As a compound antihypertensive drug, the use of valsartan and amlodipine tablets (Atedio) in special populations requires special attention to medication adjustments during pregnancy, liver and kidney dysfunction, and other groups. The following is a classification based on pharmacological characteristics to explain the usage guidelines of this drug in special populations and briefly describe its contraindications.

1. Medication during pregnancy and lactation

(1) Pregnancy: Valsartan can cause fetal damage or even death, and is contraindicated during pregnancy. If pregnancy is detected, medication should be stopped immediately and a safe antihypertensive plan should be switched to.

(2) Breastfeeding period: Valsartan may be secreted into breast milk, while the secretion of amlodipine is unknown. It is recommended that lactating women stop taking medication or breastfeeding.

2. Medication for children and the elderly

(3) Children: Safety and efficacy data for patients under 18 years old have not been established, therefore it is not recommended to use.

(4) Elderly: Patients over 65 years old should be cautious when administering medication, and the initial dose can be halved as it is more likely to cause hypotension and renal dysfunction.

3. Patients with liver dysfunction

(5) Mild to moderate damage: Cilipine needs to be reduced by 50%, while valsartan does not require adjustment. Severe liver dysfunction is prohibited.

4. Patients with renal insufficiency

(6) Mild to moderate damage: creatinine clearance rate ≥ 30mL/min does not require adjustment. Patients with severe damage or dialysis should use caution and monitor their blood potassium levels.

5. Other special groups

(7) Electrolyte disorders: Patients with low sodium/insufficient blood volume should reduce the initial dose to prevent hypotension during the first dose.

(8) Bilateral renal artery stenosis: may worsen renal function deterioration, requiring close monitoring of creatinine changes.

6. Grapefruits and citrus fruits

(1) Grapefruit/Juice: Contains coumarin, which can inhibit CYP3A4 enzyme and significantly increase the blood concentration of cilnidipine, leading to an increased risk of hypotension. It is necessary to completely avoid intake during treatment.

(2) Seville Orange: Similar to grapefruit, it has CYP3A4 inhibitory effects and may enhance the toxicity of cilnidipine. It is recommended to avoid consumption.

7. High potassium foods

(3) Bananas/Spinach: Valsartan may increase blood potassium levels, and the combination of high potassium foods (such as bananas, spinach, potatoes) can easily cause hyperkalemia, especially for those with renal dysfunction who need to limit their intake.

(4) Low sodium salt: Potassium substituted sodium salts may combine with the potassium preserving effect of valsartan, increasing the risk of arrhythmia, and are not recommended for combination.