Valsartan
Generic Name: Valsartan
Brand Names: Diovan
Valsartan is used to treat high blood pressure, heart failure, and post-heart attack. It is available as Diovan and is commonly prescribed in the cardiovascular category.
Drug Class
Angiotensin II Receptor Blocker (ARB)
Pregnancy
Category X — Contraindicated in pregnancy. Can cause fetal injury and death when used during the second and third trimesters.
Available Forms
Tablet, Oral Solution
What It's Used For
Dosage Quick Reference
These are general dosage guidelines. Your doctor will determine the appropriate dose for your specific situation.
| Condition | Starting Dose | Maintenance Dose |
|---|---|---|
| Hypertension (Adults) | 80–160 mg once daily | 80–320 mg once daily |
| Heart Failure (NYHA II–IV) | 40 mg twice daily | Titrate to 160 mg twice daily as tolerated |
| Post-Myocardial Infarction | 20 mg twice daily | Titrate to 160 mg twice daily as tolerated |
Side Effects
Common Side Effects:
- Dizziness
- Headache
- Fatigue
- Diarrhea
- Arthralgia
- Back pain
Serious Side Effects:
- Hypotension
- Hyperkalemia
- Acute renal failure
- Angioedema (rare)
Drug Interactions
Major Interactions:
- Aliskiren — Concurrent use is contraindicated in patients with diabetes and should be avoided in patients with renal impairment (GFR < 60); increases risk of hyperkalemia, hypotension, and renal failure
- ACE inhibitors (e.g., lisinopril, enalapril) — Dual RAAS blockade increases the risk of hypotension, hyperkalemia, and acute kidney injury; avoid combination
- Potassium supplements and potassium-sparing diuretics (e.g., spironolactone, triamterene) — Increased risk of hyperkalemia; monitor serum potassium closely
- NSAIDs (e.g., ibuprofen, naproxen) — May reduce the antihypertensive effect of valsartan and increase the risk of renal impairment, especially in elderly or volume-depleted patients
- Lithium — ARBs can increase serum lithium levels, potentially leading to lithium toxicity; monitor lithium levels frequently
Additional Information
Valsartan is an angiotensin II receptor blocker (ARB) used to treat hypertension, heart failure, and to reduce cardiovascular mortality post-myocardial infarction. It is one of the most widely prescribed ARBs.
Mechanism of Action
Valsartan blocks the renin-angiotensin system:
- AT1 receptor antagonism: Selectively blocks angiotensin II type 1 receptors
- Prevents vasoconstriction: Blocks angiotensin II-mediated arterial constriction
- Reduces aldosterone secretion: Decreases sodium and water retention
- Does not affect bradykinin: Unlike ACE inhibitors, no cough from bradykinin accumulation
Provides antihypertensive and cardioprotective effects.
Available Formulations
Valsartan is available as:
- Tablets: 40 mg, 80 mg, 160 mg, 320 mg
- Oral solution: 4 mg/mL
Also available in combinations with hydrochlorothiazide, amlodipine, and as part of sacubitril-valsartan (Entresto).
Medical Uses
FDA-Approved Indications:
- Hypertension (adults and pediatric patients ≥6 years)
- Heart failure (NYHA Class II-IV) to reduce hospitalizations
- Post-myocardial infarction with left ventricular failure or dysfunction
Dosing Guidelines
Hypertension:
- Initial: 80-160 mg once daily
- Maximum: 320 mg once daily
- Pediatric (6-16 years): 1.3 mg/kg once daily (max 40 mg)
Heart Failure:
- Initial: 40 mg twice daily
- Target: 160 mg twice daily
- Titrate to highest tolerated dose
Post-MI:
- Initial: 20 mg twice daily (may start as early as 12 hours post-MI)
- Target: 160 mg twice daily
- Titrate over 2 weeks as tolerated
Important Safety Information
Boxed Warning:
- Fetal toxicity: Can cause fetal harm; discontinue when pregnancy detected
Contraindications:
- Known hypersensitivity to valsartan
- Concomitant use with aliskiren in patients with diabetes
Warnings and Precautions:
- Hypotension: Risk with volume/salt depletion
- Hyperkalemia: Monitor potassium, especially in renal impairment
- Renal impairment: May worsen; monitor renal function
- Hepatic impairment: Use with caution
Drug Interactions
- Aliskiren: Contraindicated in diabetic patients; avoid in renal impairment
- Lithium: Increased lithium levels; monitor
- Potassium supplements/potassium-sparing diuretics: Increased hyperkalemia risk
- NSAIDs: May reduce antihypertensive effect; increase renal dysfunction risk
- ACE inhibitors: Dual blockade increases adverse effects
Special Populations
- Hepatic Impairment: No adjustment for mild to moderate; use with caution in severe (especially biliary obstruction)
- Renal Impairment: No adjustment for mild to moderate; use with caution in severe
- Elderly: No adjustment; start at lower end of dosing range
- Pregnancy: Contraindicated
- Lactation: Unknown if excreted; not recommended
- Pediatric: Approved for hypertension ≥6 years; not for children <6 or with eGFR <30
Frequently Asked Questions
Questions to Ask Your Doctor
Consider discussing these topics at your next appointment:
- ✓Ask your doctor how often you should have your kidney function and potassium levels checked.
- ✓Discuss whether valsartan is safe if you are planning to become pregnant or are of childbearing age.
- ✓Ask if any of your current medications, including over-the-counter pain relievers, could interact with valsartan.
- ✓Discuss your target blood pressure goal and how you will track progress at home.
Related Health Conditions
This medication is commonly used to treat or manage the following conditions:
Attention Deficit Hyperactivity Disorder (ADHD)
ADHD is a neurodevelopmental disorder marked by inattention, hyperactivity, and/or impulsivity, stemming from complex interactions between genetics, brain differences, and environmental factors, not poor parenting.
Lupus Anticoagulant
Lupus anticoagulant is an antibody causing paradoxical prolonged clotting tests yet increasing thrombosis risk, linked to antiphospholipid syndrome and autoimmune diseases, despite not always requiring lupus diagnosis.
Portal Hypertension
Portal hypertension, an elevated pressure in the portal vein due to blockage often from cirrhosis or other pre-hepatic causes, can lead to serious complications like bleeding and ascites.
Secondary Pulmonary Hypertension
Secondary pulmonary hypertension, unlike its primary form, arises from underlying conditions such as heart/lung disease, blood clots, or connective tissue disorders, increasing lung artery pressure.
Vertigo
Vertigo, a spinning sensation distinct from dizziness, often stems from inner ear or brain issues like BPPV or Meniere's, sometimes triggered by head trauma or medication.
Medical Disclaimer: This information is for educational purposes only and should not be considered medical advice. Always consult with your healthcare provider before starting, stopping, or changing any medication. Your doctor can provide personalized recommendations based on your specific health condition and medical history.
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Questions About This Medication?
Talk to your doctor or pharmacist about whether Valsartan is right for you.
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