GENERIC NAME: valsartan

BRAND NAME: Diovan

DRUG CLASS AND MECHANISM: Valsartan is an oral medication that belongs to a class of drugs called angiotensin receptor blockers (ARBs). Other ARBs include irbesartan (Avapro), losartan (Cozaar), and candesartan (Atacand). Angiotensin, formed in the blood by the action of angiotensin converting enzyme (ACE), is a powerful chemical that attaches to angiotensin receptors found in many tissues but primarily on smooth muscle cells of blood vessels. Angiotensin’s attachment to the receptors causes the blood vessels to narrow (vasoconstrict) which leads to an increase in blood pressure (hypertension). Valsartan blocks the angiotensin receptor. By blocking the action of angiotensin, valsartan dilates blood vessels and reduces blood pressure. Valsartan was approved by the FDA in December of 1996.

PRESCRIPTION: Yes

GENERIC AVAILABLE: No

PREPARATIONS: Capsules: 40, 80, 160 and 320 mg.

STORAGE: Capsules should be stored at room temperature, 15-30°C (59-86°F).

PRESCRIBED FOR: Valsartan is used to treat high blood pressure and heart failure. It is also prescribed after heart attacks since valsartan may reduce death in patients who developed congestive heart failure after a heart attack. Valsartan may also reduce hospitalizations in patients with congestive heart failure.

DOSING: The usual dose of valsartan in patients with high blood pressure is 80 to 160 mg once daily. The maximum dose is 320 mg daily. Maximum blood pressure reduction occurs within 4 weeks. For congestive heart failure, the usual dose is 40 mg twice daily. The doses may be increased to 80-160 mg twice daily. The initial dose after a heart attack is 20 mg twice daily. The dose should be increased with a target of 160 mg twice daily if tolerated without side effects.

Administration of valsartan with food decreases the absorption of valsartan by about 40%, so it should be taken on an empty stomach.

DRUG INTERACTIONS: Combining valsartan with potassium-sparing diuretics (e.g., spironolactone, triamterene, amiloride), potassium supplements, or salt substitutes containing potassium may lead to hyperkalemia (elevated potassium in the blood) and in heart failure patients, it increases serum creatinine, a test used for monitoring function of the kidneys.

PREGNANCY: When used in the second or third trimester of pregnancy , valsartan and similar drugs can cause injury and even death to the fetus. Valsartan should not be used during pregnancy. When pregnancy is detected, valsartan should be stopped as soon as possible.

NURSING MOTHERS: It is not known whether valsartan is secreted into human milk. Valsartan is secreted into the milk of rats.

SIDE EFFECTS: Valsartan is generally well-tolerated and side effects are rare. The most common side effects include headache, dizziness, fatigue, abdominal pain, cough, diarrhea and nausea. Patients may also experience hyperkalemia, impotence, reduced renal function, and allergic reactions. Rhabdomyolysis (inflammation and destruction of muscles) and angioedema (swelling of soft tissues including those of the throat and larynx) are rare but serious side effects of valsartan.