Valsarep 80mg Extractumpharma treatment for hypertension (3 blisters x 10 tablets)

Uncommon, 1/1000

Patients with severe liver failure, biliary cirrhosis and cholestasis.

Precautions for use

Concentrated with potassium -containing products, potassium diuretics or drugs that may cause hematuria to be unspecified. Monitoring blood potassium should be conducted appropriately.

kidney failure

There is no evidence of safe drug use in patients with creatinine clearance 10ml/min.

Hepatic failure

In patients with mild to moderate liver failure and non -biliary stasis, should take care of the medication.

Patients with salt or fluid loss

In patients with salt loss or severe fluid loss, as those who are taking high doses of diuretics, hypotension symptoms may occur in some rare cases after the beginning of treatment with Valsartan. Patients with salt loss and loss of fluid should be adjusted before taking the drug, for example, a diuretic reduction may be reduced.

Renal artery stenosis

In patients with kidney stenosis on both sides or one -sided renal artery stenosis, Valsartan safety use has not been set. Using short -term valsartan for 12 patients with hypertension caused by secondary kidney disease due to kidney stenosis on one side does not cause any significant changes in kidney hemodynamics, serum creatinine or urea nitrogen blood (bun). However, other factors affecting the Renin - Angiotensin system may increase serum blood urea and serum creatinine in patients with kidney stenosis on the one hand, thus monitoring the renal function is recommended when patients are treated with Valsartan.

kidney transplant

Currently, there is no experience in using safe valsartan in patients who have recently undergone kidney transplant.

Cuong Aldosteron Tien Phat

Patients with primary Aldosteron should not be treated with Valsartan because their Renin - Angiotensin system is not activated.

Aortic valve stenosis and mitral valve, hypertrophic heart muscle

As with all other vasodilators, especially cautious when taking the drug in patients with aortic stenosis or mitral valve, or hypertrophic cardiomyopathy (Hocm).

Patients with myocardial infarction

combining captopril and valsartan does not show more treatment benefits, instead is the risk of unwanted effects. Therefore, recommendations should not be combined with valsartan with ACE inhibitors. Caution should be careful when taking the drug for patients after myocardial infarction, need to closely monitor kidney function. Using valsartan for patients after myocardial infarction often leads to hypotension, but stopped treating because of continuing hypotension with symptoms often without the necessary dose instructions.

heart failure

The risk of unwanted effects, especially hypotension, hyperkalemia and impaired renal function (including acute renal failure) can increase when used in combination with valsartan with ACE inhibitors. In patients with heart failure, the combination of 3 ACE inhibitors, beta and valsartan blockers does not benefit. This combination increases the risk of unwanted effects and therefore is not recommended.

Combining 3 ACE inhibitors, Mineralocorticoid and Valsartan receptor drugs also recommend not to be used. The use of these combinations should be under the supervision of experts and closely monitor kidney function, electrolyte, and blood pressure.

Be cautious when taking medication with patients with heart failure, need to monitor tight kidney function. Using Valsartan for patients with heart failure often leads to hypotension, but stopped treating because of continuing hypotension with symptoms often without the necessary dose instructions. For patients whose renal function depends on the activity of the Renin - Angiotensin - Aldosteron system (patients with severe congestion heart failure), ACE inhibitors are related to urinary reduction or accumulation of nitrogen excreted products excreted by progressive kidneys and in rare cases with acute kidney failure or death. Because Valsartan is Angiotensin II receptor blockers, it is not possible to rule out the use of Valsartan may be related to renal function impairment.

ACE inhibitors and Angiotensin II receptor blockers should not be used simultaneously in patients with diabetes.

History of eagowns

Evala, including laryngeal swelling and bar, causes obstruction of the airway or swelling of the face, lips, throat or tongue that has been reported in patients treated with Valsartan, some of the previous patients who have had angels with other drugs including ACE inhibitors. Valsartan should be stopped immediately in angioedema patients, and Valsartan should not be repeated.

Dual Renin - Angiotensin - Aldosterone (RAAS)

There is evidence that the simultaneous use of ACE inhibitors, Angiotensin II receptor blockers or Aliskiren increases the risk of hypotension, hyperkalemia and reducing kidney function (including acute renal failure). The RAAS blocker is through the use of ACE inhibitors, The Angiotensin II or Aliskiren blockers so it is not recommended for use.

If dual blockers are considered absolutely necessary, this should only be done under the supervision of experts and regularly monitor the kidney, electrolyte and blood pressure.

ACE inhibitors and Angiotensin II receptor blockers should not be used simultaneously in patients with diabetes.

Children

Renal function impairment

Use in children with creatinine clearance 30ml/min. Kidney function and serum potassium should be closely monitored while treated with Valsartan. This is especially applied when Valsartan is used in other conditions (fever, dehydration) that can reduce kidney function.

Liver function impairment

As in adults, Valsartan is contraindicated in patients with severe liver failure, bile cirrhosis and in patients with cholestasis. Clinical experience is limited to Valsartan in patients with mild to moderate liver failure. The dose of Valsartan should not exceed 80mg in these patients.

The ability to drive and operate machinery

There is no data mentioned about the effects of Valsartan on the ability to drive and operate machinery. When driving or operating machinery, it should be noted that occasionally dizziness or fatigue may occur during treatment with any hypertension.

Pregnancy

The use of Angiotensin II (AIRAS) is not recommended in the first three months of pregnancy. Contraindicated use of Aiira in the middle 3 months and the last 3 months of pregnancy.

Breastfeeding period

Because there is no information related to the use of valsartan during breastfeeding, do not use Valsartan and recommend choosing a safe replacement treatment that has been surrounded during breastfeeding, especially when raising infants or premature babies.

Drug interaction

Dual Renin - Angiotensin - Aldosterone (RAAS) with ACE, ACE inhibitors, or Aliskiren: Clinical test data shows that the double Renin - Angiotensin - Aldosterone (RAAS) system is through combining ACE -ACE, Angiotensin II II SUPPLY Aliskiren is associated with higher frequency of unwanted effects such as hypotension, hyperkalemia and impaired renal function (including acute renal failure) compared to the only use of one -effect on RAAS.

lithium

Increasing lithium concentration in serum and toxicity has been reported during use simultaneously ACE inhibitors. Due to the lack of experience using Valsartan and Lithi simultaneously, this combination is not recommended. If the combination proves necessary, careful monitoring of lithium concentration in serum. If diuretics are also used, the risk of lithium poisoning may increase.

Potassium diuretics, potassium supplements, salt substitutes containing potassium and other drugs can increase potassium levels: If a drug product affects the potassium level is considered to be needed in combination with Valsartan, so surveillance of plasma potassium concentration.

Non-steroid anti-inflammatory (NSAID), including inhibitors with COX-2 options, acetylsalicylic acid> 3G/day) and non-selective NSAID inhibitors: When Angiotensin II antagonists are simultaneously used with NSAID, there may be anti-hypertension effects. Moreover, simultaneous use of Angiotensin II and NSAID antagonists can lead to an increased risk of impaired kidney function and increased serum potassium. Therefore, the monitoring of the kidney function at the beginning of treatment is recommended, as well as the patient's hydration status.

Transport agent: In vitro data indicates that Valsartan is a substrate of the absorption agent in the liver OATP1 B1/OATP1 B3 and the MRP2 shipping in the liver. The clinical involvement of this finding is unknown. Concentrated use of absorbent transportation inhibitors (for example, rifampin, ciclosporin) or transportation (eg Ritonavir) may increase body contact with Valsartan. Be careful when starting or ending the same use of such drugs.

In drug interactive studies with Valsartan, there is no clinical interactive interactions found with Valsartan or any of the following drugs: Cimetidin, Warfarin, Furosemid, Digoxin, Atenolol, Indometacin, Hydrochlorothiazide, Amlodipin, Glibenclamid.

High blood pressure in children and adolescents, where the kidney abnormalities are common, cautious when recommending simultaneous use of Valsartan and the Renin Angiotensin Agdosteron inhibitors that can increase serum potassium.