Valsartan

Valsartan is a prescription medication used to lower blood pressure in children and adults, as well as heart failure and heart attacks in adults.

Overview

Valsartan, also known by its brand name, Diovan, is a prescription drug used to treat high blood pressure (hypertension). It's used in both adults and children between the ages of 6 and 16. The drug is also used to treat left ventricular heart failure (when the left side of the heart swells and stiffens up), as well as lower your risk of death following a heart attack. Valsartan can also lower the need for a hospital visit after heart failure as well as improve your chances of living longer after having a heart attack.

Valsartan is usually prescribed on a long-term basis and is typically used in conjunction with other medications to treat certain conditions related to the heart. Valsartan is an angiotensin receptor blocker (ARB) which includes candesartan (Atacand), irbesartan (Avapro), and Iosartan (Cozaar). It lowers blood pressure and relaxes blood vessels, increasing oxygen and blood flow to the heart. Angiotensin is formed in the blood by the angiotensin converting enzyme (ACE) and attaches to angiotensin receptors that cause the blood vessels to narrow (vasoconstrict), leading to an increase in blood pressure.

Condition(s) treated:

  • High blood pressure
  • Heart failure
  • Heart attack (myocardial infarction)

Type of medicine

  • Angiotensin receptor blocker (ARB)

Side Effects

Valsartan does have potential side effects, some of which include:

  • Difficulty breathing,
  • Hives, or swelling of the lips, face, throat or tongue
  • Viral infection
  • Low white blood cell count
  • Loss of consciousness
  • Rhabdomyolysis (when muscles break down with signs of muscle weakness or pains, protein in the urine, soda-colored urine, etc.)

In these cases, you should seek emergency medical attention immediately. Valsartan can cause the breakdown of skeletal muscle tissue, which can lead to kidney failure. Kidney problems such as kidney disease could worsen. Your doctor may give you a lower dose of valsartan if you have a history of kidney problems. Call your doctor if swelling in the hands, feet, or ankles occurs, or if you gain weight without explanation.

Other serious side effects include peeing less than usual or not at all, feeling faint, rapid weight gain, high potassium levels (muscle weakness, slowing heart rate, weaker pulse, tingly feeling), feeling easily short of breath, confusion, pounding heartbeat, loss of appetite, increased thirst, vomiting, weakness, or fluttering in your chest.

Less serious side effects of Valsartan include:

  • blurred vision
  • nausea
  • skin rash
  • mild itching
  • stomach pain
  • back pain
  • joint pain
  • diarrhea
  • flu symptoms
  • headaches
  • feeling tired
  • cold symptoms (sneezing, stuffy nose, cough, sore throat)

You might also experience cold sweats, or lower back or side pain. Rare symptoms include trouble swallowing, chills, dark urine, yellow eyes and skin, lightly colored stools, hair loss, and stomach or upper abdominal pain (usually on the right side).

Some side effects noted during clinical trials of Valsartan (which are not 100 per cent proven to be caused by this medication) include:

  • palpitations
  • allergic reaction and asthenia
  • vertigo
  • constipation
  • dry mouth
  • pruritus and rash
  • anxiety
  • impotence
  • insomnia
  • dyspepsia
  • paresthesia
  • dyspnea
  • somnolence
  • flatulence

Standing up slowly when getting up from a chair or from lying down can help ease dizziness and lightheadedness.

Side effects of this medication in most cases are mild or rare.

Dosage

The dosing of this medicine varies from patient to patient. This is a general guideline as to how you should take the drug. Always consult your healthcare provider before taking any medication to treat high blood pressure and other heart conditions. It's also important that you read the patient information sheet that comes with the medicine. Directions are usually right on the label of the bottle. If you still have questions, contact your healthcare provider. Valsartan can be taken with or without food.

To treat high blood pressure, take one 80-milligram (mg) tablet or one 160-milligram (mg) tablet twice per day at the same time. Your doctor usually won't prescribe more than 320 milligrams (mg) per day and will adjust your dosage based on your needs. If you or your child can't swallow pills, your pharmacist can give you a liquid suspension in a bottle. When taking the liquid form, shake the bottle well for at least 10 seconds and then pour the correct dosage into a cup and drink it.

To treat heart failure, take one 40-milligram (mg) tablet twice per day at the same time every day. Again, your dosage will be no more than 320 milligrams (mg) per day. Usually, your doctor will start you off with a low dose of Valsartan and gradually increase the dosage throughout the course of your treatment in order to gauge the safest, most effective dosage.

To treat left ventricular heart failure following a heart attack, take 20 milligrams (mg) twice per day. For children with this condition, their doctor must determine the dosage.

For children ages 6 to 16, the dosage varies and depends on factors such as body weight. The maximum dosage for a child between these ages is 2.7 milligrams (mg) per kilogram (kg) of body weight - or no more than 160 milligrams (mg) per day.

If you miss a dose, take one as soon as you remember, unless it's almost time for your next dose. In that case, skip the missed dose and take the upcoming one. You should never take two doses at the same time because you forgot a dose.

Interactions

Certain medications used in conjunction with valsartan can increase your risk for serious side effects. Write out a list of all of the medications you're currently taking and give it to your doctor as well as your pharmacist. Avoid starting or stopping any current medications before talking to your doctor.

Some of the drugs that can interact with this medication include:

  • aliskiren
  • lithium (used for certain types of depression)
  • potassium supplements
  • water pills (or diuretics)
  • non-steroidal anti-inflammatory drugs (NSAIDs)
  • certain types of antibiotics (such as rifamycin group, cyclosporine, or ritonavir)

Other medications can interact with Valsartan, but in some cases, your doctor may prescribe you both. These include:

  • Moexipril
  • Simeprevir
  • Quinapril
  • Trimethoprim
  • Lisinopril
  • Enalaprilat
  • Captopril
  • Benazepril
  • Enalapril
  • Perindopril
  • Ramipril
  • Fosinopril
  • Trandolapril

Certain medications can increase your risk of side effects. They include:

  • Clonixin
  • Celecoxib
  • Cholin Salicylate
  • Indomethacin
  • Ibuprofen
  • Felbinac
  • Diclofenac
  • Feprazone
  • Floctafenine
  • Ketoprofen
  • Flufenamic Acid
  • Oxaprozin
  • Ketorolac
  • Aceclofenac
  • Meloxicam
  • Morniflumate
  • Nimesulide
  • Parecoxib
  • Phenylbutazone
  • Valdecoxib
  • Nimesulide Beta Cyclodextrin
  • Proquazone
  • Salicylic Acid
  • Amtolmetin Guacil
  • Rofecoxib
  • Niflumic Acid
  • Piketoprofen
  • Tolmetin
  • Oxyphenbutazone
  • Piroxicam
  • Acematacin
  • Dexibuprofen
  • Proglumetacin
  • Tiaprofenic Acid
  • Diflunisal
  • Sodium Salicylate
  • Tolfenamic Acid
  • Bromfenac
  • Propionic Acid
  • Sunlindac
  • Nepafenac
  • Bufexamac
  • Salsalate
  • Propyphenazone
  • Tenoxicam
  • Dexketoprofen
  • Flurbiprofen
  • Etoricoxib
  • Etodolac
  • Fepradinol
  • Etofenamate
  • Dipyrone
  • Naproxen
  • Fenoprofen
  • Lornoxicam
  • Meclofenamate
  • Lumiracoxib
  • Mefenamic Acid
  • Nabumetone
  • Loxoprofen

These types of drugs can increase the effects of Valsartan. Other interactions include tobacco, alcohol, or certain foods. Your doctor will be able to help you determine what things you need to cut out of your lifestyle in order for the drug to remain effective without harming you.

Certain medical conditions can also interfere with the use of valsartan, including congestive heart failure, severe kidney disease, angioedema (in combination with other blood pressure medicines like lisinoprol, benazepril, or enalapril), and diabetes. Those with electrolyte imbalances or fluid imbalances caused by diarrhea, dehydration or vomiting should notify a doctor about their condition before taking Valsartan.

Warnings

This medication does not cure high blood pressure; it simply helps control it. Take it only as directed if you expect to see results and keep seeing them. Many people have to take high blood pressure medication for the rest of their lives, so it's best to start thinking about that possibility. If left untreated, high blood pressure can lead to serious problems down the line, such as blood vessel disease, heart failure, stroke, or kidney disease.

Read and closely follow any directions that come with the medication. Ask you doctor if you're still unsure about anything.

Make sure you know how the medicine affects you before operating heavy machinery, such as driving a vehicle, or before doing anything dangerous. You may feel dizzy when on Valsartan, so it's important to make sure you know how the medication will affect you so you limit the risk of fainting.

Women who are pregnant or breastfeeding should not take Valsartan. It is still unknown whether this medication can be transferred into breast milk or if it can cause any harm to your nursing baby. Do not take this drug if you are pregnant, especially if you're in the second or third trimester, as doing so can reduce fetal renal function, as well as neonatal morbidity and death. Oligohydramios can result and is associated with fetal skeletal deformations and lung hypoplasia. Other potential adverse neonatal effects include hypotension, hypoplasia, renal failure, anuria, and death. Once you find out you're pregnant, stop taking Valsartan as soon as possible.

Taking birth control pills to prevent pregnancy is wise if you're already on Valsartan. Once you speak to your doctor, Valsartan can be taken with birth control pills.

If you start to feel sick after taking Valsartan, call your doctor right away, especially if you begin experiencing some of the previously discussed symptoms.

If you have had an allergic reaction to any medications or if you're taking any other non-prescription medications, let your doctor know immediately. If you've had a severe allergic reaction to medications used to treat high blood pressure, talk to your doctor. Valsartan may have inactive ingredients that could cause allergic reactions or similar issues.

Do no use potassium supplements while taking Valsartan. It's also best to avoid salt substitutes while on this medication, unless your doctor has given you the green light to do so.

Make sure to drink plenty of water when exercising or when the weather is hot. You lose water when you sweat, which can lead to low blood pressure, so stay hydrated.

This medication may be used in combination with other efforts to reduce blood pressure, such as weight control and changes in diet (such as switching to lower sodium or salt-free foods). Your doctor can help you determine which steps are best for you to take. Valsartan can be taken with or without food and it should be taken at the same time every day. Failure to do so may result in missed doses or accidental overdose.

If you have a medical history of liver disease or your body loses too many minerals as well as too much water, tell your doctor.

In case of an accidental overdose, contact a poison control center right away. Symptoms of an overdose include a fast or slow heartbeat, fainting or dizziness.

Because this drug can cause dizziness, it's advised that you avoid any activities that require you to remain alert for long periods of time. Until you're sure that you're able to perform your regular daily activities, do not try to get back into your normal routine.

Do not drink alcoholic beverages while taking Valsartan. Drinking alcoholic beverages can lower your blood pressure too much and can increase some side effects from taking Valsartan.

Do not take Valsartan for conditions other than the ones described here.

Never share your medication with others. Your doctor prescribed it for you and only you.

In patients with heart failure or post-myocardial infarction, caution should be taken when starting therapy because these patients tend to have a reduction in blood pressure. Follow dose instructions carefully while in therapy.

If extreme hypotension is detected, get into the supine position and have someone help give you an intravenous mixture of normal saline, if necessary.

Beware of impaired renal function after taking Valsartan, which includes acute renal failure. Both can be caused by medications that block the renin-angiotensin system. Patients with chronic kidney disease, renal artery stenosis, volume depletion, or severe congestive heart failure are at a particularly high risk of acute renal failure while taking Valsartan. It's important to monitor renal functions carefully and regularly in patients with these conditions.

Never take Valsartan with non-steroidal anti-inflammatory drugs (NSAIDs), especially if you're elderly, you have poor kidney function, or you're fluid depleted (including patients on diuretic therapy). Aspirin, Ibuprofen (Advil, Children's Advil/Motrin, PediaCare Fever, Motrin, Nuprin, Medipren, etc.), naproxen (Aleve, Naprosyn, Anaprox, Naprelan), and indomethacin (Indocin, Indocin-SR) can reduce the effects of Valsartan and similar medications.

Your doctor may reduce your dosage or take you off of Valsartan altogether if you have a pre-existing renal impairment. Talk to your doctor if you have any other prolonged illnesses that can cause vomiting and diarrhea.

Visit your doctor consistently while taking Valsartan so that he or she can closely monitor the condition as well as any side effects. Your doctor will need to check your blood pressure quite frequently and you may have to take Valsartan for the rest of your life. Your doctor may also need to monitor your kidney function.

It can take between 2 to 4 weeks for the medication to become effective.

Avoid eating grapefruit and drinking grapefruit juice while taking Valsartan. Grape fruit juice slows down how fast the body is able to break down the medication, which could lead to dangerously high levels of Valsartan in your system.

Never give Valsartan to children under 6 years of age.

Storage

Valsartan tablets should be stored at room temperature between 59 degrees and 86 degrees Fahrenheit (or 15 to 30 degrees Celsius). The tablets should be stored in a closed container in a dry place.

Bottles of Valsartan suspension should be stored at room temperature less than 86 degrees Fahrenheit.

Keep medications in a safe place where children or pets can't get into them, and away from direct light, heat and moisture.

Throw out any expired medication; never store it where someone else can access it. Your healthcare provider can tell you how to properly dispose of any unneeded medication.

The liquid form of this medication can be stored for up to 30 days at room temperature and up to 75 days in the refrigerator.

Summary

Valsartan is a drug used to treat high blood pressure (also known as hypertension) and certain conditions of the heart, such as heart failure and heart attack. Also called Diovan, the medication lowers blood pressure and improves blood flow. Only your doctor can prescribe you Valsartan and dosage will vary from person to person. Children ages 6 to 16, as well as adults are usually prescribed Valsartan. This medication should be taken according to the directions and/or your doctor. While generally considered a safe drug, Valsartan can cause problems for patients who don't report their medications to their doctor. As a treatment designed to alleviate the symptoms of hypertension and heart failure, Valsartan relaxes the blood vessels, lowering blood pressure.

When taken correctly, Valsartan can help lower your risk of more serious conditions associated with hypertension. It can also significantly reduce the necessity of a hospital visit after a heart attack or after heart failure. Valsartan doesn't treat any symptoms because hypertension does not cause any symptoms, contrary to popular belief. Valsartan should not be taken without a prescription (and consent) from a licensed healthcare provider. Your doctor can help you determine the best dosage to treat your condition.

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Last Reviewed:
December 25, 2017
Last Updated:
December 22, 2017
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