Comparative Pharmacology
Head-to-head clinical analysis: EXFORGE HCT versus HARMONYL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: EXFORGE HCT versus HARMONYL.
EXFORGE HCT vs HARMONYL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
EXFORGE HCT is a combination of amlodipine (a dihydropyridine calcium channel blocker), valsartan (an angiotensin II receptor blocker), and hydrochlorothiazide (a thiazide diuretic). Amlodipine inhibits calcium ion influx across cardiac and vascular smooth muscle cells, leading to vasodilation. Valsartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II. Hydrochlorothiazide increases excretion of sodium and water by inhibiting the Na+/Cl- symporter in the distal convoluted tubule.
Harmonyl is a centrally acting alpha-2 adrenergic agonist that reduces sympathetic outflow from the brainstem, leading to decreased peripheral vascular resistance and blood pressure.
One tablet orally once daily. Initial dose based on previous antihypertensive therapy; maximum dose is one tablet of 10 mg amlodipine/320 mg valsartan/25 mg hydrochlorothiazide per day.
25 mg orally once daily, taken with food. Maximum dose: 50 mg once daily.
None Documented
None Documented
Valsartan: 6 hours (terminal). Amlodipine: 30-50 hours (terminal), permits once-daily dosing. Hydrochlorothiazide: 6-15 hours (terminal).
Terminal half-life: 12–18 hours (mean 15 h); extends to 24–30 h in hepatic impairment
Valsartan: 13% excreted unchanged in urine, 83% in feces via biliary secretion. Amlodipine: 10% excreted unchanged in urine, 60% as metabolites in urine, 20-25% in feces. Hydrochlorothiazide: ≥95% excreted unchanged in urine.
Renal: 70% as unchanged drug; Biliary/fecal: 20% as metabolites; 10% other
Category C
Category C
Antihypertensive
Antihypertensive