Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome on HCM!

Regarding your concern, I would like to explain that:

1) First of all it is necessary to exclude any primary acute digestive inflammatory/infectious disorder.

It is important to review your overall clinical status with a careful physical exam, check your body temperature and some additional lab tests:

- complete blood count,
- PCR,
- ESR,
- ALT & AST
- bilirubin,
- BUN & creatinine,
- blood electrolytes level,
- fasting blood glucose level,
- microbiological stool tests (if enough suspicions about infection are raised).

2) If a digestive inflammation/infection is ruled out, then other causes of diarrhea should be sought:

a - possible adverse effect of your new generic anti-hypertensive drugs (Valsartan + Amlodipine). This may be due to any hypersensitivity to certain tablet excipients or even to the active compounds.

You should know that in Exforge both drugs micro-particles are more homogeneously and properly mixed, making thus possible for Amlodipine to counteract any adverse effect of Valsartan (diarrhea). This in not achieved so suitably when the two drugs are taken apart.

b- possible adverse effect of Metformin. It is not rarely accused of causing diarrhea.

c- Also, diabetes related neuropathy (autonomic dysfunction) may be a cause of diarrhea. It is necessary to better control your blood glucose values and check glycosylated hemoglobin level.

d- Imipramine, as a result of a possible serotonin syndrome may be associated with diarrhea.

Coming to this point, I recommend consulting with your attending physician or an ER doctor to exclude first a digestive infection and after that to review your actual therapy and medical status (including diabetes).

Hope you will find my answer helpful.

Feel free to ask me again, in case of any further uncertainties.

Kind regards,

Dr. Iliri

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