Valsartan

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Generic Name of Valsartan - Learn More

Valsartan

Valsartan Precaution - What You Need to Know

Valsartan is an angiotensin II receptor blocker (ARB) commonly used for managing hypertension and heart failure. It requires caution in certain populations due to its potential adverse effects. During pregnancy, valsartan is classified as a Category D medication, meaning it can cause harm to the fetus, particularly in the second and third trimesters. Therefore, it should be discontinued as soon as pregnancy is detected. It is also excreted into breast milk, so breastfeeding mothers should either avoid taking valsartan or discontinue breastfeeding, as it may affect the infant.
Patients with renal impairment should be monitored closely when using valsartan, as it can further impair kidney function, especially in those with pre-existing conditions such as dehydration, salt depletion, or kidney disease. Regular monitoring of kidney function (e.g., serum creatinine and potassium levels) is advised. In patients with severe hepatic impairment, valsartan is contraindicated due to the risk of increased drug levels. Additionally, individuals with a history of hyperkalemia or those on potassium-sparing diuretics should be cautious, as valsartan can increase potassium levels, leading to dangerous hyperkalemia.
Valsartan has a low potential for misuse or dependency, but its effects on blood pressure and electrolytes may be altered by the use of alcohol or other medications, requiring careful management.

Valsartan Indication - Uses and Benefits

Valsartan is primarily indicated for the treatment of hypertension (high blood pressure) and heart failure. It is also prescribed for patients who have recently experienced a myocardial infarction (heart attack) to improve survival. The drug works by blocking the action of angiotensin II, a potent vasoconstrictor, which results in vasodilation (widening of blood vessels), reduced blood pressure, and decreased workload on the heart. This makes it effective in managing conditions that involve high blood pressure or heart failure, reducing the risk of stroke, heart attack, and kidney problems.
Valsartan is used as a first-line treatment in hypertension management, particularly in patients who are intolerant to ACE inhibitors, which are another class of blood pressure medications.
Off-label, valsartan has been used in some cases to treat diabetic nephropathy and other kidney-related issues, particularly when kidney damage is related to hypertension. However, this off-label use is less commonly prescribed and may not be suitable for all patients.

Valsartan Contraindications - Important Warnings

Valsartan is contraindicated in certain conditions and patient groups.
- Pregnancy: As mentioned, valsartan can harm a developing fetus, particularly after the first trimester, and is contraindicated during pregnancy.
- Hypersensitivity: Patients with known hypersensitivity or allergy to valsartan or any of its components should avoid its use due to the risk of severe allergic reactions, including angioedema.
- Severe Renal Impairment: Valsartan is contraindicated in patients with severe renal impairment or those who are on dialysis due to the increased risk of worsening kidney function and electrolyte imbalances.
- Bilateral Renal Artery Stenosis: Patients with bilateral renal artery stenosis (narrowing of the arteries supplying the kidneys) should not use valsartan, as it can further reduce renal perfusion and increase the risk of renal failure.
- Severe Hepatic Impairment: Valsartan is contraindicated in patients with severe liver dysfunction due to its metabolism in the liver, which can lead to increased drug levels and toxicity.
- Concomitant Use with Aliskiren: Valsartan should not be used in combination with aliskiren (a direct renin inhibitor) in patients with diabetes or renal impairment due to the increased risk of hyperkalemia, renal dysfunction, and hypotension.

Valsartan Side Effects - What to Expect

Valsartan is generally well-tolerated, but it can cause some side effects, particularly related to blood pressure and electrolyte balance.
- Common Side Effects: These include dizziness, headache, fatigue, and hypotension (low blood pressure). Dizziness is most common when standing up quickly, and patients may experience fainting or lightheadedness during the initial stages of therapy.
- Serious Side Effects:
- Hyperkalemia: Elevated potassium levels can be dangerous and lead to life-threatening arrhythmias. Symptoms may include muscle weakness, fatigue, and irregular heart rhythms.
- Angioedema: Rarely, valsartan can cause angioedema, which is the swelling of the deeper layers of the skin, often around the eyes and lips, or in the throat. This is a potentially life-threatening reaction, requiring immediate medical attention.
- Renal Dysfunction: Some patients may experience worsening kidney function, which is why regular kidney function monitoring is recommended.
- Low Blood Pressure: Excessive lowering of blood pressure, especially in the elderly or patients on other antihypertensive drugs, can lead to hypotension and associated symptoms like dizziness, fainting, or shock.
- Long-term Effects: Long-term use of valsartan can have a beneficial effect on reducing heart failure symptoms and improving survival rates after myocardial infarction. However, prolonged therapy may be associated with electrolyte disturbances and renal impairment in susceptible individuals.

Valsartan Pregnancy Category ID - Safety Information

4

Valsartan Mode of Action - How It Works

Valsartan works by blocking the action of angiotensin II, a hormone that plays a critical role in regulating blood pressure, fluid balance, and cardiovascular function. Angiotensin II binds to angiotensin receptors in the blood vessels, causing vasoconstriction (narrowing of blood vessels), increased aldosterone secretion (which leads to sodium and water retention), and increased blood pressure.
By blocking the angiotensin II receptors, valsartan prevents these effects, leading to vasodilation (widening of the blood vessels), a reduction in blood pressure, and decreased fluid retention. This makes valsartan particularly effective in treating hypertension and heart failure, where reducing the strain on the heart and blood vessels is essential.
Valsartan is a selective antagonist of the AT1 receptor subtype of angiotensin II, meaning it specifically targets this receptor to counteract the negative effects of angiotensin II without interfering with other physiological processes regulated by angiotensin II, such as cell growth or repair.

Valsartan Drug Interactions - What to Avoid

Valsartan has a variety of drug interactions that may impact its effectiveness or lead to adverse effects.
- Potassium-Sparing Diuretics and Supplements: Valsartan can increase potassium levels, so caution should be exercised when used in combination with potassium-sparing diuretics (e.g., spironolactone) or potassium supplements, as this can lead to hyperkalemia.
- Other Antihypertensives: When valsartan is combined with other antihypertensive agents such as ACE inhibitors, beta-blockers, or calcium channel blockers, there may be an enhanced effect on blood pressure, which can result in hypotension. Blood pressure should be closely monitored to avoid excessive lowering of blood pressure.
- Lithium: The combination of valsartan and lithium should be avoided as valsartan can reduce lithium renal clearance, leading to increased lithium levels and potential toxicity.
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): NSAIDs, including ibuprofen and naproxen, can reduce the antihypertensive effects of valsartan and may increase the risk of renal dysfunction, especially when used long-term.
- Alcohol: Alcohol can enhance the blood pressure-lowering effect of valsartan, which may lead to increased risk of dizziness or fainting. Therefore, patients should be advised to limit alcohol intake while taking valsartan.
- Other Drugs Affecting Renal Function: Drugs that affect renal function, such as cyclosporine, may increase the risk of renal toxicity when taken with valsartan. Kidney function should be monitored regularly in patients receiving these combinations.

Valsartan Adult Dose - Recommended Dosage

The standard adult dose of valsartan for hypertension is typically 80 mg to 160 mg once daily. Depending on the patient's blood pressure response, the dose may be increased up to a maximum of 320 mg daily. For heart failure, the initial dose is generally 40 mg twice daily, with gradual increases to the target dose of 160 mg twice daily, based on patient tolerance.
Valsartan can be taken with or without food, and doses are typically adjusted based on blood pressure measurements or clinical response. In patients with heart failure or those recovering from a myocardial infarction, lower starting doses and gradual titration may be required to minimize the risk of hypotension.
Valsartan can be used alone or in combination with other antihypertensive agents such as diuretics or calcium channel blockers.

Valsartan Child Dose - Dosage for Children

Valsartan is not recommended for use in pediatric patients under the age of 6 years. For children aged 6 years and older, the starting dose for hypertension is usually 1.3 mg/kg once daily, with a maximum dose of 40 mg daily. For children with heart failure, valsartan dosing is based on the child’s weight and requires careful monitoring of blood pressure and renal function.
Because pediatric dosing and safety data are limited, valsartan should only be prescribed to children after a thorough risk-benefit assessment by the healthcare provider. Regular monitoring is necessary to ensure efficacy and safety, particularly for signs of hypotension or renal dysfunction.

Valsartan Renal Dose - Dosage for Kidney Conditions

Valsartan should be used with caution in patients with renal impairment, particularly those with severe kidney dysfunction. For patients with mild to moderate renal impairment (creatinine clearance >30 mL/min), no dose adjustment is necessary. However, in patients with severe renal impairment (creatinine clearance <30 mL/min) or end-stage renal disease (ESRD) on dialysis, valsartan is contraindicated. Regular monitoring of renal function, including serum creatinine and potassium levels, is recommended for patients on valsartan therapy to detect any changes in kidney function or electrolyte imbalance.
It is essential to assess renal function regularly, particularly in the elderly or those with additional risk factors for kidney disease.