Valsartan

What is valsartan?

Valsartan is a type of medication known as an angiotensin II receptor blocker (ARB). It is used to reduce blood pressure, and can also be used to treat heart failure, and may also be prescribed following a heart attack.

How does valsartan work?

High blood pressure, or hypertension, causes the heart and arteries to work too hard to pump blood around the body, which can lead to damaged vessels in the brain, heart and kidneys, heart failure, stroke or kidney failure. ARBs like Valsartan work by blocking the action of a hormone called angiotensin II, which contributes to the constriction of blood vessels and the retention of salt and water. Blocking the action of angiotensin II helps blood vessels to relax, lowering blood pressure.

Active ingredients

The active ingredient in valsartan tablets is valsartan.

Inactive ingredients

The inactive ingredients in valsartan are cellulose microcrystalline, silica colloidal anhydrous, crospovidone (Type-B), povidone (K 30), sodium lauryl sulphate, magnesium stearate, iron oxide black (E172), titanium dioxide (E171), gelatin, sodium lauryl sulfate, shellac (E904) propylene glycol, black iron oxide, titanium dioxide, and potassium hydroxide.

Please note: different manufacturers of generic valsartan might use different inactive ingredients in their drugs than those listed above.

How to start taking valsartan?

Always take valsartan as instructed by a doctor or pharmacist. Valsartan tablets should be swallowed with a small glass of water at around the same time each day, with or without food. If you forget to take a dose, take it as soon as you remember unless it is almost time for your next dose. In this case, just take the next dose at the normal time. Never take a double dose to make up for a missed one.

Valsartan dosage

Your dosage will be decided by a doctor depending on your age, condition and medical background. The recommended dose for treating high blood pressure in adults is 80 mg taken once daily, although a doctor may prescribe a higher dose of 160 mg or 320 mg, or combine valsartan with other drugs for maximal effect. For patients with heart failure, the recommended starting dose is 40 mg taken twice daily, which can be increased gradually to a maximum of 160 mg twice daily. For treating patients after a recent heart attack, a low dose of 20 mg twice daily may be used. Always take the dose prescribed to you, and never increase or lower the dose unless instructed to by your prescriber.

Valsartan side effects

Common side effects include: 

• Abdominal pain
• Physical weakness
• Lack of energy
• Back pain
• Cough
• Diarrhoea
• Dizziness
• Headache
• An increased level of potassium recorded in blood tests 
• Low blood pressure 
• Nausea
• Vomiting
• Changes to kidney function

Uncommon side effects may include: 

• Skin swelling or rash
• Muscle aches or pains
• Other skin reactions
• Reduced platelet count (manifested as unexpected bruising or bleeding)
• Heart failure
• Fainting

Rare side effects may include: 

• Joint pain
• Abnormal liver function

Other side effects for which the frequency is not known may include: 

• Low white blood cells
• Vasculitis (inflammation of the vessels, causing a blotchy rash)

Serious side effects are rare, however, if you experience any of the following then seek medical attention: 

• Rash, swelling of the face, lips or tongue, wheezing or difficulty breathing – this may indicate an allergic reaction
• Yellowing of the skin or whites of the eyes – this can indicate a liver problem
• Purple spots on the skin or unexpected bruising or bleeding – this may indicate a blood disorder
• Weakness, an irregular heartbeat or palpitations, pins and needles or muscle cramps – these can be signs of changes in the salt levels in your blood

Contraindications

Do NOT take valsartan if you:

• Are allergic to any of the ingredients in this medication
• Are pregnant
• Have biliary cirrhosis (a liver condition)
• Have cholestasis (an abnormality of the bile salts)
• Have severe liver disease

Before taking valsartan, tell your doctor if any of the following conditions apply to you: 

• Diabetes
• Under the age of 18 or over the age of 65
• Vomiting or diarrhoea 
• Kidney problems, including stenosis of the renal artery 
• Transplanted kidney 
• Heart problems, including heart failure or valve problems
• Liver disease
• Surgery scheduled in the future
• Pregnancy or you are trying to get pregnant 
• Currently breastfeeding
• Of black African or African-Caribbean descent
• History of angioedema (rapid and severe swelling of the skin)
• Primary aldosteronism
• Have been on a low-salt diet
• History of low blood pressure

Drug interactions

Let your doctor know if you are taking any other medication. Particularly:

• Other medications to lower your blood pressure e.g. Ramipril, Enalapril, Aliskiren 
• Potassium supplements 
• Salt substitutes containing potassium 
• Diuretics e.g. Bendroflumethiazide, Indapamide
• Lithium 
• Non-steroidal anti-inflammatories such as ibuprofen, naproxen
• Aspirin
• Heparin
• Spironolactone

Valsartan and pregnancy

Valsartan is not recommended in pregnancy. Tell your doctor immediately if you think you are pregnant or are planning on becoming pregnant.

Valsartan and alcohol

Drinking alcohol can increase the blood pressure-lowering effect of valsartan. If you experience dizziness or lightheadedness while taking this medication, it is best not to drink alcohol at all.

Valsartan alternatives

There are many different types of high blood pressure medication, including other ARBs e.g. losartan and candesartan. A doctor will be able to decide which is best for you based on your condition, age and symptoms. Alternative treatments include angiotensin-converting enzyme (ACE) inhibitors, which work in a similar way to ARBs. Beta-blockers work by both lowering your heart rate and reducing your blood pressure, while the calcium-channel blockers amlodipine, felodipine and lercanidipine work by preventing calcium from constricting your blood vessels. Diuretics alter the amount of water lost through the kidney and are sometimes taken alone or in combination with other medications.

Lifestyle changes to make when taking valsartan

Valsartan itself does not require you to make any changes to your life, but a few simple lifestyle changes can help to reduce blood pressure and improve your overall wellbeing. A major cause of high blood pressure is a high salt intake, so try to limit the amount of salt in your diet to below the recommended maximum of 6g per day. Cut back on fatty foods and try to include plenty of fruit and vegetables, whole grains and lean meats in your diet. Exercising regularly will help to keep your heart and blood vessels in good condition, and can also contribute to reducing stress. Stress is another cause of high blood pressure, so try and avoid it by spending time with friends and family, taking daily walks and finding the time to relax where possible. Limit the amount of alcohol you drink to the recommended maximum of 14 units per week and, if you haven’t already done so, quit smoking.

Will I need to take valsartan forever?

Treatment with valsartan is usually long-term, often for the rest of the patient’s life.