Diovan

Generic Name: Valsartan
Brand Name: Diovan

Indications

Hypertension

Diovan is indicated for the treatment of hypertension. It may be used alone or in combination with other antihypertensive agents.

Heart Failure

Diovan is indicated for the treatment of heart failure (NYHA class II-IV). In a controlled clinical trial, Diovan significantly reduced hospitalizations for heart failure. There is no evidence that Diovan provides added benefits when it is used with an adequate dose of an ACE inhibitor

Post-Myocardial Infarction

In clinically stable patients with left ventricular failure or left ventricular dysfunction following myocardial infarction, Diovan is indicated to reduce cardiovascular mortality.

Dosage and Administration

Diovan is available as tablets containing valsartan 40 mg, 80 mg, 160 mg, or 320 mg.
Hypertension
The recommended starting dose of Diovan® (valsartan) is 80 mg or 160 mg once daily when used as monotherapy in patients who are not volume-depleted. Patients requiring greater reductions may be started at the higher dose. Diovan may be used over a dose range of 80 mg to 320 mg daily, administered once a day.
Heart Failure
The recommended starting dose of Diovan is 40 mg twice daily. Uptitration to 80 mg and 160 mg twice daily should be done to the highest dose, as tolerated by the patient. Consideration should be given to reducing the dose of concomitant diuretics. The maximum daily dose administered in clinical trials is 320 mg in divided doses.
Post-Myocardial Infarction
Diovan may be initiated as early as 12 hours after a myocardial infarction. The recommended starting dose of Diovan is 20 mg twice daily. Patients may be uptitrated within 7 days to 40 mg twice daily, with subsequent titrations to a target maintenance dose of 160 mg twice daily, as tolerated by the patient. If symptomatic hypotension or renal dysfunction occurs, consideration should be given to a dosage reduction. Diovan may be given with other standard post-myocardial infarction treatment, including thrombolytics, aspirin, beta-blockers, and statins.
Overdose: Symptoms of a valsartan overdose may include fast or slow heartbeat, feeling light-headed, or fainting.

Drug Description
Diovan is a nonpeptide, orally active and specific angiotensin II antagonist acting on the AT1 receptor subtype.
Valsartan is chemically described as N-(1-oxopentyl)-N-[[2′-(1H-tetrazol-5-yl) [1,1′-biphenyl]-4-yl]methyl]-L-valine. Its empirical formula is C24H29N5O3, its molecular weight is 435.5, and its structural formula is

Valsartan is a white to practically white fine powder. It is soluble in ethanol and methanol and slightly soluble in water.

Side Effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty in breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effects such as:

• chest pain, fast or pounding heartbeats
• numbness or tingly feeling
• swelling

Less serious side effects may include:

• runny or stuffy nose, sore throat, cough;
• muscle or back pain;
• nausea, vomiting, diarrhea, constipation;
• dry mouth, stomach pain, loss of appetite;
• mild itching, skin rash;
• sleep problems (insomnia);
• headache, dizziness, anxiety;
• tired feeling;
• weakness;

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

Precautions

• Avoid drinking alcohol. It can lower your blood pressure and may increase some of the side effects of valsartan. Do not use potassium supplements or salt substitutes while you are taking valsartan, unless your doctor has told you to.
• Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.
• Do not use this medication if you are allergic to valsartan, or if you are unable to urinate.
• Before using valsartan, tell your doctor if you are allergic to any drugs, or if you have:
• kidney disease; or
• liver disease.
• FDA pregnancy category D. This medication can cause harm to an unborn baby. Valsartan may cause injury and even death to the unborn baby if you take it during the second and third trimesters of pregnancy. Do not use valsartan without your doctor's consent if you are pregnant. Use an effective form of birth control. Stop using this medication and tell your doctor right away if you become pregnant during treatment.
• It is not known whether valsartan passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Drug Interactions
Before taking valsartan, tell your doctor if you are also taking a diuretic (water pill).
There may be other drugs that can interact with valsartan. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

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