store at controlled room temperature, typically 20 C to 25 C. Do not store above 25 C.
Protection Protect the tablets from moisture, light, excessive heat, and freezing.
Container Keep the medicine in a closed container or its original packaging. For bottles, the post-opening shelf-life is 100 days.
Child Safety The medicine must be kept out of the sight and reach of children.

Disposal Rules

Do not dispose of unused or expired Co Vals via wastewater or household waste. The product must be disposed of according to local requirements, which typically involves consulting a pharmacist for proper collection and handling.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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