Names and pronunciation
(val′sahr-tan) Diovan
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Individual generic drug information
Extracted information for valsartan only.
(val′sahr-tan) Diovan
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Func. class.: Antihypertensive
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Chem. class.: Angiotensin II receptor antagonist (Type AT1)
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Do not confuse: Diovan/Zyban/Dioval
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ACTION: Blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II; selectively blocks the binding of angiotensin II to the AT1 receptor found in tissues
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USES: Hypertension, alone or in combination in patients >6 yr, HF, post MI with left ventricular dysfunction/failure in stable patients
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Extracted information for valsartan only.
CONTRAINDICATIONS: Hyper sensitivity, severe hepatic disease, bilat eral renal artery stenosis
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Black Box Warning: Pregnancy Precautions: Breastfeeding, children, geriatric patients, hypersensitivity to ACE inhibitors; HF, hypertrophic cardiomyopa thy, aortic/mitral valve stenosis, CAD, angioedema, renal/hepatic disease, hyper kalemia, hypovolemia, African descent Black Box Warning: Pregnancy/breast- feeding: Do not use in pregnancy, may cause fetal death; do not breastfeed Black Box Warning: Not to take product if pregnant or breastfeeding • Overdose symptoms: bradycardia or tachycardia, circulatory collapse
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SIDE EFFECTS CNS: Dizziness, insomnia, drowsiness, vertigo, headache, fatigue CV: Angina pectoris, 2nd-degree AV block, cerebrovascular accident, hypo tension, MI, dysrhythmias EENT: Conjunctivitis GI: Diarrhea, abdominal pain, nausea, hepatotoxicity GU: Impotence, nephrotoxicity, renal failure HEMA: Anemia, neutropenia META: Hyperkalemia MISC: Vasculitis, angioedema MS: Cramps, myalgia, pain, stiffness RESP: Cough
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INTERACTIONS • Do not use with aliskiren in diabetes or severe renal disease Increase: effects of lithium, antidiabetics Increase: hyperkalemia—potassium- sparing diuretics, potassium supple ments, ACE inhibitors, cycloSPORINE Increase: valsartan level—rifampin, rito navir, gemfibrozil, telithromycin Decrease: antihypertensive effects— NSAIDs, salicylates Drug/Herb Increase: antihypertensive effect—gar lic, hawthorn Decrease: antihypertensive effect— ephedra, ma huang Drug/Food Increase: hyperkalemia—salt substitutes with potasssium
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Extracted information for valsartan only.
DOSAGE AND ROUTES Hypertension • Adult: PO 80 or 160 mg/day alone or with other antihypertensives, may increase to 320 mg/day • Geriatric: PO adjust on clinical re sponse; may start with lower dose • Child and adolescent 6-16 yr: PO 1.3 mg/kg/dose daily, max 40 mg/day, ini tially adjust based on clinical response, max 2.7 mg/kg/day Heart failure, classes II to IV • Adult: PO 40 mg bid, up to 160 mg bid Post MI • Adult: PO 20 mg bid as early as 12 hr post MI, may be titrated within 7 days to 40 mg bid, then titrate to maintenance of 160 mg bid
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Available forms: Tabs 40, 80, 160, 320 mg
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Administer: • Without regard to meals • If dose is missed, give as soon as re membered; if close to next dose, skip
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Extracted information for valsartan only.
Assess: • Vital signs: B/P, pulse q4hr lying, sitting, standing; note rate, rhythm, quality periodi cally • Blood studies: BUN, creatinine, LFTs, potassium, total/direct bilirubin before treatment • Angioedema: facial swelling; SOB; edema in feet, legs daily • Dehydration: Skin turgor, dryness of mucous membranes for hydration status; correct volume depletion before initiat ing therapy
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Evaluate: • Therapeutic response: decreased B/P
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • To comply with dosage schedule, even if feeling better; that, if dose is missed, to take it as soon as possible unless it is within 1 hr of next dose • To notify prescriber of fever, swelling of hands or feet, irregular heartbeat, chest pain, dizziness, persistent cough • That excessive perspiration, dehydra tion, diarrhea may lead to fall in blood pressure; to consult prescriber if these occur; to maintain hydration • That product may cause dizziness, fainting, light-headedness; to rise slowly to sitting or standing position to mini mize orthostatic hypotension; to take B/P readings • To avoid potassium supplements and foods, salt substitutes
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Extracted information for valsartan only.
PHARMACOKINETICS Onset up to 2 hr; peak 2-4 hr; duration 24 hr; extensively metabolized; protein binding 95%; half-life 6 hr; excreted in feces, urine, breast milk V
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Filter the extracted dose blocks for this individual drug.
Hypertension
• Geriatric: PO adjust on clinical re sponse; may start with lower dose
Candidate age grouping · source page 1349