BMA Concise Guide to Medicine & Drugs

Valsartan

Brand name Diovan

Used in the following combined preparations Co-Diovan, Exforge

QUICK REFERENCE

Drug group Vasodilator and antihypertensive drug

Overdose danger rating Low

Dependence rating Low

Prescription needed Yes

Available as generic No

GENERAL INFORMATION

Valsartan belongs to the group of vasodilator drugs known as angiotensin II blockers, and is used to treat hypertension (high blood pressure). It may also be used following a myocardial infarction (heart attack) to help prevent further complications. Valsartan may be prescribed alone or in combination with other post-myocardial infarction therapies such as aspirin, beta blockers, or “statin” lipid-lowering drugs. Valsartan works by blocking the action of angiotensin II (a powerful hormone that constricts blood vessels). This relaxes the blood vessels, thereby lowering blood pressure and easing the heart’s workload.

Unlike ACE inhibitors, valsartan does not cause a persistent dry cough and may be a useful alternative for people who have to discontinue treatment with an ACE inhibitor for this reason.

INFORMATION FOR USERS

Your drug prescription is tailored for you. Do not alter dosage without checking with your doctor.

How taken/used Tablets, capsules.

Frequency and timing of doses Hypertension Once daily, generally in the morning. Post-myocardial infarction Twice daily.

Adult dosage range 20–320mg.

Onset of effect 1–2 hours; full antihypertensive effect may take 2–4 weeks.

Duration of action 24 hours for antihypertensive effect.

Diet advice None.

Storage Keep in original container at room temperature out of the reach of children.

Missed dose Take as soon as you remember. Then return to your original dosing schedule. Do not make up for the missed dose.

Stopping the drug Do not stop taking the drug without consulting your doctor. Stopping the drug may lead to worsening of the underlying condition.

Exceeding the dose An occasional unintentional extra dose is unlikely to cause problems. Large overdoses may cause dizziness and fainting. Notify your doctor.

POSSIBLE ADVERSE EFFECTS

Most adverse effects of valsartan are usually mild and transient. They include hypotension (low blood pressure), which may produce dizziness; headache; and diarrhoea. Discuss with your doctor if these are severe. The drug may also cause a cough or muscle, joint, or back pain; if so, discuss with your doctor. If you experience wheezing or swelling of the lips or tongue, stop taking the drug and contact your doctor immediately.

INTERACTIONS

Vasodilators, diuretics, and other antihypertensives These drugs may increase the blood-pressure-lowering effects of valsartan.

Potassium supplements, potassium-sparing diuretics, and ciclosporin Valsartan increases the effect of these drugs, leading to raised levels of potassium in the blood.

Cimetidine may increase valsartan’s effect.

Lithium Levels of this drug may be increased when it is combined with valsartan, leading to toxicity.

Non-steroidal anti-inflammatory drugs (NSAIDs) Certain NSAIDs may reduce the blood-pressure-lowering effect of valsartan.

SPECIAL PRECAUTIONS

Be sure to tell your doctor if:

· You have stenosis of the kidney arteries.

· You have liver or kidney problems.

· You have experienced angiodema.

· You are taking other medicines.

Pregnancy Not prescribed. There is evidence of harm to the developing fetus.

Breast-feeding Not recommended. It is not known whether the drug passes into the breast milk. Discuss with your doctor.

Infants and children Not recommended.

Over 60 No special problems.

Driving and hazardous work Do not undertake such activities until you have learned how valsartan affects you because the drug can cause dizziness or weariness.

Alcohol Avoid. Alcohol may increase the blood-pressure-lowering and adverse effects of valsartan.

PROLONGED USE

No special problems.

Monitoring Periodic checks on blood potassium levels and kidney function should be performed.