As an angiotensin II receptor antagonist (ARB), valsartan tablets play an important role in the treatment of cardiovascular diseases.
I. Indications of Valsartan Tablets (Diovan)
1. Hypertension
(1) Valsartan Tablets (Diovan) are indicated for the reduction of blood pressure in adults and children aged 1 year and older with hypertension.
(2) It may be used as monotherapy or in combination with other antihypertensive agents.
2. Heart Failure
(1) Valsartan Tablets (Diovan) are indicated to reduce the risk of hospitalization for heart failure in adult patients with heart failure (NYHA functional class II–IV).
(2) Clinical trials have shown that the addition of valsartan to standard therapy provides significant benefits, especially in patients not adequately treated with angiotensin-converting enzyme inhibitors.
(3) The additional benefit of combining valsartan is limited in patients already receiving adequate doses of ACEIs.
3. Cardiovascular Risk Management After Myocardial Infarction
(1) Valsartan Tablets (Diovan) are indicated to reduce the risk of cardiovascular death in clinically stable adult patients with left ventricular failure or left ventricular dysfunction following acute myocardial infarction.
(2) Administration may generally begin 12 hours after myocardial infarction, as part of a comprehensive treatment regimen, usually in combination with aspirin, β‑blockers, and statins.
II. Contraindications, Foods and Drugs to Avoid
1. Absolute Contraindications
(1) The use is contraindicated in patients with known hypersensitivity to valsartan or any ingredient of this product.
(2) In addition, the concomitant use of valsartan and aliskiren (a direct renin inhibitor) is contraindicated in diabetic patients, as it significantly increases the risk of hypotension, hyperkalemia, and renal impairment.
2. Drugs to Avoid or Use With Caution
(1) Drugs affecting serum potassium:
Concomitant use of potassium‑sparing diuretics (e.g., spironolactone, triamterene), potassium supplements, or potassium‑containing salt substitutes without medical advice is prohibited, as it may lead to severe hyperkalemia.
(2) Nonsteroidal anti‑inflammatory drugs (NSAIDs):
Long‑term concomitant use of ibuprofen, naproxen, celecoxib, or other NSAIDs may attenuate the antihypertensive effect and increase the risk of renal impairment, especially in elderly patients, dehydrated patients, or those with pre‑existing renal disease.
(3) Lithium:
Concomitant use may increase serum lithium concentrations and induce lithium toxicity; close monitoring of serum lithium levels is required.
(4) Other antihypertensive agents:
Concomitant use of other drugs acting on the renin‑angiotensin system (e.g., ACEIs, ARBs, aliskiren) should be avoided unless under explicit medical supervision, to prevent excessive hypotension and renal damage.
3. Dietary Precautions
(1) During treatment, a high‑potassium diet should be avoided, especially excessive intake of high‑potassium foods such as bananas, oranges, potatoes, tomatoes, and spinach, particularly in patients with renal insufficiency.
(2) A low‑salt, balanced diet is recommended to help control blood pressure and reduce the risk of adverse reactions.
III. Dosage and Administration in Special Populations
1. Pregnant Women or Women Planning Pregnancy
Contraindicated.
2. Lactating Women
(1) Use is not recommended during breastfeeding.
(2) Breastfeeding should be discontinued during treatment to avoid potential risks to the infant.
3. Pediatric Patients
(1) May be used for the treatment of hypertension in children aged 1 year and older.
(2) Dosage must be accurately calculated based on body weight, with close monitoring of blood pressure, renal function, and serum potassium.
(3) Use is not recommended in infants below 1 year of age, as it may cause long‑term adverse effects on the developing kidney.
4. Geriatric Patients
(1) Dose adjustment is generally not required in elderly patients.
(2) However, elderly patients may have higher drug exposure, longer half‑life, and increased sensitivity to the antihypertensive effect; caution should be exercised regarding orthostatic hypotension at the initiation of therapy.
5. Patients with Renal Impairment
(1) Dose adjustment is generally not required in patients with mild to moderate renal impairment.
(2) The safety and efficacy in patients with severe renal impairment (eGFR <30 mL/min/1.73 m²) have not been established; use with caution and intensified monitoring.
(3) Renal function and serum potassium should be regularly assessed during treatment.
6. Patients with Hepatic Impairment
(1) No dose adjustment is required in patients with mild to moderate hepatic impairment.
(2) No specific dosage recommendation is available for patients with severe hepatic impairment; use under close medical supervision is recommended, as drug exposure may be doubled.
