Valsartan
DIOVAN
What it isAngiotensin II receptor blocker; hypertension, heart failure and post-infarction.
Why this oneHeart-failure outcome data, no cough, and it is the ARB component of sacubitril-valsartan.
What limits itHyperkalemia and the same hemodynamic creatinine rise as an ACE inhibitor. Contraindicated in pregnancy.
FDA-approved for
- hypertension (1996)
- heart failure (2001)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Hypertension | Adults | 80–160 mg QD | 80–320 mg QD | 320 mg QD |
| Hypertension | Peds 1–16 y | 1 mg/kg QD (up to 40 mg) | 1–4 mg/kg QD (up to 160 mg) | 160 mg QD |
| Heart failure | Adults | 40 mg BID | 40–160 mg BID | 160 mg BID |
| Post-myocardial infarction | Adults | 20 mg BID | 20–160 mg BID | 160 mg BID |
Renal Undefined
Hepatic Undefined
Instructions
- Tablets and oral suspension are not substitutable mg-per-mg (suspension AUC ~60% higher); do not combine dosage forms
- Oral suspension recommended for peds 1–5 y and those who cannot swallow tablets
Contraindications
- Concomitant aliskiren in patients with diabetes
Cautions
- Hypotension (volume-/salt-depleted patients)
- Impaired renal function/acute renal failure
- Hyperkalemia (monitor potassium)
Adverse reactions
- Headache
- Dizziness
- Viral infection
- Fatigue
- Abdominal pain
- Hypotension, diarrhea, arthralgia, back pain, hyperkalemia (heart failure)
Pregnancy Can cause fetal harm; discontinue as soon as pregnancy is detected.
Lactation Breastfeeding is not recommended.
⚠ BOXED WARNING
- Fetal toxicity; discontinue as soon as pregnancy is detected
Principal riskHyperkalemia and acute kidney injury
Cost, est. cash$4–$80/month
Generic entry2014
Classes and tags
Clinical profile
Legacy pregnancy categoryD
Defining liabilityHyperkalemia, kidney injury, fetal toxicity and increased lithium exposure.
Mechanism of action: Valsartan ballicule
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