Diovan

Diovan (valsartan) is an angiotensin II receptor blocker (ARB) prescribed for the management of hypertension in adults and pediatric patients, and for the treatment of heart failure in clinically stable post-myocardial infarction patients. It works by blocking the action of angiotensin II, a substance in the body that causes blood vessels to tighten, thereby relaxing blood vessels and lowering blood pressure. This medication is also indicated to improve survival in heart failure patients and may be used in certain cases of diabetic nephropathy. Available in tablet form, Diovan is typically taken once or twice daily, with or without food, as directed by a healthcare provider.

Features

• Active ingredient: Valsartan
• Available in multiple strengths: 40 mg, 80 mg, 160 mg, and 320 mg tablets
• Formulation: Film-coated tablets for oral administration
• Mechanism of action: Selective blockade of the angiotensin II type 1 (AT1) receptor
• Prescription-only medication
• Manufactured under strict quality control standards

Benefits

• Effectively lowers high blood pressure, reducing the risk of strokes, heart attacks, and kidney problems
• Helps manage heart failure symptoms and improves survival rates in post-heart attack patients
• May provide renal protection in patients with type 2 diabetes and elevated urinary albumin excretion
• Generally well-tolerated with a favorable side effect profile compared to some other antihypertensive classes
• Once-daily dosing option available for many patients, supporting medication adherence
• Can be used as monotherapy or in combination with other antihypertensive agents

Common use

Diovan is primarily prescribed for the treatment of hypertension (high blood pressure) in adults and children 6 years and older. It is also used in the management of heart failure (NYHA Class II-IV) in clinically stable patients who have experienced a heart attack, particularly when angiotensin-converting enzyme (ACE) inhibitors are not tolerated. Additionally, Diovan is indicated for the reduction of cardiovascular mortality in patients with left ventricular failure or dysfunction following myocardial infarction. In diabetic patients with hypertension and signs of kidney involvement, it may be prescribed to slow the progression of diabetic nephropathy.

Dosage and direction

For hypertension in adults: The usual starting dose is 80 mg or 160 mg once daily. The dosage may be increased to 320 mg once daily based on blood pressure response. For patients who require further reduction, a divided dose may be considered. For pediatric hypertension (6-16 years): The recommended starting dose is 1.3 mg/kg once daily (up to 40 mg total). Dosage may be increased based on blood pressure response, with a maximum recommended dose of 2.7 mg/kg (up to 160 mg). For heart failure post-myocardial infarction: The recommended starting dose is 20 mg twice daily, which may be titrated to 40 mg twice daily within 7 days, and up to a target maintenance dose of 160 mg twice daily as tolerated. Tablets should be swallowed whole with water, with or without food.

Precautions

Patients should be monitored for hypotension, particularly after the initial dose or following dosage increases. Renal function should be assessed prior to initiation and periodically during treatment, especially in patients with pre-existing renal impairment, heart failure, or volume depletion. Serum potassium levels should be monitored regularly, particularly in patients with renal impairment, diabetes, or those taking potassium supplements or potassium-sparing diuretics. Use with caution in patients with hepatic impairment, as valsartan is extensively metabolized in the liver. Patients with significant aortic or mitral valve stenosis or obstructive hypertrophic cardiomyopathy should be closely monitored. Angioedema has been reported with ARBs; discontinue immediately if facial, lip, throat, or tongue swelling occurs.

Contraindications

Diovan is contraindicated in patients with known hypersensitivity to valsartan or any component of the formulation. Do not use in patients with severe hepatic impairment, biliary cirrhosis, or biliary obstruction. Concomitant use with aliskiren is contraindicated in patients with diabetes. Avoid use during pregnancy, as drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus. Do not administer to patients with a history of angioedema related to previous treatment with an ARB.

Possible side effect

Common side effects may include dizziness, headache, fatigue, abdominal pain, diarrhea, nausea, viral infection, upper respiratory tract infection, cough, and joint pain. Less frequent adverse reactions may include orthostatic hypotension, hyperkalemia, impaired renal function, neutropenia, and elevated liver enzymes. Rare but serious side effects include angioedema, hepatotoxicity, and severe hypotension. Some patients may experience back pain, insomnia, or decreased libido. Most side effects are mild to moderate and often diminish with continued treatment.

Drug interaction

Diovan may interact with potassium-sparing diuretics, potassium supplements, or salt substitutes containing potassium, potentially leading to hyperkalemia. Concurrent use with other antihypertensive agents may result in additive hypotensive effects. NSAIDs, including selective COX-2 inhibitors, may reduce the antihypertensive effect and increase the risk of renal impairment. Lithium levels may increase when co-administered with Diovan, requiring close monitoring. The combination with aliskiren is contraindicated in diabetic patients. Diovan may increase concentrations of drugs transported by OATP1B1/1B3 (e.g., statins). Rifampin may decrease valsartan concentrations.

Missed dose

If a dose is missed, it should be taken as soon as remembered on the same day. However, if it is almost time for the next scheduled dose, the missed dose should be skipped and the regular dosing schedule resumed. Patients should not take a double dose to make up for a missed one. Consistency in dosing is important for maintaining stable blood pressure control, so patients should try to take Diovan at the same time each day. If multiple doses are missed, patients should contact their healthcare provider for guidance.

Overdose

The most likely manifestation of overdose would be hypotension and tachycardia, with possible bradycardia if vagal stimulation occurs. Bradycardia could occur from parasympathetic (vagal) stimulation. If overdose occurs, the patient should be placed in a supine position and given supportive treatment directed at maintaining blood pressure and hydration. Valsartan is not removed by hemodialysis. Symptomatic treatment should be instituted, and vital signs, urine output, and electrolyte levels should be monitored. In cases of severe hypotension, intravenous normal saline may be administered.

Storage

Store Diovan tablets at room temperature between 20°C to 25°C (68°F to 77°F), with excursions permitted between 15°C to 30°C (59°F to 86°F). Keep in the original container with the lid tightly closed to protect from moisture and light. Do not store in bathroom cabinets where humidity levels may fluctuate. Keep out of reach of children and pets. Do not use tablets that are discolored, cracked, or otherwise damaged. Properly dispose of any expired medication according to local regulations or medication take-back programs.

Disclaimer

This information is provided for educational purposes only and is not intended as medical advice. Always consult with a qualified healthcare professional before starting or changing any medication regimen. Individual patient responses to Diovan may vary, and treatment decisions should be based on a healthcare provider’s assessment of the patient’s specific medical condition, history, and current medications. The prescribing physician should be informed of all medications, supplements, and medical conditions before beginning treatment with Diovan. This information does not cover all possible uses, directions, precautions, or adverse effects.

Reviews

Clinical studies have demonstrated Diovan’s efficacy in blood pressure control, with many patients achieving target blood pressure goals. In the VALUE trial, Diovan showed comparable cardiovascular protection to amlodipine with a lower incidence of peripheral edema. The Val-HeFT study demonstrated benefits in heart failure patients, reducing morbidity and mortality. Many healthcare providers appreciate Diovan’s generally favorable side effect profile and once-daily dosing convenience for appropriate patients. Some patients report excellent blood pressure control with minimal side effects, while others may experience dose-dependent dizziness or fatigue. The medication’s effectiveness in renal protection for diabetic patients has been well-documented in clinical trials. Overall, Diovan remains a well-established option in the ARB class with extensive clinical evidence supporting its use in appropriate patient populations.