Class: Angiotensin II Receptor Antagonist
Dosage Forms. Tablet: 40 mg, 80 mg, 160 mg, 320 mg
Common FDA Label Indication, Dosing, and Titration.
1. Heart failure: 40 mg po bid, may titrate to 320 mg/d
2. Hypertension: 80-160 mg po daily, may titrate to 320 mg po daily
3. Myocardial infarction: 20 mg po bid, may titrate to 320 mg po daily
1. Diabetes mellitus, prophylaxis: 80-160 mg po daily
2. Diabetic nephropathy: 40-80 mg po daily
MOA. Valsartan is a selective, reversible, competitive antagonist of the angiotensin II receptor (AT1), which is responsible for the physiologic effects of angiotensin II including vasoconstriction, aldosterone secretion, sympathetic outflow, and stimulation of renal sodium reabsorption.
Drug Characteristics: Valsartan
Medication Safety Issues: Valsartan
Drug Interactions: Valsartan
Adverse Reactions: Valsartan
Efficacy Monitoring Parameters. Decreased BP, signs/symptoms of CHF.
Toxicity Monitoring Parameters. Signs/symptoms of hypotension, tachycardia, angioedema (swelling of the face, eyes, lips, tongue, or throat), hyper-kalemia (confusion, body weakness, uneven heartbeat, or numbness/tingling in hands or feet), reduction in urination, jaundice, or skin rash. Monitor vital signs, weight, LFTs.
Key Patient Counseling Points. Do not discontinue abruptly. Use potassium supplements or salt substitutes only under medical supervision. This medicine may cause dizziness. Avoid driving, using machinery, or doing anything else that could be dangerous if not alert. Recommend avoiding alcohol and NSAIDs while taking this drug.
Clinical Pearls. Angiotensin II receptor antagonists can cause injury or death to the developing fetus when used during 2nd and 3rd trimesters. Therapy should be stopped as soon as possible when pregnancy is detected. Blood chemistry, serum electrolytes, and renal function tests should be conducted prior to therapy initiation and monitored periodically thereafter.