Can Valsartan 320/12.5 Tablets Be Cut in Half?
No, you should not cut valsartan 320/12.5 combination tablets in half, as this would result in subtherapeutic dosing of both components and unpredictable drug delivery.
Why Splitting Is Not Recommended
Cutting this fixed-dose combination tablet creates multiple problems:
Subtherapeutic dosing: Splitting would yield valsartan 160 mg/HCTZ 6.25 mg per half-tablet, which is below the established therapeutic range for both components 1
Unvalidated dose: The 6.25 mg HCTZ dose has no evidence base for efficacy in hypertension management, as guidelines recommend HCTZ 12.5-50 mg daily 1
Inconsistent drug delivery: Fixed-dose combination tablets are not scored and may not split evenly, leading to variable dosing between halves 2, 3, 4
Appropriate Dosing Alternatives
If dose reduction is needed, prescribe a lower-strength fixed-dose combination tablet instead:
Valsartan 160/12.5 mg is the next lower available combination strength 2, 3, 4
Valsartan 80/12.5 mg is available for patients requiring further dose reduction 2, 3, 4
These validated combinations maintain the proven therapeutic ratio of both components 2, 3
Clinical Context for the 320/12.5 Dose
The valsartan 320 mg/HCTZ 12.5 mg combination represents high-dose therapy:
This combination achieves blood pressure goal in 84.8% of patients by week 8, with median time-to-goal of 2.1 weeks 2
In stage 2 hypertension, 75.8% of patients reach goal by week 8 with this dose 2
The valsartan 320 mg dose represents the maximum recommended daily dose for hypertension 1
If blood pressure is well-controlled on the 320/12.5 dose and reduction is desired:
Consider switching to valsartan 160/12.5 mg and monitor blood pressure response within 2-4 weeks 1
Alternatively, consider valsartan 320 mg monotherapy if the diuretic component is no longer needed 2, 3
Important Safety Considerations
When adjusting antihypertensive therapy: