Valsartan

What is Valsartan?

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

How does Valsartan work?

High blood pressure, or hypertension, causes the heart and arteries to work too heart 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 reception of angiotensin II, a hormone in the body which contributes to the narrowing of blood vessels and the retention of salt and water. Blocking angiotensin II helps blood vessels to relax, lowering blood pressure.

Active ingredients

The active ingredient is Valsartan 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 that 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 conditions and severity of your symptoms. 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 a diuretic. For adult 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 is usually administered as soon as 12 hours after. This dose can be gradually increased over time to a maximum of 160 mg twice daily.    

Valsartan side effects

Like all medications, Valsartan can cause side effects in some people. If you experience signs of a severe allergic reaction (swollen face, lips, tongue or throat, difficulty breathing or swallowing, hives and itching) stop taking Valsartan and seek medical help immediately.

The following common side effects can affect up to 1 in 10 people:

• Dizziness
• Low blood pressure with or without symptoms such as dizziness and fainting when standing up
• Decreased kidney function

Uncommon side effects (affecting up to 1 in 100 people) include:

• Angioedema
• Sudden loss of consciousness
• Vertigo
• Severely decreased kidney function
• Muscle spasms, abnormal heart rhythm
• Breathlessness, difficulty breathing when lying down, swelling of the feet or legs
• Headache
• Cough
• Abdominal pain
• Nausea
• Diarrhoea
• Tiredness
• Weakness

  The following side effects have been reported, although their frequency is not known:

• Blistering skin
• Allergic reaction with symptoms of fever, swollen joints, joint pain, muscle pain, swollen lymph nodes and/or flu-like symptoms
• Purplish-red spots, fever itching (inflammation of blood vessels known as vasculitis)
• Unusual bleeding or bruising
• Muscle pain
• Fever, sore throat or mouth ulcers due to infections (symptoms of low white blood cell level)
• Decrease of level of haemoglobin and decrease in percentage of red blood cells in the blood
• Increase in level of potassium, which can trigger muscle spasms and abnormal heart rhythm in severe cases
• Increase of level of blood urea nitrogen and increase of level of serum creatine, which can indicate abnormal kidney function
• Low level of sodium in the blood

Contraindications

Do NOT take Valsartan if:

• You are allergic to any of the ingredients in this medication
• You have severe liver disease
• You are more than 3 months pregnant (it best not to take Valsartan at all during pregnancy)

If any of the following apply to you, speak to a doctor before taking Valsartan:

• You have liver disease
• You have severe kidney disease or are undergoing dialysis
• You are suffering from a narrowing of the kidney artery
• You have recently undergone kidney transplantation
• You are being treated for heart attack or heart failure
• You have severe heart disease other than heart failure or heart attack
• You have ever experienced an allergic reaction called angioedema when taking another medication
• You are taking potassium supplements or salt substitutes containing potassium
• You are under the age of 18
• You suffer from aldosteronism
• You are dehydrated at a result of diarrhoea or vomiting
• You think you might be pregnant or you are planning on becoming pregnant

Drug interactions

Before taking Valsartan, tell your doctor or pharmacist if you are taking any other medications, including those purchased over the counter without a prescription. In particular, tell your doctor if you are taking any of the following:

• Other medicines that lower blood pressure, in particular diuretics, ACE inhibitors or aliskiren
• Medicines that increase the amount of potassium in your blood, including potassium-sparing medicines and heparin
• Non-steroidal anti-inflammatory painkillers
• Antibiotics of the rifamycin group, ciclosporin or ritonavir
• Lithium
• Aliskiren

For treatment following a heart attack, a combination of Valsartan with ACE inhibitors is not recommended. For treatment of heart failure, a triple combination of Valsartan, ACE inhibitors and beta blockers is not recommended.   

Valsartan and pregnancy

Valsartan is not recommended in early pregnancy, and must not be taken after the 3rd month of 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 the other ARBs 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. However, both of these options are thought to be less effective in patients over the age of 55 or of Afro-Caribbean descent, in which cases a different alternative might be preferable. Beta-blockers work by blocking the angiotensin II hormone and by lowering your heart rate, while the calcium-channel blockers Amlodipine, Felodipine and Lercanidipine work by preventing calcium from causing blood vessels to constrict. Diuretics aid the relaxing of blood vessels and are sometimes taken in combination with the ACE inhibitor Enalapril.

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, wholegrains and lean meats in your diet. Exercising regularly will help to keep you 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, ofen for the rest of the patient’s life.

Sources

• Patient Information Leaflet
• NHS > Valsartan