Diovan 80 Novartis medicine for hypertension, heart failure (2 blisters x 14 tablets)
Dosage form Box of 2 blisters x 14 tablets
Specifications Valsartan
Ingredient Myocardial infarction, psoriasis, heart failure, high blood pressure
Ingredient
| Composition information | Content |
| Valsartan | 80mg |
Uses
Indications
Diovan drugs are indicated in the following cases:
Hypertension
Treatment of hypertension.
heart failure
Treatment of heart failure (Grade II - IV according to the classification of the New York - NYHA Heart Association) in adult patients who are treating standard with diuretics, digitalis with or beta blockers or angiotensin transferring enamel inhibitors (ACE) but not both use; There is no mandatory all this standard treatment.
Diovan improves the incidence of these patients, mainly by reducing hospitalization due to heart failure. Diovan also slows down the progression of heart failure, improves the functional failure of NYHA's classification, improves blood emulsion, reduces the signs and symptoms of heart failure and improves the quality of life compared to the placebo.
after myocardial infarction:
diovan is indicated to improve the survival after myocardial infarction in clinical stable patients with signs, symptoms or manifestations of X -rays of left ventricular failure and/or there is a left ventricular systolic dysfunction.
Pharmacokological
Hormone has the activity of the Renin - Angiotesin - Aldosterone system, Angiotensin II, formed from angiotensin I through Angiotensin transfer enzyme. Angiotensin II attached to specific receptors on the cell membrane of different tissues.
It has a wide special physiological effect including direct and indirect participation in regulating blood pressure. As a strong vasoconstrator, Angiotensin responds to direct hypertension. In addition, it also promotes sodium retention and stimulates Aldosterone secretion.
Diovan (Valsartan) is an angiotensinii receptor antagonist (Ang II) that is active, strong and specific to oral. It selectively affects the AT1 receptor.
The concentration of angiotensin II in plasma increases after the AT1 receptor is inhibited with Valsartan, which can stimulate the AT2 receptor not inhibited, which works to balance with the effect of the AT1 receptor. Valsartan does not show any partial activity at AT1 receptor and has a higher AT1 receptor (about 20,000 times higher) than the AT2 receptor.
Valsartan does not inhibit the angiotensin transfer enzyme, also known as Kininase II, has the effect of converting angiotensin I into angiotensin II and bradykinin. Because there is no effect on angiotensin transfer enzymes and not further strengthening Bradykinin or P substance, Angiotensin II antagonists are not associated with cough.
In clinical trials in valsartan measurements are compared to an angiotensin transfer inhibitor, the rate of dry cough is significantly lower (p
In a clinical trial in patients with a history of dry cough while being treated with enzyme inhibitors, 19.5% of patients in the test have used Valsartan and 19% of patients who are taking thiazide diuretics are coughed up from 68.5% of patients treated with enzyme inhibitors (P
Valsartan is not attached to or does not block other receptors of hormones or not blocking ion channels is known as important in the cardiovascular regulation.
pharmacokinetic
absorption
After taking the single -dose valsartan, the peak of the plasma of Valsartan is achieved for 2-4 hours. Absolute bioavailability is 23%.
When using diovan along with food, the area under the concentration curve (AUC) in the plasma of Valsartan decreases 48%, although about 8 hours after use, Valsartan concentration in plasma is similar to the group that has eaten and fasting.
However, the decrease in AUC does not have a significant reduction in clinical treatment, so you can use diovan with or not with food.
Distribution
The volume of distribution in the stable state of Valsartan after intravenous injection is about 17 liters, showing that Valsartan is not distributed into spacious tissues. Valsartan is strongly attached to plasma proteins (94 - 97%), mainly serum albumin.
Metabolism
Valsartan is not transferred to a high level of biological form, only about 20% of the dose is sought in the form of metabolites.
A hydroxy metabolites have been determined in plasma at decades (less than 10% AUC valsartan). This metabolic substance is an inactive pharmacy.
Elimination
Valsartan has pharmacokinetic decay according to a polyploid cone function (t ½ α After intravenous injection, the purification in Valsartan's hemorrhage is about 2 l/h and the purification of the kidney is 0.62 l/h (about 30% of total purification). Valsartan's half -life is 6 hours.
The pharmacokinetics of Valsartan linear at the test of tested. There is no change in the dynamics of Valsartan when repeated, and the accumulation is rarely used 1 time/day. The concentrations in plasma are similar in men and women.
Time to achieve the average peak concentration and the sale time of Valsartan in heart failure patients similar to being observed in healthy volunteers. Valsartan's AUC and CMAX values increased linearly and mostly proportional to the dose increasing when using the clinical dose level (40 - 160mg, 2 times/day).
The average accumulation coefficient is about 1.7. The apparent clearance of Valsartan after drinking is about 4.5 liters/hour. Age does not affect the apparent clearance in patients with heart failure.
Special patient group
Elderly (from 65 years of age)
has recorded a whole body contact for Valsartan slightly higher in some elderly people than young people; However, this has not seen any clinical significance.
Renal function impairment
As may be encountered for a substance whose kidney clearance accounts for only 30% of the total plasma clearance, not yet recorded between kidney function and body contact level for Valsartan. So do not need to adjust the dose in patients with renal failure.
There has been no research conducted in the patient being divided. However, Valsartan is strongly attached to plasma proteins and is not sure to be removed by fertilizer.
Hepatic failure
About 70% of the absorption dose is excreted in bile mainly in the form of constant drugs. Valsartan does not undergo strong biological change, and the level of body contact for Valsartan may not be related to the level of liver dysfunction.
So do not adjust the dose in patients with liver failure not due to biliary tract or not due to gallstones. Valsartan's AUC has been twice the interval in patients with cirrhosis or bile congestion.
Clinical studies
Hypertension
Use Diovan 80mg for patients with hypertension leading to a decrease in blood pressure without affecting the pulse.
On most patients, after taking a single dose of oral, onset the anti -hypertensive effect occurs within 2 hours, and maximum hypotension achieved within 4-6 hours. Anti -hypertension effect lasts more than 24 hours after use.
During the continuous use of the drug with repeated dose, the maximum reduction in blood pressure at any dose is generally achieved within 2-4 weeks and is maintained during the long -term treatment. When combined with hydrochlorothiazide, there has been a significant decrease in blood pressure.
Sudden diovan stops not related to hypertension or clinical side effects.
In multi -dose studies in hypertension patients, Valsartan does not have a significant effect on total cholesterol, triglycerides at hunger, serum glucose when hungry or uric acid.
heart failure
On hemodynamics and nerves. Hemorrhagic and nervous nerves in plasma are costly in patients with heart failure II - IV according to the classification of the New York Heart Association (NYHA) with the pressure capillary pressure> 15mmHG in 2 short -term studies, prolonged treatment.
In a study including a long -term treatment patient with angiotensin transferring enzyme inhibitors, using single -dose and multi -dose valsartans in combination with an angiotensin enzyme inhibitors that improved hemodynamics including cleft capillary pressure (PCWP), pulmonary artery blood pressure (PAD) and systolic blood pressure (SBP). Observed a decrease in aldosterone levels (PA) and Noradrenalin plasma (PNE) after 28 days of treatment.
In the second study, only patients who are not treated with Angiotensin transferred inhibitors at least 6 months before treatment with Valsartan, Valsartan significantly improve the pressure of the pulmonary capillary (PCWP), the resistance of the systemic blood vessels (SVR), cardiac supply (CO) and centrifugal blood pressure after 28 days of treatment.
In long -term research Val - Heft, plasma and sodium peptides (BNP) (BNP) are significantly reduced compared to the initial concentration in the valsartan treatment group compared to the placebo group.
Incidence and mortality. Val - HEFT is a randomized clinical test with control, multinational, comparing Valsartan with placebo for the incidence of disease and death rate in patients with heart failure II (62%), degree III (36%) and IV (2%) according to the classification of NYHA are under normal treatment with LVEF 2.9cm/m2.
This study includes 5010 patients in 16 countries that are randomly used Valsartan or placebo with all other appropriate treatments including Angiotensin (93%), diuretics (86%), Digoxin (67%) and beta blockers (36%).
The average tracking time is nearly 2 years. The average daily diovan dose in Val - HEFT test is 254mg.
This research has two main criteria: all causes of death (time leading to death) and heart failure rate (time leading to the first treatment of heart failure) is determined to include death, died with resuscitation, hospitalization due to heart failure, or intravenous medication to increase myocardial or vasodilat drug for 4 hours or longer without hospitalization.
All causes of death are similar in the group using Valsartan and the placebo group.
The incidence of disease is significantly reduced by 13.2% when using Valsartan compared to placebo.
The first benefit is to reduce the risk of 27.5% leading to the first hospital for treatment of heart failure. The biggest benefit in patients without angiotensin transferring enzyme or beta blockers.
However, a decrease in the risk of a place of placebo for a group of patients treated with three combined drugs including beta blockers, Angiotensin and Valsartan inhibitors.
Additional studies such as Valiant, in which the mortality rate does not increase in these patients, reduces the concern about the combination of these three drugs.
The ability to practice and endure. The effectiveness of Valsartan added to the treatment of conventional heart failure about tolerance during exercise has been assessed by Modified Naughton method in patients with heart failure II - IV according to the classification of NYHA with left ventricular dysfunction (LVEF ≤ 40%).
Increasing training time from the initial level for all treatment groups has been observed.
recorded the average increase in practice time from the original level in the group using Valsartan higher than the placebo group, although there was no statistical significance.
The greatest improvement is observed in the group of patients who are not treated with angiotensin transferring enzyme inhibitors that change the average of the exercise time 2 times higher than in the group using Valsartan compared to the placebo group.
The effect of Valsartan is equivalent to Enalapril on the ability to practice with a 6 -minute walking test that has been determined in patients with heart failure II and III according to NYHA's classification with left ventricular blood emulsion fraction ≤ 45% are those who have been treated with angiotensin transferring enzyme inhibitors at least 3 months before participating in research.
Use Valsartan 80mg to 160mg, 1 time/day at least the same effect as using enalapril 5mg to 10mg, 2 times/day for the ability to practice when assessed by 6 -minute walking test in patients who have previously been stable treatment with angiotensin transferred enzyme inhibitors and direct transfer to valsartan or enalapril.
Classification by nyha, signs and symptoms.
quality of life, blood emulation. In Val - Heft study, patients treated Valsartan showed significant improvement in heart failure as classified by NYHA, signs and symptoms of heart failure including shortness of breath, fatigue, edema and ran compared to placebo.
Patients treated with Valsartan have better living quality than placebo, which has been shown by changing the quality of life in heart failure with the Minesota Living method at the end of the original.
The ability to pump blood in patients treated with Valsartan increased significantly and Lvidd decreased significantly from the beginning to the end of the study compared to the placebo.
after myocardial infarction
Valsartan testing in acute myocardial infarction (Valiant) is a double, random, controlled, multinational study of over 14,703 patients with acute myocardial infarction with signs, symptoms or evidence of congestive heart failure on X -rays and/or evidence of systolic dysfunction in the left ventricular centrifugal (manifested as a blood emulsion rate ≤ 40% with radioactive orgard. or X -rong blood vessel with ventricular fluid).
The patient is randomly selected within 12 hours to 10 days after the onset of symptoms of myocardial infarction in one of three groups: Valsartan groups (titrated from 20mg, 2 times/day to the highest tolerance to a maximum level of 160mg, 2 times/day), captlil is an angiotensin transferred inhibitor (which is the highest dosage from 6.25mg, 3 times/day to the highest level of up to the maximum of the maximum of up to the maximum of the maximum of the maximum of the maximum of the maximum of the maximum of the maximum of the maximum level of the maximum of the maximum of the maximum of the maximum level of the maximum of the maximum of the maximum dosage, 3 mg, 3 mg 3mg times/day), or combined with valsartan and captopril.
In the combined group, Valsartan dose is titrated from 20mg, 2 times/day to the highest tolerance to the maximum of 80mg, 2 times/day; Captopril dose is similar to when using a single therapy. The average treatment time is 2 years. The daily daily dioan dose in the group used for monomers is 217mg.
Basic treatment includes acetylsalicylic acid (91%), beta blockers (70%), angiotensin transfer enzyme inhibitors (40%), thrombolytic drugs (35%), and statins (34%). The research group includes 69% male, 94% of whites and 53% from 65 years of age. The evaluation criterion is the time leading to death due to all causes.
Valsartan is at least as effective as captopril in reducing mortality due to all causes after myocardial infarction.
The mortality rate for all similar causes in the group using Valsartan (19.9%), Captopril (19.5%) and Valsartan + Captepta (19.3%).
Valsartan is also effective in prolonging the time leading to death and reducing cardiovascular mortality, hospital stay due to heart failure, recurrent myocardial infarction, resuscitation and non -fatal stroke (extra assessment criteria).
Because this is an active control test (captopril), further analysis of the mortality rate due to all causes has been done to estimate the effects of valsartan compared to placebo.
When using the results of previous myocardial infarction tests for reference such as Save, Aire and Trace tests - Valsartan's estimates have preserved 99.6% of the effect of captopril (97.5% Cl = 60 - 139%).
The combination of valsartan with captopril does not create additional benefits compared to using Captopril alone.
There is no difference in mortality due to all causes based on age, gender, race, basic treatment or available disease.
There is no difference in the mortality rate due to all causes or mortality or cardiovascular disease rates when using beta blockers along with coordination Valsartan + captopril, Valsartan alone or simply captopril.
Regardless of any medication in the study, the higher mortality rate in the group of patients is not treated with beta blockers, shows that the benefits of Beta blockers have known in this group of patients who have been maintained in the test.
In addition, the treatment benefits of combining Valsartan + captopril, single valsartan therapy and Captopril's single therapy have been maintained in patients treated with beta blockers.
Preceptic research
Preceptic data from common studies on pharmacological safety pharmacological, gene toxicity, cancer -causing and fertility effects show that there is no special danger on people.
Safe and long -term toxic pharmacology
In a series of preclinical studies conducted on some animals, there was no detection that will eliminate the use of Valsartan's treatment doses for humans.
In preclinical safety studies, high doses of Valsartan (200 to 600mg/kg of body weight/day) causes reduction of red blood cell parameters in mice (red blood cells, hemoglobin, hematocrit) and evidence of hemodynamic changes in the kidneys (vapor hyperiemia urea, and hyperplasia at Kidney and alkali hypercasses in men).
With doses in mice (200 and 600mg/kg/day), about 6 and 18 times the maximum dose is recommended on mg/m2 (calculating the assumption with orally 320mg/day and a 60kg patient). With squirrel tail monkeys at the corresponding dose, there are similar changes, but more severe, especially in the kidneys where kidney disease development changes include hypercurine nitrogen and blood creatinine.
The hypertrophy of cells near the glomerular is also seen in both species.
All of these changes are considered to be due to the pharmacological effects of Valsartan to lower blood pressure, especially with squirrel tail monkeys. For the treatment of Valsartan in humans, the hypertrophy of cells near the glomerular cell does not seem to have any related.
Reproductive toxicity
Valsartan has no unwanted effect on reproductive productivity in male and female rats at oral dose up to 200 mg/kg/day.
In embryo development studies (Segment II) in mice, rats and rabbits, the toxicity on the fetus is observed with toxicity on the mother mouse at the dose of Valsartan 600mg/kg/day and on rabbits with the dose of 10mg/kg/day.
In a study of postpartum toxicity development and SEGment (Segment III), the child's child's life was used for 600 mg/kg/day in the last 3 months of pregnancy and during breastfeeding, showing a slight reduction in survival and slightly slow development.
Main clinical safety findings are provided for the pharmacological effects of the drug and have not been shown to be clinically significant.
Causing mutations
Valsartan is not likely to cause mutations at a gene or chromosomal level in many standard in vitro studies and study in vivo gene toxicity.
Cancer
There is no evidence of cancer causing when using Valsartan for mice and rats for 2 years at a dose of up to 160 and 200 mg/kg/day, respectively.
Before taking Diovan 80 Novartis medicine for hypertension, heart failure (2 blisters x 14 tablets)
How to use
Film tablets: Diovan should drink away from the meal and should be used with water.
Dosage
Hypertension:
Diovan's recommended dose is 80mg or 160mg of film tablets, 1 time/day, regardless of racism, age or gender. The anti -hypertension effect is clearly shown within 2 weeks and the maximum effect is recorded after 4 weeks, in patients where blood pressure is not controlled satisfactorily, can increase daily dose to 320mg of film bags or can add diuretics.can also use diovan with other anti -hypertension drugs.
heart failure:
Diovan's recommended starting dose is 40mg of film tablets, 2 times/day. Increase the dose to 80mg - 160mg, 2 times/day in patients with the highest dose tolerance. It is necessary to consider reducing dosage of diuretics simultaneously. The maximum dose/day used in clinical trials is 320mg divided into several times.
When assessing patients with heart failure must always include kidney function assessment.
after myocardial infarction:
Treatment may start early 12 hours after myocardial infarction. After the starting dose of 20mg, 2 times/day, Valsartan treatment should be adjusted to 40mg, 80mg and 160mg of film tablets, 2 times/day in the following weeks. The starting dose is given by a 40mg tablet that can be broken.
Maximum destination dose is 160mg, 2 times/day. In general, the patient is recommended to achieve a dose of 80mg, 2 times/day 2 weeks after the beginning of treatment and the maximum destination dose achieved after 3 months, based on the patient's tolerance for Valsartan during the dose increase. If symptomic hypotension occurs or kidney dysfunction, the dose reduction should be considered. Valsartan may be used in patients who have been treated with other medications after myocardial infarction, for example, forced medications, acetylsalicylic acid, beta blockers or statins.
When assessing patients with myocardial infarction must always include kidney function assessment.
Note for all indications:
No dose adjustments for patients with impaired renal function or patients with liver failure due to biliary tract and non -stasis.
Use in children and teenagers:
Diovan's safety and effectiveness has not been determined in children and teenagers (under 18 years old).
Used in patients with renal failure:
No dose adjustments for patients with renal failure have creatinine clearance> 10ml/min.
Used in patients with liver failure:
Dosage should not exceed 80mg for patients with mild to moderate liver failure without biliary obstruction.
Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.
What to do when overdose? If new to medication, it is necessary to cause vomiting. On the other hand, the common treatment is the intravenous fluid infusion.
Valsartan is not sure to be removed by hemorrhage.
In an emergency, call the 115 emergency center immediately or go to the nearest local health station.
What to do when forgetting a dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.
Side Effects
When using diovan, you may experience unwanted effects (ADR).
In verified clinical studies in patients with hypertension, the overall frequency of side effects (ADRS) is compared with the placebo and in accordance with the pharmacological properties of Valsartan.
The frequency of side effects is not related to the dose or treatment time and also shows that it is not related to gender, age or race.
Side reactions are reported from clinical studies, after -sales experience and subclinical results listed below by organ system groups.
Side reactions are classified by frequency, first is most common, using the following convention: very common (≥ 1/10); Or meet (≥ 1/100,
For side effects reported from after -sales experience and subclinical results cannot be arranged in any frequency of side effects and therefore they are mentioned with the frequency of "unknown".
Hypertension
Table 1: Adverse reactions on hypertension
unknown
unknown angioedema, water dermatitis, rash, itching Urology
heart failure and/or after myocardial infarction
Safety is observed in controlled clinical studies on patients with heart failure and/or after myocardial infarction other than the safety of observed in patients with hypertension. This may be related to the patient's existing disease. The side effects occur in patients with heart failure and/or after myocardial infarction listed below.
Table 2: Adverse reaction on heart failure and/or after myocardial infarction.
unknown
less common
The following reactions are also observed in clinical trials on heart failure patients and/or after myocardial infarction regardless of their association with research drugs: joint pain, abdominal pain, back pain, insomnia, helplessness, neutrophils, edema, pharyngitis, sinusitis, upper respiratory infection, viral infection.
Notify the doctor with unwanted effects when using the drug.
Warnings
Before using Diovan, you need to read the instructions carefully and refer to the information below.
Contraindicated
Diovan is contraindicated in the following cases:
It is known to be hypersensitively to Valsartan or with any excipients of Diovan.
Pregnant women.
Concomitance Angiotensin (ARBS) antagonistic drugs - including diovan - or enzyme inhibitors (Aceis) with Aliskiren in patients with diabetes Type 2.
Patients with severe liver failure, severe cirrhosis, cholestatic cirrhosis.
Precautions when using
Read the user manual carefully before use. If you need more information, please consult your doctor.
This drug is only used as prescribed by a doctor.
Hemorrhage
Some patients with heart failure have increased potassium. These phenomena are often light and transient, and are more likely to occur in patients with renal failure. Dose reduction and/or diovan stop may be required.
It is not recommended to use simultaneously with potassium supplements, diuretics that keep potassium, salt -replacement products containing potassium, or other drugs that cause increased potassium levels (such as heparin, ...). Need to monitor the potassium concentration appropriately.
Patients with sodium loss and/or epidemic loss
In patients with sodium loss and/or severe loss of epidemic such as high diuretic treatment, symptomic hypotension may occur after the beginning of treatment with diovan. Loss of sodium and/or loss of epidemic should be treated before starting treatment with diovan, for example, reducing diuretics.
If the hypotension occurs, the patient must be on his back and if necessary, the intravenous salt solution is isomer. Can continue treatment once the blood pressure is stable.
Patients with renal artery stenosis
Use diovan in a short time for 12 patients with hypertension due to secondary kidney blood vessels after narrowed narrowed kidney narrowing on one side does not cause significant changes in hemodynamics in the kidneys, serum creatinine or blood urea nitrogen (bun). However, because other drugs affect the Renin-Anotensin-Aldosterone (RAAS) system that can increase blood urea and serum creatinine in patients with narrowed kidney stenosis on both sides or one side, recommend monitoring both of the above parameters as a safety measure.
Patients with renal function
No dose adjustment for patients with renal failure. However, there is no data on severe cases (creatinine clearance
Avoid using Antagonists (ARBS) - including diovan - or enzyme inhibitors (ACEIS) with Aliskiren in patients with renal impairment (glomerular filtration speed - GFR
Patients with liver failure
No dose adjustment for patients with liver failure. Valsartan is almost excreted in bile in a constant form, and patients with bile congestion show that the lower valsartan clearance is needed, especially careful when using Valsartan for patients with bile congestion.
Patients with heart failure/myocardial infarction
Use diovan in patients with heart failure or after myocardial infarction often leads to a part of blood pressure, but the stop use of diovan due to hypotension is often not needed as long as the dose is in accordance with the instructions.
Be cautious when starting treatment in patients with heart failure or after myocardial infarction.
As a result of the inhibition of the renin-ankiotensin-aldosterone system (Rass), changes in renal function can be predicted in sensitive patients. In patients with severe heart failure, their kidney function may depend on the activity of the Renin-Anotensin-Aldosterone system, the treatment with Angiotensin (ACE) or Angiotensin receptor is associated with urinary tract and/or hypercondemia and (rare) acute renal failure and/or death. When assessing patients with heart failure or after myocardial infarction, the kidney function must always be assessed.
In patients with heart failure, caution should be careful when combining three types including angiotensin transferring enzyme inhibitors, beta and valsartan blockers (see the pharmacological part).
Tharma
Evala, including larynx swelling and bars, causes obstruction of the airway and/or swelling of the face, lips, throat, and/or tongue that have been reported in patients treated with Valsartan, some of these patients who have previously had angels when taking other drugs including angiotensin transferred enamel inhibitors. Diovan should be stopped immediately in angioedema patients, and should not be reused diovan anymore.
Double blockade drugs Renin - Angiotensin (RAS)
Be cautious when using Angiotensin receptor antagonists simultaneously, including diovan, with other radiating drugs such as enamel inhibitors (ACEIS) or Aliskiren (see the drug interaction, dual blockade of Renin-Anotensin).
The ability to drive and operate machinery
as well as other anti -hypertension drugs, need to be cautious when driving or operating machinery.
Pregnancy and lactation
Women are likely to be pregnant
Similar to any drug that has a direct effect on RAAS, Diovan should not be used in women who are intended to become pregnant. Doctors who prescribe any factors affect RAAS should advise women who are likely to get pregnant about the potential risk of these drugs during pregnancy.
Pregnant women
Similar to any drug that has a direct effect on RAAS, Diovan is not used during pregnancy (see the contraindications). Due to the mechanism of action of Angiotensin II antagonistic drugs, the risk of fetus is not excluded. The effect of angiotensin transferring enzyme inhibitors (special drugs acting on the renin-angiotensin-aldosterone system) in the three months between and the last 3 months of pregnancy causes damage and death of the fetus is developing in the uterus.
Moreover, according to the rescue data, the use of angiotensin transferring enzymes in the first 3 months of pregnancy is associated with the potential risk of defects in infants. There has been a report on spontaneous miscarriage, little amniotic fluid and kidney dysfunction in newborn children when pregnant women accidentally use Valsartan. If you find pregnancy during treatment, you must stop diovan as soon as possible.
breastfeeding
It is not clear whether Valsartan is excreted in breast milk or not. Because Valsartan is excreted in breast feeding mice, do not recommend diovan in breastfeeding mothers.Reproduction
There is no information on the effects of Valsartan on human fertility. Mouse studies do not show any effects of Valsartan about fertility.
Medicinal interaction
Dual blockade of Renin - Angiotensin (RAS) including Angiontensin receptor antagonistic drugs, Move inhibitors, or Aliskiren:
Concomitance the antagonistic drug with Angiotensin receptor, including diovan, with other agents that affect the Renin - Angiotensin system associated with increased hypotension, hyperkalemia, and renal function changes compared to monomers. Therefore, it is necessary to recommend monitoring of kidney and electrolyte blood pressure in patients with diovan and other drugs that affect the RAS system.
Concomitance the Angiotensin receptor antagonist (ARB) including diovan - or enzyme inhibitors (Aceis) with Aliskiren, should be avoided in patients with severe renal impairment (GFR
Simultaneous use of ARB - including Diovan - or Aceis with Aliskiren is contraindicated for patients with type 2 diabetes (see the contraindication section).
Potassium: Concentrated with potassium diuretics (e.g. Spironolactone, triamterene, amiloride), potassium supplements or replacement salts containing potassium or other drugs may increase other potassium levels (such as heparin) can lead to hyperpassionoma and in patients with heart failure, leading to hypoglyced serum creatinine. If the simultaneous use of these drugs is necessary, serum potassium must be monitored.
Non-steroid anti-inflammatory drugs (NSAIDs) include the selective inhibitor group cyclooxygenase-2 (Cox-2 inhibitors):
When using Angiotensin II antagonistic medication at the same time with NSAIDs, the decrease in the effectiveness of hypotension may occur.
Moreover, in elderly patients, decreased volume of circulatory volume (including diuretic treatment patients), or kidney function damage, simultaneous use of antagonistic drugs Angiotensin II and NSAID can lead to an increased risk of severe impaired renal function. Therefore, monitoring of kidney function is recommended when starting or changing treatment in patients using Valsartan used simultaneously with NSAIDs.
Lithium: Increased lithium recovery in blood and toxicity has been reported when used simultaneously lithium with enzyme inhibitors or angiotensin II receptor inhibitors including diovan. Due to measurement, encourage careful monitoring of blood lithium concentration in combination. If a diuretic is also used, the risk of lithium poisoning may increase with diovan.
Shipping substances:
Results from a test tube on human liver tissue shows that Valsartan is a substrate of the transportation that absorbs drugs into the OatP1B1 liver and the drug transportation to the liver MRP2. Simultaneously treating drugs inhibitors into the liver (such as rifampin, ciclosporin) or transportation to the liver (ritonavir) may increase the levels of valsartan in the body.
Because Valsartan is not metabolized at a significant level, unable to have drug interactions - drugs with valsartan clinically with induction drugs or inhibition of Cytochrome P450. Although Valsartan is strongly attached to plasma proteins, in vitro studies do not show any interaction in this form with a range of molecules also strongly attached to plasma proteins such as Diclofenac, Furosemide and Warfarin.
Storage
Leave a cool place, avoid light, temperature below 30⁰C.
To be out of reach of children.
Other drugs
- Betmiga
- ETORICOXIB 120MG TABLETS
- FUCIDIN H CREAM
- NEULACTIL 2.5MG TABLETS
- Pregabalin Pfizer
- ZINNAT TABLETS 250MG
Disclaimer
Every effort has been made to ensure that the information provided by Drugslib.com is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Drugslib.com information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Drugslib.com does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Drugslib.com's drug information does not endorse drugs, diagnose patients or recommend therapy. Drugslib.com's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.
The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Drugslib.com does not assume any responsibility for any aspect of healthcare administered with the aid of information Drugslib.com provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Popular Keywords
- metformin obat apa
- alahan panjang
- glimepiride obat apa
- takikardia adalah
- erau ernie
- pradiabetes
- besar88
- atrofi adalah
- kutu anjing
- trakeostomi
- mayzent pi
- enbrel auto injector not working
- enbrel interactions
- lenvima life expectancy
- leqvio pi
- what is lenvima
- lenvima pi
- empagliflozin-linagliptin
- encourage foundation for enbrel
- qulipta drug interactions