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Living with Valsartan: Your Questions Answered

Answers to Frequently Asked Questions About Valsartan

Valsartan belongs to a category of drugs called angiotensin II receptor blockers (ARBs). It is mainly used to treat high blood pressure, and sometimes heart failure which helps prevent heart attacks and kidney failure.

Valsartan is taken orally in the form of a tablet.

We’ve gathered some of the most common questions people ask about valsartan and put together this handy Q&A.

If you are seeking information about the recall of valsartan, go to question ‘Should I be concerned about the valsartan recall?’

The content on this page is provided for informational purposes only. If you have any questions or concerns about your treatment, you should talk to your doctor, pharmacist, or healthcare professional. This is particularly important if you are taking multiple medications or have any existing medical conditions.

What is valsartan?

Valsartan belongs to a class of drugs called angiotensin II receptor blockers (ARBs). Other drugs in the class include:

  • Candesartan
  • Losartan
  • Irbesartan
  • Eprosartan
  • Azilsartan
  • Olmesartan
  • Telmisartan

Angiotensin II is a hormone that binds to receptors on blood vessels and other parts of the body. When this happens, the muscles surrounding the blood vessels contract, which restricts blood flow and increases blood pressure.

ARBs work by blocking angiotensin II from binding to receptors, thus avoiding the contraction that increases blood pressure and relaxing blood vessels so that blood can flow more easily.

What is valsartan HCTZ?

Valsartan HCTZ is valsartan that also contains hydrochlorothiazide (HCTZ), which is a diuretic medicine commonly referred to as a water pill.

Diuretics help treat high blood pressure by averting the reabsorption of electrolytes such as sodium, chloride, magnesium, and potassium, which are subsequently flushed out through urine along with excess water.

The removal of excess water and electrolytes from blood vessels helps blood flow and lowers your blood pressure.

Diuretics are often a first-line treatment for high blood pressure. When diuretics alone are not able to sufficiently lower blood pressure, they will often be combined with another treatment. This is why Valsartan and HCTZ are available as a combined medication.

In other words, you can say that both valsartan and valsartan HCTZ work together in reducing high blood pressure.

Is Diovan and valsartan the same drug?

Valsartan is the generic name and Diovan is the brand name of valsartan - a common medication that is prescribed to treat high blood pressure, heart failure, and hypertension.

Diovan keeps blood vessels from narrowing which improves blood flow and lowers blood pressure.

Diovan and valsartan are sometimes used interchangeably. Both the generic and branded medications work the same.

What is valsartan used for?

Valsartan is primarily used to treat high blood pressure (and heart failure which helps prevent heart attacks/kidney failure). Along with other ARBs, it is often used as a first-line treatment. Other first-line treatments include:

  • Angiotensin-converting-enzyme (ACE) inhibitors
  • Diuretics
  • Calcium channel blockers

There are Further treatment options such as:

  • Vasodilators
  • Beta-blockers
  • Alpha blockers
  • Renin inhibitors
  • Central-acting agents
  • Aldosterone antagonists

Your doctor will take factors such as your age, sex, race, blood pressure level, and other conditions into consideration when deciding the most suitable treatment options.

If you do not respond to one type of treatment or have an adverse/allergic reaction, your doctor may try a different medication or a combination of two drugs.

However, some types of drugs are not routinely used in combination, such as ARBs and ACE inhibitors.

Treatment for hypertension will usually include recommendations for healthy lifestyle changes, such as an improved diet and exercise within one’s capabilities.

How long does it take for valsartan to work?

Valsartan starts working almost immediately, usually within 6 hours after taking your first dose. It takes 3 to 6 weeks for valsartan to take full effect.

Because the symptoms of high blood pressure are often inconspicuous, you may not feel any difference when you take valsartan. That does not mean it is not working. You should continue taking it as prescribed unless told otherwise by your doctor.

What are the most common side effects of valsartan?

The most common side effects of valsartan are:

  • Dizziness
  • Hypotension
  • Headaches
  • Feeling sick (nausea)
  • Pain in joints and muscles
  • Sickness and diarrhea

These side effects will often go away after a few days, although can last a couple of weeks. If they don’t subside or are severe, you should speak to your doctor.

Serious side effects of valsartan are rare. You should contact your doctor immediately if you experience any of the following:

  • Yellow skin or the whites of your eyes turning yellow (this can be a sign of liver problems)
  • Fainting
  • Pale skin
  • Muscle weakness, slow/irregular heartbeat (symptoms of a high potassium blood level)
  • Kidney problems
  • Chills, fever, hoarseness

Serious allergic reactions to valsartan are also rare. If you do experience signs of a serious allergic reaction, seek medical attention immediately. If you have ever had any of these reactions to another type of ARB, you should not take valsartan. Symptoms include:

  • Swelling of your face, lips, tongue, or throat
  • A skin rash that may include itchy, red, swollen, blistering, or peeling skin
  • Tightness in your chest or throat
  • Wheezing or trouble breathing

Although this covers the majority of known side effects caused by valsartan, check the information leaflet for an extensive list.

What is the correct dosage of valsartan?

Valsartan tablets commonly come in doses of 40 mg, 80 mg, 160 mg, and 320 mg.

An initial dose of valsartan for adults is 80 to 160 mg orally once a day with a maintenance dose of 80 to 320 mg orally once a day. The maximum dose is 320 mg daily.

For children between 6 to 16 years old with hypertension, the dosage may be calculated by weight starting with 1.3 mg/kg once a day (up to 40 mg) and a maintenance dose up to 2.7 mg/kg (up to 160 mg) once a day titrated according to patient response.

However, If the calculated dosage does not correspond to the available tablet strengths, or if children are unable to swallow tablets, the use of a suspension (which can be prepared from the tablets) is recommended. The valsartan dose may need to be increased if the suspension is replaced by a tablet.

If you are living with other conditions, they will usually be taken into consideration when your doctor is deciding on the correct dosage.

Your doctor will take your blood pressure levels, age, other conditions, and any other mitigating factors into account when deciding the correct dosage.

What is the difference between valsartan and losartan?

Although both valsartan and losartan are ARBs, they interact with your body slightly differently and have different characteristics. Likewise, the other drugs in the class (azilsartan, irbesartan, olmesartan, candesartan, eprosartan, and telmisartan) each differ from one another.

Your doctor will likely take factors such as your blood pressure level, the risk of cardiovascular events (such as stroke or heart attack), and other existing conditions into consideration when deciding which specific ARB is most suitable.

Aside from other conditions you live with, your doctor may take the half-life of each ARB into consideration. Half-life refers to the amount of time it takes for 50% of the drug to be eliminated from the body. With each half-life, the amount of drug reduces by a further 50%.

Losartan has a shorter half-life (about 2 hours) than valsartan (about 6 hours).

Therefore, it would take around 24 hours, rather than 8 hours, for valsartan to be reduced to 6.25%. Valsartan may, therefore, be more effective at providing 24-hour coverage from a single dose.

Your doctor will likely consider other conditions you live with and the half-life of different ARBs when deciding which is most suitable for you. If you have any concerns about your treatment, you should always discuss them with your doctor.

How long does valsartan stay in your system?

It takes approximately 5.5 x elimination half-life for a drug to be cleared from one’s system.

Given the fact that valsartan has an elimination half-life of about 6 hours, it would take approximately 33 hours (5.5 x 6 hours) for valsartan to be cleared from your system.

What should I consider before taking valsartan?

Valsartan can be taken by adults aged 18 and over. Children over the age of 6 can also take it but only to treat high blood pressure.

Your doctor may prescribe valsartan if you’ve tried taking other blood pressure lowering drugs like ACE inhibitors (e.g. ramipril, lisinopril) but had to stop because of adverse side effects like a dry and irritating cough.

Valsartan may not be suitable in conjunction with treatment for other conditions, such as diabetes, impaired kidney function, cardiovascular conditions, and liver disease.

Valsartan may also be unsuitable if you have had an allergic reaction to another blood pressure medication.

The vital point is to talk to your doctor about any medical conditions, medications, or allergies before prescription or before you start taking valsartan. Likewise, if you take supplements or maintain a low-salt-diet, these topics should be discussed with your doctor.

Should I take valsartan in the morning or at night?

It is widely agreed that taking valsartan at the same time each day is more important than the actual time of day. There is no conclusive evidence that taking valsartan either in the morning or in the evening leads to better or worse results.

However, it could be important to schedule when you take valsartan and when you take other medications or supplements, to avoid interactions.

Otherwise, it may just be a case of choosing a time that allows you to achieve consistency.

Topics like these should be discussed with your doctor, together with whom you can figure out the most suitable time to take valsartan.

Is valsartan safe during pregnancy or when breastfeeding?

No. Valsartan, like other ARBs, poses serious risks to a developing baby and can cause birth defects or even a miscarriage. The risks are heightened in the second and third trimesters of pregnancy.

If you are planning on having a baby, speak to your doctor about your options before trying to conceive.

If you think you may be pregnant, speak to your doctor immediately. The risks posed by valsartan are present early in a baby’s development, so it is important to find a safe alternative as soon as possible.

There’s currently no available information on the use of valsartan when breastfeeding.

As such, drugs with a more defined safety profile are usually recommended for women who are breastfeeding, especially while nursing a newborn or preterm infant.

Can I take painkillers or other drugs with valsartan?

Some painkillers may reduce valsartan’s effectiveness at reducing blood pressure and should not be taken together. This includes non-steroidal anti-inflammatory drugs (NSAIDs) such as:

  • Ibuprofen
  • Diclofenac
  • Celecoxib
  • Naproxen
  • Indomethacin

NSAIDs may also increase your risk of kidney problems when taken together with valsartan. You should not take them together unless told to by your doctor.

Paracetamol (acetaminophen) is considered safe to use with valsartan.

Other products that may interact with valsartan include aliskiren, lithium, drugs that may increase the potassium level in your blood (ACE inhibitors like benazepril/lisinopril, birth control pills containing drospirenone).

This is not a comprehensive list of drug interactions with valsartan.

Do not start, change or stop the dosage of any medication without telling your doctor first. If you have any questions or concerns about taking painkillers with valsartan, you should discuss them with your doctor.

What foods should I avoid when taking valsartan?

Grapefruit and grapefruit juice may reduce your ability to absorb valsartan and therefore be avoided. It slows down how quickly the body is able to break down the medication, which could cause valsartan levels in the blood to rise dangerously high.

Valsartan and other ARBs tend to increase potassium levels in your bloodstream, which can increase your risk of developing a weak or an irregular heartbeat. Foods high in potassium should, therefore, be limited, such as:

  • Bananas, oranges, cantaloupe, honeydew, apricots, raisins, and dates
  • Avocadoes
  • Tomatoes
  • Mushrooms
  • Potatoes and sweet potatoes
  • Peas
  • Dried fruits

Be aware of salt substitutes, as they often replace sodium with potassium.

You should discuss your consumption of potassium-rich foods, salt substitutes, and potassium supplements with your doctor.

Can I drink alcohol while taking valsartan?

It is not recommended to drink alcoholic beverages while taking valsartan. You should avoid alcohol for at least a few days when you start taking valsartan or when your dose is increased.

Some of the side effects of valsartan, such as dizziness, are caused by the blood pressure-lowering effect of the drug. Alcohol also lowers your blood pressure, so the combination can exacerbate the symptoms and damage many different organ systems, such as the cardiovascular, urinary, and immune systems of the body.

If you live with other conditions, such as heart failure, it is important to discuss your alcohol consumption with your doctor and follow the advice you are given.

How can I wean myself off of valsartan?

Never stop taking valsartan without first speaking to your doctor, even if you think you’re feeling better.

Valsartan, like other medications that lower blood pressure, is usually required for life, even if it has successfully lowered your blood pressure. Continued use will help keep your blood pressure under control and may help mitigate the risk of a stroke or heart attack.

This is mostly true if the primary underlying causes of your high blood pressure are non-modifiable, such as age, genetics, or another chronic illness.

Regardless, there are some circumstances when stopping treatment may be appropriate, i.e. if the primary underlying causes of your high blood pressure are modifiable, such as a high-salt diet, lack of exercise, and smoking. If you have successfully made lifestyle changes that tackle these causes, stopping your treatment may be appropriate.

If this is the case, you must discuss it with your doctor. Together you can discuss the best course action, be it continuing your treatment, reducing your dosage, switching to a different medication (such as a diuretic), or stopping your treatment.

Should I be concerned about the valsartan recall?

You may have read about lots of valsartan, other BP meds and ARBs being recalled since July 2018, due to being contaminated by chemicals considered to be probable human carcinogens. A carcinogen is a substance capable of causing cancer.

Daunting though that sounds, an FDA laboratory analysis came to the following conclusion:

“FDA previously estimated that if 8,000 people took the highest valsartan dose (320 mg) containing NDMA from the recalled batches daily for four years, there may be one additional case of cancer over the lifetimes of the 8,000 people. That estimate was based on the highest daily dose; however, many people may have taken lower doses, and therefore their risks would theoretically be less. FDA expects the actual cancer risk to most consumers to be lower than our estimate.”

The European Medicines Agency also found the risk to be low.

If you are taking valsartan, it is therefore important to continue taking your medication as normal. The risks posed by suddenly stopping your medication significantly outweigh the risks posed by the contamination.

Also, understand that not all valsartan is being recalled. If you are in the USA, you can keep track of the latest updates via the FDA website, while a complete list of valsartan products being recalled can be found here.

If you are outside the USA, you can check the website of your national regulatory body.

If you are taking valsartan that is being recalled, continue taking your medications and speak to your doctor or pharmacist about switching to an alternative treatment.

The content on this page is provided for informational purposes only. If you have any questions or concerns about your treatment, you should talk to your doctor, pharmacist, or healthcare professional. This is particularly important if you are taking multiple medications or have any existing medical conditions.