Medicinal reference book geotar. Valsartan - an assistant for the cardiovascular system Vacation conditions and price

Obsolete trade name:Valsartan Zentiva Dosage form: & nbspfilm-coated tablets Composition:

1 film-coated tablet contains:

active substance: valsartan - 80.0 / 160.0 mg;

excipients:

nucleus:salted SMCC 90 (microcrystalline cellulose - 32.83 / 65.66 mg, colloidal silicon dioxide - 0.67 / 1.34 mg) - 33.5 / 67.0 mg, sorbitol - 9.25 / 18.5 mg, magnesium destab carbonate 90 (magnesium carbonate - 8.325 / 16.65 mg, pregelatinized starch - 0.8325 / 1.665 mg, water - 0.0925 / 0.185 mg) - 9.25 / 18.5 mg, pregelatinized corn starch - 3.0 / 6.0 mg, povidone K-25 - 7.5 / 15.0 mg, sodium stearyl fumarate - 4.0 / 8.0 mg, sodium lauryl sulfate - 1.0 / 2.0 mg, crospovidone Type A - 13.0 / 26.0 mg, anhydrous colloidal silicon dioxide(Aerosil 200 Pharma) - 2.0 / 4.0 mg;

film casing: lactose monohydrate - 0.327 / 0.948 mg, hypromellose - 2.027 / 4.054 mg, talc - 0.385 / 0.770 mg, macrogol/ PEG 6000 - 0.324 / 0.649 mg, iron dye red oxide - 0.137 / 0 mg, iron dye yellow oxide - 0 / 0.018 mg, iron dye brown oxide - 0 / 0.052 mg, indigo carmine aluminum lacquer dye - 0 / 0.009 mg.

Description:

Tablets 80 mg: round, biconvex film-coated tablets of dark pink color, scored on one side. The core is white or almost white in cross section.

160 mg tablets: round, biconvex, brownish-yellow film-coated tablets with a scored on one side. The core is white or almost white in cross section.

Pharmacotherapeutic group:Angiotensin II receptor antagonist ATX: & nbsp

C.09.C.A.03 Valsartan

C.09.C.A Angiotensin II antagonists

Pharmacodynamics:

Valsartan is an active specific angiotensin II receptor antagonist (ARA II) intended for oral administration. Selectively blocks receptor subtypeAT 1, which are responsible for the known effects of angiotensin II. The consequence of blockade of AT 1 -receptors is an increase in the plasma concentration of angiotensin II, which can stimulate unblocked AT 2 -receptors.

Valsartan does not have any pronounced agonist activity against AT 1 receptors. The affinity of valsartan for the AT 1 subtype receptors is approximately 20,000 times higher than for the AT 2 subtype receptors.

Valsartan does not interact and does not block other hormone receptors or ion channels, which are important in the regulation of the functions of the cardiovascular system.

The likelihood of coughing when using valsartan is very low, due to the lack of effect on the angiotensin-converting enzyme (ACE), which is responsible for the degradation of bradykinin.

Comparison of valsartan with an ACE inhibitor demonstrates that the incidence of dry cough is significant (p< 0,05) ниже у пациентов, принимающих , чем у пациентов, принимающих ингибитор АПФ (2,6% против 7,9%, соответственно). В группе пациентов, у которых ранее при лечении ингибитором АПФ развивался сухой кашель, при лечении валсартаном это нежелательное явление (НЯ) отмечается в 19,5% случаев, а при лечении тиазидным диуретиком - в 19,0 случаев, в то время как в группе пациентов, получавших лечение ингибитором АПФ, кашель наблюдается в 68,5% случаев (р < 0,05).

Application for arterial hypertension in patients over 18 years of age

When treating with valsartan, patients with arterial hypertension there is a decrease in blood pressure (BP), not accompanied by a change in heart rate (HR).

After oral administration of a single dose of the drug in most patients, the onset of antihypertensive action is observed within 2 hours, and the maximum decrease in blood pressure is achieved within 4-6 hours, which lasts more than 24 hours.

With repeated use of the drug, the maximum decrease in blood pressure, regardless of the dose taken, is usually achieved within 2-4 weeks, and is maintained at the achieved level during long-term therapy.

In the case of the simultaneous use of the drug with hydrochlorothiazide, a significant additional decrease in blood pressure is achieved.

Abrupt cessation of valsartan use is not accompanied by a significant increase in blood pressure or other AEs.

In patients with arterial hypertension, type 2 diabetes mellitus and nephropathy, taking a dose of 160-320 mg, there is a significant decrease in proteinuria (36-44%).

Application after acute myocardial infarction in patients over 18 years of age

When using valsartan for 2 years in patients who began to take in the period from 12 hours to 10 days after suffering an acute myocardial infarction (complicated by left ventricular failure and / or left ventricular systolic dysfunction), the rates of overall mortality, cardiovascular mortality decrease and the time before the first hospitalization for exacerbation of chronic heart failure (CHF), repeated myocardial infarction, sudden cardiac arrest and stroke (without death) increases.

The safety profile of valsartan in patients with acute heart attack the myocardium is similar to that in other conditions.

Use in patients over 18 years of age with CHF

When using valsartan (in an average daily dose of 254 mg) for 2 years in patients with CHF II (62%), III (36%) and IV (2%) functional class according to NYHA classification with left ventricular ejection fraction (LV ) less than 40% and LV internal diastolic diameter of more than 2.9 cm / m receiving standard therapy, including ACE inhibitors (93%), diuretics (86%), (67%) and beta-blockers (36%), there is a significant decrease (by 27.5%) the risk of hospitalization due to exacerbation of CHF.

In patients who did not receive ACE inhibitors, there was a significant decrease in overall mortality (by 33%), cardiovascular mortality and morbidity associated with CHF (time to the onset of the first cardiovascular event), which were assessed by the following indicators: death, sudden death with resuscitation, hospitalization for exacerbation of CHF, intravenous administration inotropic or vasodilator drugs for 4 or more hours without hospitalization (44%).

In the group of patients treated with ACE inhibitors (without beta-blockers), no decrease in the overall mortality rate was observed during treatment with valsartan, however, the rates of cardiovascular mortality and morbidity associated with CHF decreased by 18.3%.

In general, the use of valsartan leads to a decrease in the number of hospitalizations for CHF, a slowdown in the progression of CHF, an improvement in the functional class of CHF according to the NYHA classification, an increase in the left ventricular ejection fraction, as well as a decrease in the severity of signs and symptoms of heart failure and an improvement in the quality of life compared with placebo.

Use in patients over 18 years of age with arterial hypertension and impaired glucose tolerance

With the use of valsartan and changes in lifestyle, there was a statistically significant reduction in the risk of developing diabetes mellitus in this category of patients. did not affect the frequency of deaths as a result of cardiovascular events, myocardial infarction and ischemic attacks without fatal outcome, hospitalization due to heart failure or unstable angina pectoris, arterial revascularization, in patients with impaired glucose tolerance and arterial hypertension, differing in age , gender and race.

It is not recommended to use the drug Valsartan Sanofi simultaneously with ACE inhibitors, since this combination therapy has no advantages over valsartan monotherapy or an ACE inhibitor in terms of overall mortality for any reason.

Pregnancy and lactation:

Like any other drug that affects the RAAS, it should not be used in women planning a pregnancy. When prescribing any drug that affects the RAAS, the doctor should inform the woman of childbearing age about potential danger using these drugs during pregnancy.

Like any other drug that has a direct effect on the RAAS, it should not be used during pregnancy.

Given the mechanism of action of ARA II, the risk to the fetus cannot be excluded. The effect of ACE inhibitors (drugs that also affect the RAAS) on the fetus, if used in the second and third trimester of pregnancy, can lead to its damage and death.

According to retrospective data, the use of ACE inhibitors in the first trimester of pregnancy increases the risk of having children with birth defects. There have been reports of spontaneous abortions, oligohydramnios and renal dysfunction in newborns whose mothers inadvertently took during pregnancy.

If pregnancy is diagnosed during treatment with valsartan, treatment should be discontinued as soon as possible.

Impact on the ability to drive vehicles. Wed and fur .:

Patients taking Valsartan Sanofi should be careful when administering vehicles and activities requiring increased concentration of attention and speed of psychomotor reactions (during therapy, dizziness and fainting may occur).

Release form / dosage:

Film-coated tablets, 80 mg and 160 mg.

Packaging:

14 or 15 tablets in a PVC / PE / PVDC / Al blister.

2 or 6 blisters with instructions for use in a cardboard box.

Storage conditions:

At a temperature not higher than 30 ° C.

Keep out of the reach of children.

Shelf life:

Do not use after the expiration date printed on the package.

Pharmacy dispensing conditions:On prescription Obsolete brand name: & nbspValsartan Zentiva Rename date: & nbsp01.08.2018 Registration number:LP-001726 Registration date:02.07.2012 / 01.08.2018 Expiration date:Indefinite

Valsartan is a drug that lowers blood pressure (i.e. tablets produce an antihypertensive effect). Many drugs are included in the class of hypertensive drugs, of which valsartan is the most researched: according to published honey. statistics, the evidence base of the drug's action includes more than 140 thousand patients.

Valsartan was the top-selling drug for high pressure in the period from 2008 to 2010. Sales statistics take into account not only the Russian Federation, but the whole world. One of the reasons for the popularity of the drug is the low price of valsartan.

The dosage depends on the effectiveness of the drug. The average recommended is valsartan 80 mg per day at a time or 40 mg twice a day. If the expected result is not observed, the dose is gradually increased. The extreme limit is 320 mg / day, divided into 2 doses.

When to wait for action:

• The effect will come 2 hours after the moment you took the drug;
• The medicine will work for a day;
• Blood pressure is stabilized 3 weeks after the start of the course of treatment;
• The maximum efficiency is observed 4 weeks after the start of the course.

When taken, the tablets are swallowed, not chewed. You need to drink plenty of water.

The given dates are approximate, since more accurate forecasts need to be made based on specific data.

Valsartan will have a stronger effect on someone (this means that the dosage needs to be reduced), on someone too weak (in this case, the dose will have to be increased if you want to achieve the effect with this medication).

With an implicitly expressed efficacy of the drug, a higher dosage is prescribed (as indicated) or diuretics are added to the course of treatment (when using them, permanent observation by a doctor and frequent tests are necessary).

Valsartan: indications for use

The medicine valsartan is prescribed for heart failure and chronic low blood pressure (hereinafter - AD). The drug can be used after myocardial infarction.

In their group (sartan), these are the only pills that cannot negatively affect the state and vital activity of the body after a heart attack.

Valsartan tablets are used by those who drank digitalis, beta-blockers or inhibitors.

Release form

Valsartan is available in 40, 80 and 160 mg tablets. Not only the price of the packages is different, but also the filling of the drug:

• At 40 mg, croscaramellose sodium, microcrystalline cellulose, magnesium stearate and dye (it is harmless) act as additional components;
• Valsartan 80 and 160 includes, in addition to those listed above, one more auxiliary element - aerosil.

Tablets are not the only form of release. In the pharmacy, you will find valsartan in granules, powders and capsules. The drug is sold exclusively by prescription, although it is possible to order it through online pharmacies.

The product is stored for 3 years. After the expiration of the limitation period, it is categorically impossible to accept it.

Self-administration of medication (self-medication) can lead to unexpected results - from failure to provide any therapeutic effect to kidney failure and death.

Contraindications

Contraindications to valsartan are minimal. The main emphasis is on sensitivity (allergy) to the components of the drug and the presence of pregnancy (+ lactation period).

It is not known how valsartan affects the child's body, therefore its use under 18 is not recommended, although the drug can be prescribed in small doses. The effectiveness of the use of the drug by children has also not been established, so it makes sense to use other drugs whose usefulness for child's body no doubt about it. The border at 18 is conditional.

When should you take your medicine carefully?

Are not contraindications for valsartan, but the following diseases / abnormalities require close medical supervision:

• Sodium deficiency in the blood;
• Decreased blood circulation;
• Any disorders of the renal arteries;
• Dysfunction (abnormalities) of the kidneys;
• Insufficiently efficient liver function;
• Problems with bile ducts;
• Cirrhosis of various types and degrees of development.

Interaction with other drugs and foods

If you are taking RAAS inhibitors, be prepared for a possible change in kidney function.

And when using ACE inhibitors, patients with chronic cardiovascular insufficiency often received acute renal failure, kidney dysfunction and excess of the permissible level of nitrogen in the blood. Very rarely, this led to dangerous conditions, including death.

Pregnancy

The drug valsartan is not prescribed for pregnant women. During breastfeeding, it is used only in extreme cases.

Clinical trials have not proven the fact that valsartan is released together with breast milk, and experimental studies have proven that the drug is excreted together with milk (although the experiments were performed on rats, it is believed that a nursing girl should not take this medicine, so as not to harm the child).

Side effects

Please note: a side effect with valsartan is rare. Usually the course of treatment is not clouded even by a headache.

Most of the negative effects are caused by non-compliance with the schedule for taking pills (or other form of release), which is prescribed by the doctor, or by exceeding the dosage.

Sometimes side effect manifests itself when valsartan is combined with other drugs without prior agreement with the doctor.

What complications can you expect?

• Constant low blood pressure;
• Decrease in pressure when trying to get up;
• Permanent dizziness;
• Dizziness when changing position of the body (getting up, turning over on one side, etc.);
• Nausea;
• Diarrhea;
• High levels of bilirubin;
• High levels of urea nitrogen and creatinine (especially in heart failure);
• Impaired renal function (rare);
• Saturation with potassium;
• Low hematocrit and / or hemoglobin;
• Neutropenic fever (lack of neutrophils in the blood);
• Vasculitis (rare)
• Rash and / or itching (rare);
• Serum sickness (rare)
• Quincke's edema (rare);
• Cough;
• Fast fatiguability;
• Pharyngitis;
• General weakness;
• Decreased immunity (as a result - increased risk of catching a viral infection).

A decrease in blood pressure should be expected in one of 3 cases:

1. Oversaturation of the body with sodium;
2. Busting with diuretics containing sodium;
3. Disruptions in blood circulation (reduced flow).

Lowering blood pressure in these cases can be pronounced. The first aid in this situation is the correction of water-salt metabolism.

If hypertension is caused by renal impairment (i.e., renovascular hypertension), caution should be exercised to monitor creatinine and urea levels. If the renal function (CC) is less than 10 ml / min, it is better to refrain from taking valsartan. This is due to the lack of data on patients who used the drug with such poor kidney function. Equally careful should be those who have obstruction of the bile streams.

Drivers and people dealing with various mechanisms should refrain from basic activities during the course of treatment, since the drug can reduce attention, impair memory and affect the speed of your reaction.

Overdose

There are no reliable data regarding valsartan overdose.

Presumably, the effect of drug oversaturation will be as follows:

• Strong decrease in pressure;
• Dizziness when trying to get up.

First aid in this case:

• Bring the patient to a horizontal position;
• Inject to patient saline solutionto restore the necessary balance.

Valsartan is not excreted from the body naturally (i.e. urine, feces, sweat, etc.), as it binds to proteins. Therefore, it is necessary to influence the overdose from the outside.

Also, in case of an overdose, there may be a change in the heart rhythm - tachycardia or bradycardia. When assisting a patient, it is necessary to proceed from the symptoms, since valsartan, as already indicated, is not excreted from the body.

Treatment with valsartan in combination with other drugs

In case of a previous heart attack, captopril is prescribed along with valsartan (it reduces the risk of complications that can be caused by a heart attack).

Valsartan is often used in conjunction with amlodipine (this is the active ingredient), which is contained in drugs such as vamloset, exforge.

In the complex, the medicine is used when the patient is diagnosed with heart failure in a chronic form. With increased blood pressure and post-infarction stage, valsartan is usually used as an independent drug.

Valsartan price in pharmacies

You can buy valsartan at a pharmacy. Prices vary depending on the region, although you can set an average price limit for the drug:

• Valsartan 40 mg (tablets) - about 130 rubles;
• Valsartan 80 mg (tablets) - 220 rubles;
• Packing of 160 mg - around 350 rubles.

Valsartan analogs

The closest analogues are valsacor, valsatran valz, valsatran zentiva, valsatran sandoz (plus), sandoz, valsartan n, diovan, valsartan plus, valsartan nan and others. These drugs differ in their components (both in a qualitative sense and in a quantitative sense).

According to the degree of sales and assignability, the following are the most popular of the valsartan analogues (according to the Vyshkovsky index):

1. Valsakor;
2. Diovan.

It is impossible to change the medicine arbitrarily, since the drugs may have a slightly different effect than the original valsartan.

Tablets - 1 tab .:

• Active substance: valsartan 80 mg.
• Excipients: salting SMCC 90 (microcrystalline cellulose - 32.83 mg, colloidal silicon dioxide - 670 μg) - 33.5 mg, sorbitol - 9.25 mg, destab magnesium carbonate 90 (magnesium carbonate - 8.325 mg, pregelatinized starch - 832.5 μg, water - 92.5 μg ) - 9.25 mg, pregelatinized corn starch - 3 mg, povidone K25 - 7.5 mg, sodium stearyl fumarate - 4 mg, sodium lauryl sulfate - 1 mg, crospovidone Type A - 13 mg, anhydrous colloidal silicon dioxide (Aerosil 200 Pharma) - 2 mg.
• The composition of the film shell: lactose monohydrate - 327 μg, hypromellose - 2.027 mg, talc - 385 μg, macrogol / PEG 6000 - 324 μg, iron oxide red dye - 137 μg.

14 pcs. - blisters (2) - cardboard packs.

Description of the dosage form

Film-coated tablets of dark pink color, round, biconvex, with a line on one side; the core is white or almost white in cross section.

pharmachologic effect

Specific angiotensin II receptor antagonist. Selectively blocks AT1 subtype receptors, which are responsible for the known effects of angiotensin II. The consequence of the blockade of AT1 receptors is an increase in the plasma concentration of angiotensin II, which can stimulate unblocked AT2 receptors.

Valsartan does not have any pronounced agonist activity against the AT1 receptors. The affinity of valsartan for the AT1 subtype receptors is approximately 20,000 times higher than for the AT2 subtype receptors.

The likelihood of coughing when using valsartan is very low, which is due to the lack of effect on ACE, kininase II, which is responsible for the degradation of bradykinin.

When treating patients with arterial hypertension with valsartan, a decrease in blood pressure is noted, which is not accompanied by a change in heart rate.

After taking the drug inside in a single dose in most patients, the onset of the antihypertensive effect is observed within 2 hours, and the maximum decrease in blood pressure is achieved within 4-6 hours. After taking the drug, the antihypertensive effect lasts for more than 24 hours. from the dose taken, is usually achieved within 2-4 weeks and is maintained at the achieved level during prolonged therapy. In the case of a combination of the drug with hydrochlorothiazide, a significant additional decrease in blood pressure is achieved. A sudden discontinuation of valsartan is not accompanied by a sharp increase in blood pressure or other undesirable clinical consequences.

The mechanism of action of valsartan in chronic heart failure (CHF) is based on its ability to eliminate the negative consequences of chronic hyperactivation of the RAAS and its main effector, angiotensin II, namely, vasoconstriction; fluid retention in the body; cell proliferation leading to remodeling of target organs (heart, kidneys, blood vessels); stimulation of excessive synthesis of hormones that act synergistically with the RAAS (catecholamines, aldosterone, vasopressin, endothelin). Against the background of the use of valsartan for CHF, the preload decreases, the wedge pressure in the pulmonary capillaries (PLC) and diastolic pressure in pulmonary artery, cardiac output is increased. Along with the hemodynamic effects of valsartan, due to the indirect blockade of aldosterone synthesis, it reduces sodium and water retention in the body.

It was found that the drug had no significant effect on the concentration of total cholesterol, uric acid, as well as in the study on an empty stomach - on the concentration of triglycerides and glucose in the blood serum.

Pharmacokinetics

Suction

After taking the drug inside, the absorption of valsartan occurs quickly, but the degree of absorption varies widely. The average absolute bioavailability is 23%.

In the range of doses studied, the kinetics of valsartan is linear. With repeated use of the drug, no changes in kinetic parameters were observed. Food reduces exposure to valsartan by about 40% and Css by about 50%, although about 8 hours after dosing, plasma valsartan concentrations were the same in the food group and the fasting group. However, this decrease in concentration is not accompanied by a clinically significant decrease in therapeutic effect, therefore, valsartan can be prescribed regardless of food intake.

Distribution

Vd of valsartan in equilibrium after intravenous administration is about 17 liters, which indicates that valsartan is not intensively distributed in tissues. The binding of valsartan to plasma proteins is significant - 94-97%, mainly with albumin.

Metabolism

Valsartan is metabolized slightly. Only about 20% of the dose is found as metabolites. In blood plasma, a pharmacologically inactive hydroxymetabolite is found.

Withdrawal

Compared to the hepatic blood flow (about 30 l / h), the plasma clearance of valsartan is relatively small (about 2 l / h). T1 / 2 is about 9 hours. The amount of valsartan excreted through the intestine is 70%. About 30% is excreted by the kidneys, mainly unchanged.

Pharmacokinetics in special clinical situations

In some elderly patients, the systemic effect of valsartan was somewhat more pronounced than in young patients, but this has not been shown to have any clinical significance.

There was no correlation between renal function and systemic action of valsartan. In patients with impaired renal function (CC\u003e 10 ml / min), dose adjustment is not required. The experience of safe use of the drug in patients with CC<10 мл/мин и находящихся на гемодиализе отсутствует. Однако валсартан имеет высокую степень связывания с белками плазмы крови, поэтому его выведение при гемодиализе маловероятно.

About 70% of the absorbed dose of valsartan is excreted through the intestine, mainly unchanged. Valsartan does not undergo significant biotransformation, the systemic effect of valsartan does not correlate with the degree of liver dysfunction. Therefore, in patients with hepatic insufficiency of non-biliary origin and in the absence of cholestasis, no dose adjustment of valsartan is required. The use of valsartan in patients with severely impaired liver function has not been studied.

The average time to reach Cmax and T1 / 2 of valsartan in patients with CHF are similar to those in healthy volunteers. Cmax in blood plasma and AUC increase linearly and almost proportionally with increasing doses in the range of clinical doses (from 40 to 160 mg 2 times / day).

Clinical pharmacology

Angiotensin II receptor antagonist.

Indications for Valsartan Zentiva's use

• Arterial hypertension;
• chronic heart failure (II-IV functional class according to NYHA classification) in patients receiving standard therapy, incl. diuretics, cardiac glycosides, as well as ACE inhibitors or beta-blockers (not simultaneously) (the use of each of these drugs is optional);
• to increase the survival rate of patients with acute myocardial infarction and after acute myocardial infarction complicated by left ventricular failure and / or left ventricular systolic dysfunction, in the presence of stable hemodynamic parameters.

Contraindications to the use of Valsartan Zentiva

• severe liver dysfunction, biliary cirrhosis and cholestasis;
• age up to 18 years;
• pregnancy;
• lactation period (breastfeeding);
• lactose intolerance, lactase deficiency or syndrome, glucose-galactose malabsorption;
• hypersensitivity to drug components.

The drug should be taken with caution in case of bilateral renal artery stenosis; stenosis of an artery of a single kidney; when following a diet with limited consumption of table salt; in conditions accompanied by a decrease in the BCC (including diarrhea and vomiting); in patients with severe renal insufficiency (CC<10 мл/мин), в т.ч. при проведении гемодиализа, при применении у пациентов после трансплантации почки; при первичном гиперальдостеронизме; легких и умеренных нарушениях функции печени небилиарного генеза без явлений холестаза; при митральном и аортальном стенозах; при гипертрофической обструктивной кардиомиопатии.

Valsartan Zentiva Use during pregnancy and children

Given the mechanism of action of angiotensin II receptor antagonists, a risk to the fetus cannot be excluded. The action of ACE inhibitors (drugs that affect the RAAS) on the fetus, if administered in the II and III trimesters of pregnancy, leads to its damage and death. According to retrospective data, the use of ACE inhibitors in the first trimester of pregnancy increases the risk of having children with birth defects. There are reports of spontaneous abortions, oligohydramnios and renal dysfunction in newborns whose mothers unintentionally received valsartan during pregnancy. Valsartan Zentiva, like any other drug that has a direct effect on the RAAS, should not be used during pregnancy. If pregnancy is detected during the period of treatment with Valsartan Zentiva, the drug should be discontinued as soon as possible.

There are no data on the excretion of valsartan in breast milk. Therefore, you should not prescribe the drug during breastfeeding.

Application in children

Contraindicated in children and adolescents under 18 years of age.

Valsartan Zentiva Side effects

Frequency of side effects: very common (\u003e 10%); often (\u003e 1% and<10%); нечасто (>0.1% and<1%); редко (>0.01% and<0.1%); очень редко (<0.01%), включая отдельные сообщения; неуточненной частоты - частоту установить невозможно.

Patients with arterial hypertension

From the side of cardio-vascular system: frequency unspecified - vasculitis.

From the digestive system: infrequently - abdominal pain; unspecified frequency - impaired liver function, hyperbilirubinemia, increased activity of "hepatic" transaminases.

From the side of the skin: very rarely - angioedema, skin rash, itching.

From the musculoskeletal system: unspecified frequency - myalgia.

From the urinary system: unspecified frequency - impaired renal function, increased serum creatinine concentration.

From the hematopoietic system: unspecified frequency - decreased hemoglobin and hematocrit, neutropenia, thrombocytopenia.

Allergic reactions: unspecified frequency - hypersensitivity reaction, serum sickness.

Others: infrequently - increased fatigue.

Laboratory parameters: unspecified frequency - increased serum potassium concentration.

Patients after myocardial infarction and / or with CHF

From the side of the cardiovascular system: often - orthostatic hypotension and a marked decrease in blood pressure; infrequently - increased symptoms of CHF; unspecified frequency - vasculitis.

From the respiratory system: infrequently - cough.

From the digestive system: infrequently - diarrhea, nausea; unspecified frequency - impaired liver function.

From the nervous system: often - dizziness, incl. postural; infrequently - fainting, headache.

From the senses: infrequently - vertigo.

From the side of the hematopoietic system: unspecified frequency - thrombocytopenia.

Allergic reactions: very rarely - angioedema; unspecified frequency - hypersensitivity reactions, serum sickness.

From the musculoskeletal system: rarely - rhabdomyolysis; unspecified frequency - myalgia.

On the part of the skin: unspecified frequency - skin rash, itching.

From the urinary system: often - impaired renal function; infrequently - acute renal failure; unspecified frequency - hypercreatininemia, increased serum urea nitrogen concentration.

From the side of metabolism: infrequently - hyperkalemia.

Others: infrequently - increased fatigue, asthenia.

Drug interactions

With the simultaneous use of lithium preparations with ACE inhibitors, a reversible increase in the lithium content in the blood plasma and the development of toxic effects have been reported. Due to the lack of experience with the simultaneous use of valsartan and lithium, this combination is not recommended. If necessary, such a combination is recommended to control the lithium content in the blood plasma.

Potassium-sparing diuretics, potassium preparations, salts containing potassium, drugs that increase the level of potassium in the blood plasma (such as heparin) increase the development of hyperkalemia. If it is necessary to use it together with valsartan, it is recommended to control the potassium content in the blood plasma.

The antihypertensive effect of the drug can be weakened by simultaneous use with NSAIDs, incl. selective inhibitors of COX-2.

In the treatment of arterial hypertension with valsartan, there was no clinically significant interaction with other concomitantly used drugs (for example, cimetidine, warfarin, digoxin, atenolol, amlodipine, glibenclamide, furosemide, indomethacin, hydrochlorothiazide).

Other antihypertensive drugs and diuretics enhance the antihypertensive effect.

Dosage of Valsartan Zentiva

It is taken orally, without chewing, regardless of the meal.

Arterial hypertension

The recommended starting dose is 80 mg 1 time / day, regardless of race, gender, and age of the patient. The onset of the antihypertensive effect is observed within 2 hours, the maximum decrease in blood pressure is achieved within 4-6 hours. The antihypertensive effect persists for more than 24 hours. The maximum daily dose is 320 mg. Combination with diuretics is possible.

Chronic heart failure

40 mg (1/2 tablet of 80 mg) 2 times / day, with a gradual increase to 80 mg 2 times / day, with good tolerance - up to 160 mg 2 times / day. The maximum daily dose is 320 mg in 2 divided doses.

The period after myocardial infarction

Treatment begins within 12 hours after myocardial infarction with an initial dose of 20 mg 2 times / day, followed by an increase in the dose (40 mg, 80 mg, 160 mg 2 times / day) for several weeks, until the target dose of 160 mg is reached 2 times / day

Achievement of the target dose depends on the tolerance of the drug during the titration period.

No dose adjustment is required in elderly patients.

In patients with impaired renal function with CC\u003e

In patients with mild to moderate liver dysfunction without the development of cholestasis, the maximum daily dose of the drug should not exceed 80 mg.

Overdose

Symptoms: a pronounced decrease in blood pressure, which can lead to loss of consciousness and to collapse and / or shock.

Treatment: gastric lavage, intake of a sufficient amount of activated carbon, intravenous administration of 0.9% sodium chloride solution. Valsartan is not excreted during dialysis due to pronounced binding to blood plasma proteins.

Precautions

Deficiency in the body of sodium and / or BCC

In patients with severe sodium deficiency and / or reduced BCC, for example, receiving high doses of diuretics, in rare cases, after starting therapy with Valsartan Zentiva, severe arterial hypotension may occur. Before starting treatment, it is necessary to correct sodium deficiency and / or BCC, for example, by reducing the dose of a diuretic.

Renal artery stenosis

The use of valsartan in a short course in 12 patients with renovascular hypertension secondary to unilateral renal artery stenosis did not lead to significant changes in renal hemodynamics, serum creatinine concentration or blood urea nitrogen. However, given that other drugs that affect the RAAS can cause an increase in serum urea and creatinine concentrations in patients with bilateral or unilateral renal artery stenosis, monitoring of these parameters is recommended as a precautionary measure.

Chronic heart failure / period after myocardial infarction

In patients with CHF or after myocardial infarction who begin treatment with valsartan, there is often a slight decrease in blood pressure, and therefore, it is recommended to control blood pressure at the beginning of therapy. If the recommendations for the dosing regimen of drug withdrawal are followed, there is usually no need to cancel the drug due to arterial hypotension.

Due to inhibition of the RAAS in sensitive patients, changes in renal function are possible. In patients with severe CHF, treatment with ACE inhibitors and angiotensin receptor antagonists may be accompanied by oliguria and / or an increase in azotemia and, in some cases, acute renal failure and / or death. Therefore, it is necessary to assess the degree of impaired renal function in patients with heart failure and in patients with acute myocardial infarction.

Impaired renal function

Safe use experience in patients with CC<10 мл/мин и у пациентов, находящихся на гемодиализе, отсутствует, поэтому применять Валсартан Зентива у таких пациентов необходимо с осторожностью. У пациентов с КК >10 ml / min dose adjustment is not required.

During treatment with valsartan, it is necessary to carefully monitor renal function and potassium content in blood plasma.

Liver failure

In patients with mild or moderate hepatic impairment without cholestasis, Valsartan Zentiva should be used with caution.

Combination therapy

In CHF, valsartan can be prescribed both for monotherapy and in conjunction with other drugs - diuretics, cardiac glycosides, as well as ACE inhibitors or beta-blockers. In patients with CHF, caution should be exercised when using a combination of an ACE inhibitor, a beta-blocker and valsartan. With arterial hypertension, Valsartan Zentiva can be prescribed both for monotherapy and in conjunction with other antihypertensive drugs, in particular, diuretics. It is possible to use valsartan in combination with other drugs prescribed after myocardial infarction: thrombolytics, acetylsalicylic acid as an antiplatelet agent, beta-blockers and HMG-CoA reductase inhibitors (statins).

Influence on the ability to drive vehicles and use mechanisms

Patients taking Valsartan Zentiva should be careful when driving and doing activities that require an increased concentration of attention and speed of psychomotor reactions (during therapy, dizziness and fainting may occur).

Valsartan: instructions for use and reviews

Latin name: Valsartan

ATX code: С09СА03

Active substance: valsartan (valsartan)

Manufacturer: Maylen Laboratories Limited (India), KRKA (Slovenia), Zhuhai Rundumintong Pharmaceutical Co., Ltd., Livzon Group Changzhou Kony Pharmaceutical Co., Second Pharma Co. (China), LLC "Ozon", LLC "Atoll", Obolensk pharmaceutical company (Russia)

Description and photo update: 19.08.2019

Valsartan is an angiotensin II receptor antagonist.

Release form and composition

Dosage forms:

• film-coated tablets: round, biconvex, light pink, the core is almost white or white, tablets at a dose of 40 mg and 80 mg have a dividing line on one side (7, 10, 14, 20, 28, 30 or 56 pcs. In a blister strip, in a cardboard box 1, 2, 3, 4, 5, 6, 8 or 10 packages; 7, 10, 14, 20, 28, 30, 40, 50 or 100 pcs. in a polymer can, in a cardboard box 1 can);
• capsules: hard gelatinous, opaque, size No. 2 (capsules 20, 40, 80 mg), size No. 0 (capsules 160 mg); capsules 20 mg - light yellow, body - with a beige tint, the cap - with a cream shade; capsules 40 mg - body and cap are light yellow with a cream shade; capsules 80 mg - body and cap are light yellow with a beige tint; capsules 160 mg - light brown body and cap (10, 20 or 30 pieces in a blister, in a cardboard box 1, 2, 3, 4, 5 or 10 packages; 10, 20, 30, 40, 50 or 100 pcs. In a polymer can, in a cardboard box 1 can).

1 tablet contains:

• active substance: valsartan - 40 mg, 80 mg or 160 mg;
• auxiliary components: microcrystalline cellulose, croscarmellose sodium, colloidal silicon dioxide, magnesium stearate;
• shell composition: Pink opadry (macrogol-3350, polyvinyl alcohol, talc, titanium dioxide, iron dye yellow oxide, iron dye red oxide).

1 capsule contains:

• active substance: valsartan - 20 mg, 40 mg, 80 mg or 160 mg;
• auxiliary components: microcrystalline cellulose, croscarmellose sodium, povidone K17, colloidal silicon dioxide, magnesium stearate;
• composition of the capsule body and cap: gelatin, iron dye yellow oxide, iron dye red oxide, titanium dioxide; in addition, in capsules at a dose of 160 mg - iron oxide black oxide.

Pharmacological properties

The drug is characterized by antihypertensive properties.

Pharmacodynamics

Valsartan is an active specific antagonist of angiotensin II receptors intended for oral administration. It selectively blocks the AT 1 subtype receptors responsible for the effects of angiotensin II. As a result of this blockade, the concentration of angiotensin II in the blood plasma increases, which can lead to the stimulation of unblocked AT 2 receptors. For valsartan, agonistic activity against AT 1 -receptors of any severity is uncharacteristic. The affinity of this substance for the AT 1 subtype receptors is approximately 20,000 times higher than for the AT 2 subtype receptors.

The risk of coughing during treatment with the drug is very low, due to the lack of effect on the angiotensin-converting enzyme (ACE), which is responsible for the degradation of bradykinin. When comparing valsartan with an ACE inhibitor, it was found that the incidence of dry cough attacks was significantly lower in patients taking valsartan compared with patients taking an ACE inhibitor (2.6% and 7.9%, respectively). In the group of patients who previously had dry cough during ACE inhibitor therapy, when using valsartan, this complication was observed in 19.5% of cases, and when using a thiazide diuretic - in 19% of cases, while in the group of patients undergoing a course ACE inhibitor therapy, cough was reported in 68.5% of cases.

Valsartan does not interact with or block ion channels or receptors of other hormones, which play an important role in the regulation of the cardiovascular system. Treatment with this drug in patients with arterial hypertension is accompanied by a decrease in blood pressure, which does not lead to a change in the heart rate.

After oral administration of a single dose of valsartan in most patients, the antihypertensive effect is recorded within 2 hours, and the peak decrease in blood pressure is observed after about 4–6 hours. After taking the drug, the antihypertensive effect persists for about 24 hours. With repeated administration of valsartan, the maximum decrease in blood pressure, regardless of the dose taken, is achieved on average within 2-4 weeks and remains at the achieved level during a long course of therapy. When this drug is combined with hydrochlorothiazide, an additional decrease in blood pressure is observed, confirmed by reliable clinical data. A sudden withdrawal of valsartan does not lead to a sharp increase in blood pressure or other undesirable consequences.

The mechanism of action of the drug in chronic heart failure lies in its ability to eliminate the negative consequences of chronic hyperactivation of the renin-angiotensin-aldosterone system (RAAS) and its main effector, angiotensin II. These include vasoconstriction, stimulation of excessive synthesis of hormones that have a synergistic effect with respect to the RAAS (endothelin, catecholamines, vasopressin, aldosterone, etc.), cell proliferation, causing remodeling of target organs (kidneys, blood vessels, heart), fluid retention in the body ... In patients with chronic heart failure, while taking valsartan, cardiac output increases, diastolic pressure in the pulmonary artery and wedge pressure in the pulmonary capillaries decrease, and preload decreases. The use of the drug is not only accompanied by hemodynamic effects, but also reduces the retention of water and sodium in the body due to an indirect blockade of aldosterone production.

It has been proven that valsartan does not significantly affect the level of uric acid, total cholesterol, as well as when conducting a study on an empty stomach - on the level of glucose and triglycerides in the blood serum.

Pharmacokinetics

After oral administration, valsartan is absorbed at a high rate, but the degree of absorption can vary widely. On average, the absolute bioavailability of this substance reaches 23%. Its maximum concentration in blood plasma is recorded after 2 hours. With regular use of valsartan, the maximum decrease in blood pressure is noted after 4 weeks. With a single dose of the drug during the day, valsartan is accumulated slightly. Its content in blood plasma is the same in women and men.

Valsartan demonstrates a high activity of binding to blood plasma proteins (94–97%), mainly albumin. Its volume of distribution is small and is approximately 17 liters. Plasma clearance is relatively low (about 2 L / h) compared to hepatic blood flow (about 30 L / h).

Valsartan metabolism is not very pronounced (approximately 20% of the dose taken is converted into metabolites). In blood plasma, a hydroxyl metabolite is determined in low concentrations [its AUC (area under the concentration-time curve) is less than 10% of that for valsartan]. This metabolite has no pharmacological activity. Valsartan is distinguished by two-phase elimination from the body: the half-life for the alpha phase is less than 1 hour, and for the beta phase it is approximately 9 hours.

Valsartan is excreted mainly unchanged in feces (approximately 83% of the dose taken) and in the urine (approximately 13% of the dose taken).

Taking valsartan with food leads to a decrease in the AUC indicator by about 48%. However, 8 hours after the drug enters the body, the concentration of the active substance in the blood plasma taken on an empty stomach and with food is the same. The decrease in AUC is not accompanied by a clinically significant decrease in the therapeutic effect of valsartan, so the drug can be taken both before and after meals.

In patients with chronic heart failure, the time to peak concentration and the elimination half-life are identical to those in healthy volunteers. The increase in the maximum concentration and AUC is directly proportional to the increase in the dose of the drug (during the experiment, it increased from 40 to 160 mg taken 2 times a day). The average cumulation factor is 1.7. With oral administration in such patients, the clearance of valsartan reached approximately 4.4 l / h, while the age of the patients did not affect its value.

In some patients over the age of 65, the systemic bioavailability of the drug is higher than that in young patients, but this fact is not of particular clinical significance.

No correlation was found between renal function and systemic drug bioavailability. In patients with renal dysfunction and CC more than 10 ml / min, there is no need to adjust the dose of valsartan. Until now, studies of the use of the drug in patients on hemodialysis have not been conducted. Valsartan is distinguished by a high degree of binding to blood plasma proteins, so its excretion by hemodialysis is practically impossible.

In patients with mild and moderate liver dysfunctions, the bioavailability of valsartan is doubled compared with healthy volunteers. However, the AUC values \u200b\u200bof this substance do not correlate with the degree of impaired hepatic function. The use of the drug in patients with severe liver dysfunction has not been studied.

Indications for use

• chronic heart failure (as part of standard therapy with cardiac glycosides, diuretics, angiotensin-converting enzyme inhibitors or beta-blockers);
• arterial hypertension.

In addition, to increase the survival rate, Valsartan is prescribed to patients with stable hemodynamic parameters after acute myocardial infarction complicated by left ventricular systolic dysfunction and / or left ventricular failure.

Contraindications

• age up to 18 years;
• severe form (above 9 points on the Child - Pugh scale) liver dysfunction, cholestasis, biliary cirrhosis;
• concomitant therapy with angiotensin II receptor antagonists or ACE (angiotensin converting enzyme) inhibitors with aliskiren in patients with diabetes mellitus;
• the period of planning pregnancy and bearing a child;
• breast-feeding;
• individual hypersensitivity to the components of the drug.

According to the instructions, Valsartan should be used with caution in patients who limit the intake of table salt, with bilateral renal artery stenosis, stenosis of the artery of a single kidney, after kidney transplantation, with renal failure [creatinine clearance (CC) less than 10 ml / min], hemodialysis, primary hyperaldosteronism , reduced circulating blood volume (BCC) (including conditions with diarrhea and vomiting), liver failure of non-biliary genesis of mild to moderate severity (without cholestasis), hypertrophic obstructive cardiomyopathy, chronic heart failure II-IV functional class according to NYHA classification, mitral or aortic stenosis.

Instructions for the use of Valsartan: method and dosage

Film-coated tablets

The tablets are taken orally, swallowed whole and washed down with water.

• chronic heart failure: initial dose - 40 mg 2 times a day. Within 14 days, taking into account the individual tolerance of the drug, a single dose should be gradually increased to 80 mg or 160 mg. This may require a reduction in the dose of concurrently used diuretics. The maximum daily dose is 320 mg;
• arterial hypertension: initial dose - 80 mg once a day. In the absence of the desired therapeutic effect after 14–28 days of therapy, the daily dose can be increased to 320 mg or an additional intake of diuretics can be prescribed.

To increase the survival rate after myocardial infarction, the use of Valsartan should be started within the first 12 hours, taking 20 mg 2 times a day. Over the next 14 days, the dose is gradually increased by titration, taking 40 mg, then 80 mg 2 times a day. By the end of the third month of therapy, it is recommended to reach the target dose of 320 mg per day, taking 160 mg 2 times a day. When increasing the dose, it is necessary to take into account the patient's tolerance of the drug.

In case of impaired renal function or in elderly patients, dose adjustment is not required.

With a mild or moderate form of impaired liver function of non-biliary genesis without cholestasis, the dose of the drug should not exceed 80 mg per day.

Capsules

The capsules are intended for oral administration.

Side effects

• digestive system: nausea, diarrhea, increased bilirubin levels;
• cardiovascular system: postural hypotension, postural dizziness, arterial hypotension;
• hematopoietic system: a decrease in the level of hemoglobin and hematocrit, neutropenia;
• nervous system: headache, dizziness;
• metabolism: hyperkalemia;
• urinary system: rarely - functional kidney disorder, increased levels of urea nitrogen and creatinine (especially in patients with chronic heart failure);
• allergic reactions: rarely - itching, rash, serum sickness, angioedema, vasculitis;
• others: general weakness, fatigue, cough, increased risk of developing viral infections, pharyngitis.

Overdose

The main symptom of an overdose of Valsartan is a pronounced decrease in blood pressure, which in the future can lead to clouding of consciousness, shock and / or collapse. In this case, symptomatic therapy is recommended, the features of which depend on the severity of the symptoms and the time elapsed since the drug was taken. In case of accidental overdose, vomiting should be provoked (if Valsartan has been taken recently) or gastric lavage should be performed. With a pronounced decrease in blood pressure, according to the protocols, it is necessary to inject 0.9% sodium chloride solution intravenously and lay the patient down, placing his legs in an elevated position, for a period of time sufficient for therapy. Active measures are also taken to restore the full functioning of the cardiovascular system, including regular monitoring of the amount of urine excreted, the volume of circulating blood and the activity of the heart and respiratory system.

special instructions

With a reduced content of BCC and / or sodium, the use of Valsartan should be started after the restoration of their level in the body, if necessary, then reduce the dose of the diuretic. This will avoid clinical manifestations of arterial hypotension, which rarely occur at the beginning of treatment.

It is recommended to combine with caution with potassium-containing dietary supplements and salt substitutes, potassium-sparing diuretics, heparin or other agents that may contribute to the development of hyperkalemia.

With unilateral or bilateral renal artery stenosis, regular monitoring of serum creatinine and urea levels is required.

Avoid the combination of the drug or ACE inhibitors with aliskiren in severe renal impairment (CC less than 30 ml / min).

When treating patients with obstruction of the biliary tract, the clearance of valsartan decreases.

Patients in whom Valsartan caused Quincke's edema, drug therapy is canceled with a ban on resuming its intake.

In case of arterial hypertension in patients with primary hyperaldosteronism, the use of the drug has no therapeutic effect.

Due to the risk of a significant hypotensive effect of the drug at the beginning of therapy in patients with chronic heart failure or myocardial infarction, it is necessary to regularly monitor blood pressure (BP).

There is a risk of oliguria and / or aggravation of azotemia, in rare cases - acute renal failure and / or death in chronic heart failure II – IV functional class (NYHA classification), therefore, these categories of patients should be provided with periodic assessment of renal function.

In the treatment of arterial hypertension, in addition to monotherapy, the drug can be used in combination with acetylsalicylic acid, thrombolytics, beta-blockers and HMG-CoA reductase inhibitors (statins). It is not recommended to use concomitantly with ACE inhibitors, as monotherapy has advantages in this case.

With the combination therapy of chronic heart failure, the appointment of diuretics, cardiac glycosides, beta-blockers or ACE inhibitors is indicated. The use of a combination of ACE inhibitors, beta-blockers and Valsartan is not recommended.

Due to the risk of dizziness or fainting during the treatment period, care should be taken when driving vehicles and mechanisms.

Application during pregnancy and lactation

Taking Valsartan during pregnancy is strictly contraindicated. The risk to the fetus in this case is quite significant, which is due to the mechanism of action of angiotensin II receptor antagonists. The effect of ACE inhibitors (drugs affecting the RAAS) on the fetus, when administered in the II and III trimesters of pregnancy, can lead to impaired development and intrauterine death. According to retrospective data, when taking ACE inhibitors in the first trimester of pregnancy, the risk of having children with intrauterine malformations increases. There is information about renal dysfunction, oligohydramnios in newborns and spontaneous abortions in mothers who accidentally received valsartan during pregnancy. This drug should also not be used in women planning a pregnancy. In this case, the doctor should inform women of reproductive age about the possible risk of negative effects of valsartan on the fetus during pregnancy.

If pregnancy occurs during treatment with Valsartan, it should be canceled as soon as possible. There is no information about the penetration of the drug into breast milk, therefore, taking the drug is contraindicated for breastfeeding.

Pediatric use

The effectiveness and safety of the drug in children have not been proven.

With impaired renal function

There are no data on the safety of taking Valsartan by patients with CC less than 10 ml / min. Since inhibition of the RAAS is observed in predisposed patients, it may be accompanied by changes in renal function.

Drug interactions

With the simultaneous use of Valsartan:

• agents acting on the renin-angiotensin-aldosterone system (RAAS), have an effect on an increase in the incidence of renal dysfunction, arterial hypotension and hyperkalemia compared to monotherapy;
• atenolol, warfarin, cimetidine, furosemide, digoxin, indomethacin, amlodipine, hydrochlorothiazide, glibenclamide do not cause clinically significant interactions;
• nonsteroidal anti-inflammatory drugs, including selective inhibitors of cyclooxygenase-2, can reduce the antihypertensive effect of valsartan, cause an increase in plasma potassium and impairment of renal function;
• lithium preparations increase their toxic effect by increasing the lithium content in the blood plasma;
• potassium preparations, potassium-sparing diuretics (including amiloride, spironolactone, triamterene), potassium-containing salts can increase the level of potassium concentration in the blood serum, and in heart failure - the content of creatinine in the blood serum;
• rifampicin, cyclosporine, ritonavir may increase the serum valsartan concentration.

Analogs

The analogues of Valsartan are: Valz, Diovan, Valsakor, Valsartan Zentiva.

Terms and conditions of storage

Keep out of the reach of children.

Store at temperatures up to 25 ° C in a dark place.

The shelf life is 3 years.

Description up to date on 07.02.2015

• Latin name:Valsartan
• ATX code:C09CA03
• Active substance:Valsartan (Valsartan)
• Manufacturer:KRKA (Slovenia), Obolenskoe - pharmaceutical company, Ozone LLC (Russia), Second Pharma Co., Livzon Group Changzhou Kony Pharmaceutical Co., Zhuhai Rundumintong Phamaceutical Co., Ltd. (China), Maylen Laboratories Limited (India)

Composition

The drug contains valsartan as an active ingredient.

40 mg tablets include the following additional components: magnesium stearate, croscaramellose sodium, microcrystalline cellulose, "Opadrii pink" dye.

Tablets 80 and 160 mg contain the following auxiliary elements: croscaramellose sodium, magnesium stearate, dye "Opadrai pink", microcrystalline cellulose, aerosil.

Release form

The medicine is sold in pharmacies in the form of powder, capsules, granules and tablets.

pharmachologic effect

Antihypertensive drug.

Pharmacodynamics and pharmacokinetics

The active substance of the drug provokes competitive blocking aT1 receptors of angiotensin II , which are found in the vascular endothelium, heart muscle, adrenal cortex, kidney tissue, brain and lung tissue. This leads to inhibition of angiotensin effects. The medicine reduces myocardial hypertrophy at arterial hypertension .

After a single application, the effect is noticeable after 120 minutes, it lasts throughout the day. A persistent therapeutic effect is achieved 3 weeks after the first day of the course.

People with CHF the medicine will eliminate hyperstimulation of the RAAS , prevents pathological proliferation cells, reduces swelling ... Its reception reduces preload and increases cardiac output .

When combined with, it reduces the likelihood of postinfarction complications.

In addition, a combination such as valsartan and amlodipine ... These active ingredients are found in medicines such as Vamloset .

The original drug is rapidly absorbed from the gastrointestinal tract. Bioavailability on average is 23%.

The connection with proteins (mainly with) is about 95%.

It is excreted mainly in the feces (70%), it is also excreted in the urine (30%), mostly unchanged.

Indications for use

The drug is used for arterial hypertension as well as to improve the survival of people with sharp which is complicated left ventricular systolic dysfunction and / or left ventricular failure ... When chronic heart failure used as part of a comprehensive treatment.

Contraindications

Cannot be used in case of hypersensitivity to drug components. For children, the effectiveness and safety of the drug has not been established.

Side effects

Taking this drug may cause some unwanted effects:

• CCC and hematopoietic system: neutropenia , decrease, hyperkalemia ;
• CNS:, weakness,;
• gastrointestinal tract: , abdominal pain , nausea, increased activity hepatic transaminases ;
• others: cough, viral infections, hyperkalemia .

Adverse reactions when using the drug are rare.

Instructions for use of Valsartan (Way and dosage)

For those who use Valsartan, the instructions for use inform that the product is intended for oral use. Recommended dosage in case arterial hypertension is 80 mg. The norm for the day is taken at one time. If necessary, the dosage can be increased to 160 mg, or another antihypertensive drug can be additionally used. Instructions for use of Valsartan indicate that the maximum daily dosage is 320 mg. It is not recommended to exceed it.

Overdose

Overdose symptoms - hypotension , bradycardia ,. The treatment is symptomatic. Dialysis has no effectiveness.

Interaction

The drug enhances the effect diuretics ... Medicines containing potassium, and potassium-sparing diuretics increase the likelihood hyperkalemia .

Terms of sale

With a prescription from a specialist.

Storage conditions

Temperature up to 25 ° C. Store the drug in a place protected from light and out of reach of children.

Shelf life

Three years. Do not use after the expiration date printed on the package.

Valsartan's analogs

Matching ATX level 4:

The following synonyms and analogues of Valsartan are known:

• Valaar ;
• Valsartan A ;
• Valsasin ;
• Valsartan N ;
• Valsartan Zentiva ;
• Valsafors ;
• Tantordio ;
• Tareg .

All of these drugs have their own characteristics of use. Valsartan analogs cannot be replaced at your own discretion, without consulting your doctor.

Reviews about Valsartan

Reviews about Valsartan are mostly approving. Those who have used this remedy note its fast action. The doctors' comments also indicate a pronounced hypotensive activity of the drug.

Valsartan's price where to buy

The price of Valsartan in 40 mg capsules, 40 pieces in a pack - 130 rubles. Tablets of 80 mg (30 pieces per pack) cost about 220 rubles. And the price of Valsartan in tablets of 160 mg (30 pieces in a pack) is about 350 rubles.

• Online pharmacies in RussiaRussia

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Valsartan tablets p.p. 80mg 30 Pcs.Vertex AO

Valsartan tablets p.p. 160mg 30 Pcs. VertexVertex AO