Drug Index

Valsartan

 
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Mechanism :

Valsartan, an angiotensin II receptor antagonist, produces its BP lowering effects by antagonizing angiotensin II-induced vasoconstriction, aldosterone release and renal reabsorption of sodium.


Indication :

• Hypertension


Contraindications :

Hypersensitivity; Severe hepatic impairment; Cirrhosis or biliary obstruction; Primary hyperaldosteronism.


Dosing :

<6 years: Safety and efficacy not established

>6 years: 0.65-1.3 mg/kg/dose twice daily. Increase upto 40 mg/day. Maximum dose: 160 mg/day. In adults, maximum dose is 320 mg/day.


Adverse Effect :

Dizziness, headache, dose-related orthostatic hypotension, rash, angioedema, hyperkalaemia, myalgia, dry cough, back pain, fatigue, GI disturbances, abdominal pain, LFT elevations, increase in BUN and serum creatinine, blood dyscrasias (e.g. neutropenia).


Interaction :

NSAIDs and Ciclosporin: Increased risk of renal impairment and hyperkalaemia with NSAIDs and ciclosporin.
General Anaesthetics, Clozapine, Dopamine agonists and other Antihypertensives: Increased risk of hypotension.

Lithium: Increased risk of lithium toxicity.
Potassium-Sparing Diuretics, Potassium Supplements, ACE Inhibitors, Heparin: Increased risk of hyperkalaemia.



Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Dose as in normal renal function
10-20Initial dose 40 mg; titrate according to response
<10Initial dose 40 mg; titrate according to response

Dose in Patients undergoing Renal Replacement Therapies
CAPDNot dialysed. Dose as in GFR<10 mL/min
HDNot dialysed. Dose as in GFR<10 mL/min
HDF/High fluxUnknown dialysability. Dose as in GFR<10 mL/min
CAV/VVHDUnlikely to be dialysed. Dose as in GFR=10–20 mL/min

Hepatic Dose :

Mild to moderate hepatic impairment: Dose adjustment is not necessary but use cautiously as in liver impairment, levels can increase 2 times.
Severe hepatic impairment: Dose may need to be reduced, however guidelines do not specify dose, as it has not been studied.
05/28/2020 02:26:09 Valsartan
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