Covam Tablet 5mg/80mg

About Covam Tablet 5mg/80mg

Covam Tablet Uses

• Hypertension (high blood pressure) in adults whose blood pressure is not adequately controlled on a single antihypertensive medicine.
• Reduction of cardiovascular events including heart attack and stroke in patients with hypertension and established cardiovascular disease.
• Management of hypertension in patients with coexisting conditions such as type 2 diabetes, chronic kidney disease, or stable coronary artery disease.
• Prevention of atherosclerosis progression by controlling blood pressure in high-risk patients.
• Stable angina pectoris in patients where the Amlodipine component provides coronary vasodilation and anti-anginal benefit alongside blood pressure control.

Covam Tablet Benefits

• Combines two complementary antihypertensive mechanisms in one tablet, providing additive blood pressure reduction that is greater than either medicine alone at equivalent doses.
• Amlodipine's vasodilatory effect reduces peripheral resistance while Valsartan blocks the renin-angiotensin-aldosterone system (RAAS), targeting two independent blood pressure pathways simultaneously.
• The Valsartan component mitigates the peripheral edema (ankle swelling) commonly caused by Amlodipine alone, improving tolerability.
• Once-daily dosing with 24-hour blood pressure coverage reduces the risk of early morning pressure surges, which are associated with the highest rates of cardiovascular events.
• Available in three strength combinations, allowing flexible titration to match the individual patient's blood pressure target and tolerability.

What Experts Say

Covam contains Amlodipine and Valsartan, two first-line antihypertensive agents from different drug classes combined to provide dual-pathway blood pressure control.

How It Works

Amlodipine is a dihydropyridine calcium channel blocker that blocks L-type voltage-gated calcium channels in vascular smooth muscle cells. By preventing calcium influx, it inhibits smooth muscle contraction, causing arterial vasodilation and reducing peripheral vascular resistance. This lowers blood pressure without significantly affecting heart rate at standard doses. Amlodipine also dilates coronary arteries, providing anti-anginal benefit by improving myocardial oxygen supply. Valsartan is an angiotensin II receptor blocker (ARB) that selectively antagonizes the AT1 receptor subtype. Blocking this receptor prevents angiotensin II from causing vasoconstriction, aldosterone release, and sodium and water retention, all of which raise blood pressure. By targeting the RAAS, Valsartan provides additional blood pressure reduction and organ protection effects that are independent of and complementary to those of Amlodipine.

The Edema Advantage

Peripheral edema (ankle and leg swelling) is the most common reason patients discontinue Amlodipine monotherapy. It occurs because Amlodipine's vasodilatory effect selectively dilates arterioles more than venules, increasing capillary hydrostatic pressure and causing fluid leakage into tissues. Valsartan counteracts this by reducing the venous tone and capillary pressure through its RAAS-blocking effect, significantly reducing the incidence and severity of Amlodipine-associated edema. Clinical trials have confirmed that the combination produces less peripheral edema than Amlodipine alone at equivalent blood pressure reduction, making Covam better tolerated for long-term use.

Clinical Note

Covam is a long-term or lifelong medicine for most patients with hypertension. It must not be stopped without medical advice, as blood pressure rebound can occur within days of discontinuation. Patients with diabetes or chronic kidney disease derive additional benefit from the Valsartan component beyond blood pressure reduction, as RAAS blockade slows the progression of diabetic nephropathy. Hyperkalemia is a clinically important risk when Valsartan is combined with ACE inhibitors, potassium supplements, or potassium-sparing diuretics, and this combination should be avoided or closely monitored.

Drug Class

• Dual Antihypertensive Combination.
• Amlodipine: Dihydropyridine Calcium Channel Blocker (CCB).
• Valsartan: Angiotensin II Receptor Blocker (ARB).

Packaging and Quantity

• 1 pack contains 14 tablets (2 strips of 7 tablets each).
• Available in 5mg/80mg, 5mg/160mg, and 10mg/160mg strength combinations.

When Not to Use Covam

• Known allergy or hypersensitivity to Amlodipine, Valsartan, or any other dihydropyridine or ARB medicine.
• Pregnancy, as Valsartan can cause serious fetal harm and death, particularly in the second and third trimesters.
• Severe liver disease or biliary cirrhosis.
• Severe kidney impairment or bilateral renal artery stenosis.
• Concurrent use of Aliskiren in patients with diabetes or renal impairment.
• Cardiogenic shock or hemodynamically unstable heart failure.

Covam Tablet 5mg/80mg formula

• Amlodipine + Valsartan

Available forms

• Tablets

How to use Covam Tablet 5mg/80mg?

• Covam may be taken with or without food.
• The tablet should be swallowed whole with a full glass of water. It should not be crushed or chewed.
• Covam should be taken at the same time each day to maintain consistent 24-hour blood pressure control.
• Blood pressure should be monitored regularly during treatment to confirm the target is being maintained.
• Potassium supplements and potassium-rich salt substitutes should be avoided unless specifically directed by a doctor, as Valsartan raises potassium levels.
• The standard adult starting dose is one tablet once daily at the lowest appropriate strength, titrated upward under medical supervision based on blood pressure response.
• The dose should not be changed or stopped without consulting a doctor. Sudden discontinuation can cause rebound hypertension.

Contraindications

The use of Covam is contraindicated in:

• Patients who have hypersensitivity to its active ingredients
• Severe hypotension
• Severe hepatic impairment, biliary cirrhosis, or cholestasis
• Acute myocardial infarction
• Shock
• Patients in second or third trimester of pregnancy
• Hemodynamically unstable heart failure

Drug Interactions

All current medicines, supplements, and herbal products must be disclosed to the prescribing doctor before starting Covam. Key interactions include:

• Aliskiren: Concurrent use with Valsartan is contraindicated in patients with diabetes or renal impairment due to the risk of severe hypotension, hyperkalemia, and acute kidney injury.
• ACE inhibitors such as lisinopril and enalapril: Combining with Valsartan doubles RAAS blockade, significantly increasing the risk of hypotension, hyperkalemia, and renal impairment.
• Potassium supplements and potassium-sparing diuretics: Valsartan raises potassium levels. Adding potassium supplementation or spironolactone increases the risk of dangerous hyperkalemia.
• NSAIDs such as ibuprofen and naproxen: Reduce the antihypertensive effect of both Amlodipine and Valsartan and increase the risk of kidney impairment.
• Lithium: Valsartan reduces renal clearance of lithium, raising lithium blood levels and the risk of toxicity. Lithium levels must be monitored closely.
• Simvastatin: Amlodipine inhibits CYP3A4 and can raise Simvastatin blood levels. The Simvastatin dose should not exceed 20mg daily when used with Amlodipine.
• Cyclosporine: Amlodipine may increase cyclosporine blood levels, requiring monitoring and possible dose adjustment.
• Rifampicin: This CYP3A4 inducer may reduce Amlodipine blood levels, potentially reducing blood pressure control.

Risks and warnings

• Pregnancy: Covam is contraindicated in pregnancy. Valsartan causes fetal harm including renal dysgenesis, oligohydramnios, limb contractures, and death in the second and third trimesters. Treatment must be stopped immediately if pregnancy is detected.
• Hyperkalemia: Valsartan raises serum potassium levels. The risk is significantly amplified by concurrent use of ACE inhibitors, potassium supplements, or potassium-sparing diuretics. Potassium levels and renal function must be monitored regularly.
• Kidney disease: Valsartan is renally cleared and can raise serum creatinine. Kidney function should be monitored during treatment. Covam is contraindicated in bilateral renal artery stenosis.
• Liver disease: Amlodipine is metabolized by the liver. Patients with significant hepatic impairment require dose reduction and careful monitoring.
• Volume depletion: Patients who are sodium or volume depleted from diuretics, vomiting, or diarrhea are at high risk of symptomatic hypotension when starting Covam. Volume status should be corrected before initiating treatment.
• Breastfeeding: Valsartan is not recommended during breastfeeding. Amlodipine passes into breast milk. A doctor must be consulted before using Covam during breastfeeding.
• Elderly patients: Older adults are more sensitive to blood pressure lowering, particularly on standing. The lowest effective dose should be used and blood pressure monitoring should be more frequent.
• Driving and machinery: Covam may cause dizziness. Caution is advised when driving or operating heavy machinery, particularly at the start of treatment.

Covam Tablet Side Effects

Most patients tolerate Covam well. The combination of Amlodipine and Valsartan produces fewer side effects than higher doses of either medicine alone.

• Dizziness or lightheadedness, particularly when standing up quickly (orthostatic hypotension).
• Ankle or leg swelling, though less common than with Amlodipine monotherapy.
• Flushing or a sensation of warmth in the face.
• Fatigue or tiredness.
• Nausea or mild stomach discomfort.
• Upper respiratory tract infections.

Serious side effects are rare. Medical attention should be sought immediately if any of the following occur:

• Swelling of the face, lips, tongue, or throat, which may indicate angioedema, a rare but serious reaction associated with ARBs.
• Signs of high potassium including muscle weakness, irregular heartbeat, or numbness.
• Significant reduction in urination or unusual swelling, which may indicate kidney impairment.
• Chest pain or worsening shortness of breath.
• Severe dizziness or fainting, indicating a significant drop in blood pressure.

Storage Conditions

• Store the medicine at room temperature
• Keep out of reach and sight of children
• Protect it from sunlight and moisture