Valsartan

Indications
 Oral
Hypertension
Adult: Initially, 80 mg once daily, increased to 160 mg once daily. Max: 320 mg daily.
Elderly: > 75 yr: Initially, 40 mg once daily.
CrCl (ml/min)Dosage Recommendation
<20Initiate at 40 mg once daily.
Hepatic impairment: Mild to moderate impairment: Initial dose 40 mg once daily; max: 80 mg once daily. Severe hepatic impairment, cirrhosis, or biliary obstruction: contra-indicated.
Oral
Heart failure
Adult: 40 mg bid, may be increased to 160 mg bid if tolerated.
Renal impairment: Use with caution.
Hepatic impairment: Severe hepatic impairment, cirrhosis, or biliary obstruction: contra-indicated.
Oral
Post myocardial infarction
Adult: Start as early as 12 hr after MI in stable patients, at an initial dose of 20 mg bid, increased over a few wk up to 160 mg bid if tolerated.
Renal impairment: Use with caution.
Hepatic impairment: Mild to moderate: max: 80 mg bid. Patients with severe hepatic impairment, cirrhosis or biliary obstruction: Avoid.

Special Populations: Care should be exercised with dosing of valsartan in patients with hepatic or severe renal impairment. Moderate to severe renal impairment (creatinine clearance < 20 mL/min), intravascular vol depletion or hepatic impairment: 40 mg once daily.
Contraindications
 Hypersensitivity; severe hepatic impairment, cirrhosis or biliary obstruction; primary hyperaldosteronism. Pregnancy (2nd and 3rd trimesters) and lactation.
Warnings / Precautions
 Volume depletion; renal artery stenosis; monitor serum potassium concentrations; severe CHF; renal impairment; mild to moderate hepatic impairment. Elderly.
Adverse Reactions
 Dizziness; headache; dose-related orthostatic hypotension; rash; angioedema; hyperkalaemia; myalgia; resp tract disorders; back pain; GI disturbances; fatigue; increase in BUN and serum creatinine; abdominal pain; dry cough; LFT elevations.
Potentially Fatal: Blood dyscrasias (e.g. neutropenia).
Overdose Reactions
 Symptoms: Hypotension, tachycardia or bradycardia, depressed level of consciousness, circulatory collapse and shock. Management: Treatment is mainly supportive. Haemodialysis is not likely to be useful.
Drug Interactions
 Increased risk of renal impairment and hyperkalaemia with NSAIDs and ciclosporin. Increased risk of hypotension with general anaesthetics, clozapine, dopamine agonists and other antihypertensives. Increased risk of lithium toxicity. Increased risk of hyperkalaemia with potassium-sparing diuretics, potassium supplements, ACE inhibitors, heparin.
See Below for More valsartan Drug Interactions
Mechanism of Actions
 Valsartan, an angiotensin II receptor antagonist, produces its BP lowering effects by antagonizing angiotensin II-induced vasoconstriction, aldosterone release and renal reabsorption of sodium.
Onset: 2 hr.
Duration: >24 hr.
Absorption: Rapidly absorbed with oral bioavailability 23%. Peak plasma concentrations: 2-4 hr. Food may decrease the rate and extent.
Distribution: Protein binding: 94-97% to serum albumin. Volume of distribution after IV admin: 17 L.
Metabolism: Not significantly metabolised.
Excretion: Excreted via bile in faeces (about 83% of dose) and urine (about 13% of dose), mainly as unchanged drug and some as metabolites (20% of dose). Terminal elimination half life: 5-9 hr.
Administration
 May be taken with or without food.
Storage Conditions
 Oral: Store between 15-30°C (59 - 86<249>F).
ATC Classification
 C09CA03 - valsartan ; Belongs to the class of angiotensin II antagonists. Used in the treatment of cardiovascular disease.
Storage
 Oral: Store between 15-30°C (59 - 86<249>F).
Available As
  • Valsartan 160 mg
  • Valsartan 40 mg
  • Valsartan 80 mg

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