Home Drug Guide Valsartan

Drug Guide

Generic Name

Valsartan

Brand Names Diovan, Prexxartan

Classification

Therapeutic: Antihypertensive, Angiotensin II Receptor Blocker (ARB)

Pharmacological: Selective angiotensin II receptor antagonist

FDA Approved Indications

Hypertension
Heart failure (NYHA Class II-IV)
Post-myocardial infarction (reduces cardiovascular mortality)

Mechanism of Action

Blocks the binding of angiotensin II to the AT1 receptor, resulting in vasodilation, decreased aldosterone secretion, and lowered blood pressure.

Dosage and Administration

Adult: Typically, 80-320 mg once daily, titrated based on response.

Pediatric: Approved for children ≥ 6 years for hypertension; dosing varies by weight and age.

Geriatric: Start with lower doses due to increased sensitivity; adjust as necessary.

Renal Impairment: Use with caution; dose adjustment may be required, especially in bilateral renal artery stenosis.

Hepatic Impairment: Use with caution; no specific dose adjustment recommended but monitor closely.

Pharmacokinetics

Absorption: Good oral absorption (~25%)

Distribution: High protein binding (~95%)

Metabolism: Minimal hepatic metabolism; primarily excreted unchanged in feces and urine.

Excretion: Excreted mainly in feces and urine.

Half Life: About 6 hours; once-daily dosing typically sufficient.

Contraindications

History of allergy to valsartan or other ARBs
Pregnancy (especially in second and third trimesters)

Precautions

Pregnancy risk, caution in renal artery stenosis, monitor renal function, and electrolytes particularly potassium.

Adverse Reactions - Common

Dizziness (Common)
Hyperkalemia (Common)
Fatigue (Common)

Adverse Reactions - Serious

Angioedema (Rare)
Hypotension (Rare)
Acute kidney injury (Rare)

Drug-Drug Interactions

Diuretics, potassium supplements, lithium, other antihypertensives

Drug-Food Interactions

Salt substitutes containing potassium

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure, renal function, and serum electrolytes.

Diagnoses:

Risk for decreased cardiac output
Risk for electrolyte imbalance

Implementation: Administer medication as prescribed, monitor for adverse effects, educate patient on blood pressure monitoring.

Evaluation: Assess for effective reduction in blood pressure and absence of adverse reactions.

Patient/Family Teaching

Take medication at the same time daily.
Do not discontinue abruptly.
Report signs of angioedema, hyperkalemia, or hypotension.
Avoid pregnancy while on medication.

Special Considerations

Black Box Warnings:

Pregnancy : can cause injurious or fatal effects to the fetus, discontinue as soon as pregnancy is detected.

Genetic Factors: Genetic polymorphisms may influence drug response.

Lab Test Interference: May alter serum creatinine and potassium levels.

Overdose Management

Signs/Symptoms: Hypotension, tachycardia, dizziness.

Treatment: Supportive care, IV fluids for hypotension, and monitor vital signs. No specific antidote.

Storage and Handling

Storage: Store at room temperature, away from moisture and heat.

Stability: Stable when stored properly.