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Valsartan

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Valsartan, Diovan, Exforge, Diovan HCT

  • See Also
  1. Angiotensin Receptor Blocker
  • Indications
  1. See Angiotensin Receptor Blocker
  2. Hypertension
  3. Congestive Heart Failure
  4. Post-Myocardial Infarction
  5. Diabetic Nephropathy (not FDA approved)
  • Contraindications
  1. See Angiotensin Receptor Blocker
  2. Age <6 years old
  3. Creatinine Clearance <30 ml/min
  • Mechanism
  1. See Angiotensin Receptor Blocker
  • Dosing
  • Adults
  1. Hypertension or Diabetic Nephropathy
    1. Start 80 to 160 mg orally daily
    2. Maximum 320 mg/day
  2. Congestive Heart Failure
    1. Start 40 mg orally twice daily
    2. Target 160 mg orally twice daily
  3. Post-Myocardial Infarction
    1. Start 20 mg orally twice daily
    2. Next increase to 40 mg orally twice daily in first week
    3. Target 160 mg orally twice daily
  • Dosing
  • Children (age over 6 years)
  1. Start 1.3 mg/kg orally divided once to twice daily
  2. Maximum 2.7 mg/kg/day up to 160 mg/day
  • Medications
  • Combinations
  1. Amlodipine and Valsartan (Exforge)
  2. Hydrochlorothiazide and Valsartan (Diovan HCT)
  3. Sacubitril and Valsartan (Entresto)
    1. Indicated in Systolic Dysfunction (consider as an alternative to ACE Inhibitor or mono Angiotensin Receptor Blocker)
    2. Sacubitril (Neprilysin Inhibitor) increases vasodilation and Sodium excretion
    3. Risk of Hypotension (Number needed to harm 21)
    4. Risk of Angioedema (Number needed to harm 200)
    5. See Systolic Dysfunction for dosing and references
  • Adverse Effects
  1. See Angiotensin Receptor Blocker
  • Safety
  1. See Angiotensin Receptor Blocker
  2. Pregnancy Category X
  3. Unknown Safety in Lactation
  • Resources
  1. Valsartan (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=ab5e0e5a-5bdf-4cfc-9d18-57ea4d642f65
  • References
  1. (2018) Presc Lett, Resource #340901, Angiotensin Receptor Blocker (ARB) Antihypertensive Dose Comparison
  2. (2020) Med Lett Drugs Ther 62(1598): 73-80
  3. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 66-7
  4. Hamilton (2020) Tarascon Pocket Pharmacopoeia