II. Indications
- See Angiotensin Receptor Blocker
- Hypertension
- Congestive Heart Failure
- Post-Myocardial Infarction
- Diabetic Nephropathy (not FDA approved)
III. Contraindications
- See Angiotensin Receptor Blocker
- Age <6 years old
- Creatinine Clearance <30 ml/min
IV. Mechanism
V. Dosing: Adults
-
Hypertension or Diabetic Nephropathy
- Start 80 to 160 mg orally daily
- Maximum 320 mg/day
-
Congestive Heart Failure
- Start 40 mg orally twice daily
- Target 160 mg orally twice daily
- Post-Myocardial Infarction
- Start 20 mg orally twice daily
- Next increase to 40 mg orally twice daily in first week
- Target 160 mg orally twice daily
VI. Dosing: Children (age over 6 years)
- Start 1.3 mg/kg orally divided once to twice daily
- Maximum 2.7 mg/kg/day up to 160 mg/day
VII. Medications: Combinations
- Amlodipine and Valsartan (Exforge)
- Hydrochlorothiazide and Valsartan (Diovan HCT)
-
Sacubitril and Valsartan (Entresto)
- Indicated in Systolic Dysfunction (consider as an alternative to ACE Inhibitor or mono Angiotensin Receptor Blocker)
- Sacubitril (Neprilysin Inhibitor) increases vasodilation and Sodium excretion
- Risk of Hypotension (Number needed to harm 21)
- Risk of Angioedema (Number needed to harm 200)
- See Systolic Dysfunction for dosing and references
VIII. Adverse Effects
IX. Safety
- See Angiotensin Receptor Blocker
- Pregnancy Category X
- Unknown Safety in Lactation
X. Resources
XI. References
- (2018) Presc Lett, Resource #340901, Angiotensin Receptor Blocker (ARB) Antihypertensive Dose Comparison
- (2020) Med Lett Drugs Ther 62(1598): 73-80
- Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 66-7
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
Images: Related links to external sites (from Bing)
Related Studies
valsartan (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
VALSARTAN 160 MG TABLET | Generic | $0.23 each |
VALSARTAN 320 MG TABLET | Generic | $0.27 each |
VALSARTAN 40 MG TABLET | Generic | $0.16 each |
VALSARTAN 80 MG TABLET | Generic | $0.19 each |
VALSARTAN-HYDROCHLOROTHIAZIDE 160-12.5 MG TAB | Generic | $0.26 each |
VALSARTAN-HYDROCHLOROTHIAZIDE 160-25 MG TAB | Generic | $0.30 each |
VALSARTAN-HYDROCHLOROTHIAZIDE 320-12.5 MG TAB | Generic | $0.34 each |
VALSARTAN-HYDROCHLOROTHIAZIDE 320-25 MG TAB | Generic | $0.34 each |
VALSARTAN-HYDROCHLOROTHIAZIDE 80-12.5 MG TAB | Generic | $0.22 each |
diovan (on 7/27/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
DIOVAN 160 MG TABLET | Generic | $0.23 each |
DIOVAN 320 MG TABLET | Generic | $0.27 each |
DIOVAN 80 MG TABLET | Generic | $0.19 each |
exforge (on 7/27/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
EXFORGE HCT 10-320-25 MG TAB | $12.94 each |
Ontology: valsartan (C0216784)
Definition (NCI) | An orally active nonpeptide triazole-derived antagonist of angiotensin (AT) II with antihypertensive properties. Valsartan selectively and competitively blocks the binding of angiotensin II to the AT1 subtype receptor in vascular smooth muscle and the adrenal gland, preventing AT II-mediated vasoconstriction, aldosterone synthesis and secretion, and renal reabsorption of sodium, and resulting in vasodilation, increased excretion of sodium and water, a reduction in plasma volume, and a reduction in blood pressure. |
Definition (PDQ) | An orally active nonpeptide triazole-derived antagonist of angiotensin (AT) II with antihypertensive properties. Valsartan selectively and competitively blocks the binding of angiotensin II to the AT1 subtype receptor in vascular smooth muscle and the adrenal gland, preventing AT II-mediated vasoconstriction, aldosterone synthesis and secretion, and renal reabsorption of sodium, and resulting in vasodilation, increased excretion of sodium and water, a reduction in plasma volume, and a reduction in blood pressure. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=464172&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=464172&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C47781" NCI Thesaurus) |
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | C081489 |
SnomedCT | 108581009, 386876001 |
LNC | LP171649-9 |
English | N-valeryl-N-((2'-(1H-tetrazol-5-yl)biphenyl-4-yl)methyl)valine, valsartan, L-Valine, N-(1-oxopentyl)-N-((2'-(1H-tetrazol-5-yl)(1,1'-biphenyl)-4-yl)methyl)-, N-(p-(o-1H-Tetrazol-5-ylphenyl)benzyl)-N-valeryl-L-valine, valsartan (medication), VALSARTAN, valsartan [Chemical/Ingredient], Valsartan, Valsartan (product), Valsartan (substance) |
Spanish | valsartano, valsartano (sustancia), valsartán (producto), valsartán (sustancia), valsartán |
Ontology: Diovan (C0719949)
Definition (CHV) | brand name of a high blood pressure medication |
Definition (CHV) | brand name of a high blood pressure medication |
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | C081489 |
English | Diovan, valsartan (Diovan), diovan, diovan [brand name], Novartis brand of valsartan, Tareg |