UNIVERSITI TEKNOLOGI MARA (UiTM)
PUNCAK ALAM CAMPUS
FACULTY OF HEALTH SCIENCES
BACHELOR OF PHYSIOTHERAPY (Hons.)
HS244
UPH654 KNOW YOUR MEDICINE
CASE STUDY 20%
PREPARED BY:
MUHAMMAD FA’IZ DANIAL BIN MUZAFFAR SHAH (2020468146)
HS244-4F
PREPARED FOR:
PN. NUR SABIHA BINTI MD HUSSIN
SUBMISSION DATE:
21st MAY 2021
Subject Information’s
Name Mr. M
Age 48 years old
Weight 90kg (Latest Early April)
Height 165.7cm (n.d)
BMI 32.8 (Obese Class I)
Past Medication Exforge 5mg/160mg
Current Medication Exforge 10mg/160mg
Social History Smoking: Non-smoker
Alcohol: Non-drinker
Recreational Drugs: N/A
Accommodation: Double-storey house
Marital Status: Married
Baseline Functioning: Good
Occupation: Banker (since 1997)
Nature of Work- Prolong sitting (Normally take a walk every
10 mins of sitting
Living Arrangement: Living with wife and 2 children
Living environment- Double-storey house, slightly having
difficulties in house (pain during squatting and climbing up
and down stairs), Sitting toilet.
Daily Lifestyle- Active Lifestyle (frequent having sport
activity 3-4 times per week, e.g., Badminton, ping pong,
30mins to 2 hrs durations)
Dominant side- Left side
Past medical conditions N/A
Current medical conditions Hypertension (since 35 y/o)
Medicine information’s
Generic Name Amlodipine and Valsartan
Brand Name Exforge 10mg/160mg
Specific indication Hypertension
• Indicated in adults whose blood pressure is not
adequately controlled on amlodipine or valsartan
monotherapy
(Krzesinski & Cohen, 2009; Lone & Candidate,
2008)
Strength 10mg- amlodipine free-base per tablet
160mg- valsartan per tablet
(Rxlist, 2020)
Dose One tablet (10mg/160mg) per day
Instruction on how to take the medicine The recommended dose of Exforge 10mg/160mg is
one tablet per day.
• Exforge may be administered with or without
food.
• Exforge may be administered with other
antihypertensive agents.
(Rxlist, 2020; EXFORGE ®, n.d.)
Formulation of the medicine Exforge is a fixed combination of amlodipine and
valsartan.
Amlodipine
• Amlodipine besylate's chemical name is 3-Ethyl-
5-methyl(4RS)-2-[(2-aminoethoxy)methyl]-4-
(2chlorophenyl)-6-methyl-1,4-dihydropyridine-
3,5-dicarboxylate benzenesulphonate
• Its empirical formula is C20H25ClN2O5•C6H6O3S
and its molecular weight is 567.1.
Valsartan
• Valsartan's chemical name is N-(1-oxopentyl)-N-
[[2'-(1H-tetrazol-5-yl) [1,1'-biphenyl]-4yl]methyl]-
L-valine
• Its empirical formula is C24H29N5O3 and its
molecular weight is 435.5.
(Rxlist, 2020)
Route of administrations Oral Administrations
Registrations Number Malaysian Registration Number:
Exforge 10mg/160mg: MAL20081729ARZ
(PDSB, 2018)
Medicine storage Bottles of 30 tablet / Blister pack of 30 tablet
1. Keep your tablets in the original container until it
is time to take them
2. Store them in a cool dry place below 30°C (room
temperature).
3. Do not store EXFORGE or any other medicine in
the bathroom or near a sink
4. Do not leave EXFORGE in the car or on window
sills.
Heat and dampness can destroy some
medicines. EXFORGE will keep well if it is cool
and dry.
(EXFORGE ®, n.d.)
Contraindications 1. Hypersensitivity to the active substances such as
Cellulose Microcrystalline, Magnesium Stearate
and Silica.
2. Severe hepatic impairment, biliary cirrhosis or
cholestasis.
3. Concomitant use of Exforge with aliskiren-
containing products in patients with diabetes
mellitus or renal impairment which the GFR is
less than60 ml/min/1.73 m2
4. Second and third trimesters of pregnancy
5. Severe hypotension.
6. Shock including cardiogenic shock
7. Obstruction of the outflow tract of the left ventricle
for example hypertrophic obstructive
cardiomyopathy and high-grade aortic stenosis
8. Hemodynamically unstable heart failure after
acute myocardial infarction.
(EMC, 2019)
Adverse reaction Infections and Infestations
Common: Nasopharyngitis, Influenza
Immune System Disorder
Rare: Hypersensitivity
Eye Disorder
Rare: Visual Disturbance
Psychiatric Disorder
Rare: Anxiety
Nervous System Disorder
Common: Headache
Uncommon: Dizziness Postural, Somnolence,
Paresthesia
Eat and Labyrinth Disorder
Uncommon: Vertigo
Rare: Tinnitus
Cardiac Disorder
Uncommon: Tachycardia, Palpitations
Rare: Syncope
Vascular
Uncommon: Orthostatic Hypotension
Rare: Hypotension
Respiratory, Thoracic and Mediastinal Disorder
Uncommon: Cough, Pharyngolaryngeal Pain
Gastrointestinal Disorder
Uncommon: Diarrhea, Nausea, Abdominal Pain,
Constipation, Dry Mouth
Skin and Subcutaneous Tissue Disorder
Uncommon: Rash, Erythema
Rare: Hyperhidrosis, Exanthema, Pruritus
Musculoskeletal and Connective Tissue Disorder
Uncommon: Joint Swelling, Back Pain, Arthralgia
Rare: Muscle Spasm, Sensation of Heaviness
Renal and Urinary Disorder
Rare: Pollakiuria, Polyuria
Reproductive system Disorder
Rare: Erectile Dysfunction
General Disorder
Common: Oedema, Fatigue, Flushing, Asthenia
(Exforge Full Prescribing Information, Dosage &
Side Effects | MIMS Malaysia, n.d.)
Use in pregnancy and lactations Exforge are contraindicated during pregnancy which
can cause harm towards the fetus
Administration of angiotensin converting enzyme
(ACE) inhibitors to pregnant women during the
second and third trimesters has been reported to
cause injury and death to the developing fetus.
In addition, in retrospective data, first trimester use
of ACE inhibitors has been associated with a
potential risk of birth defects.
(Exforge Full Prescribing Information, Dosage &
Side Effects | MIMS Malaysia, n.d.)
Shape Oval Film-coated tablet, imprinted with “NVR” on
one side and “UIC” on the other side.
Approximate size: 14.2 mm x 5.7 mm.
(EMC, 2019)
Colour Light yellow
(EMC, 2019)
Photo
References
EMC. (2019, August 28). Exforge 10mg/160mg film coated tablets - Summary of Product
Characteristics (SmPC) - (emc). Www.medicines.org.uk.
https://www.medicines.org.uk/emc/product/7769/smpc#gref
EXFORGE ®. (n.d.). Retrieved May 11, 2021, from
http://www.guildlink.com.au/gc/ws/nv/cmi.cfm?product=nvcexfor11213
Exforge Full Prescribing Information, Dosage & Side Effects | MIMS Malaysia. (n.d.).
Www.mims.com. Retrieved May 11, 2021, from
https://www.mims.com/malaysia/drug/info/exforge?type=full
EXFORGE ®. (n.d.). Retrieved May 11, 2021, from
http://www.guildlink.com.au/gc/ws/nv/cmi.cfm?product=nvcexfor11213
Krzesinski, J. M., & Cohen, E. P. (2009). Exforge® (amlodipine/valsartan combination) in
hypertension: The evidence of its therapeutic impact. Core Evidence, 4, 1–11.
https://doi.org/10.2147/ce.s6007
Khan, K. M., Iqtadar, S., Nasir, M., Siddiqui, A. S., & Rehman, A. (2020). Amlodipine/Valsartan
(Avsar®): Efficacy in Hypertensive Patients. A Real World Observational Study (ALERT).
Cureus, 12(5). https://doi.org/10.7759/cureus.8174
Lone, R., & Candidate, P. D. (2008). EXFORGE ®: A NEW COMBINATION TO TREAT
HYPERTENSION INSIDE THIS ISSUE: EXFORGE ®: A NEW COMBINATION TO TREAT
HYPERTENSION AND MARAVIROC (SELZENTRY ®): A NOVEL ANTIRETROVIRAL (Vol.
23).
PDSB. (2018). QUEST 3+ Product Search. Bpfk.gov.my.
https://quest3plus.bpfk.gov.my/pmo2/detail.php?type=product&id=MAL20081729ARZ
Rxlist. (2020, June 10). Exforge (Amlodipine and Valsartan): Uses, Dosage, Side Effects,
Interactions, Warning. RxList. https://www.rxlist.com/exforge-drug.htm#description
