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Related to Diovan hct: hydrochlorothiazide, valsartan


an angiotensin II antagonist used as an antihypertensive, administered orally.



Pharmacologic class: Angiotensin II receptor antagonist

Therapeutic class: Antihypertensive

Pregnancy risk category C (first trimester), D (second and third trimesters)

Pregnancy risk category C (first trimester), D (second and third trimesters)


Blocks the vasoconstrictive and aldosterone-producing effects of angiotensin II at various receptor sites, including vascular smooth muscle and adrenal glands


Tablets: 40 mg, 80 mg, 160 mg, 320 mg

Indications and dosages


Adults: Initially, 80 to 160 mg P.O. daily. May increase as needed to a maximum of 320 mg P.O. daily, or a diuretic may be added.

Children ages 6 to 16: Initially, 1.3 mg/kg (up to 40 mg total) P.O. once daily; dosage range is 1.3 to 2.7 mg/kg (40 to 160 mg total).

Heart failure

Adults: 40 mg P.O. b.i.d., titrated to 80 mg or 160 mg P.O. b.i.d., as tolerated

Reduction of cardiovascular mortality in clinically stable patients with left ventricular failure or left ventricular dysfunction following myocardial infarction

Adults: 20 mg P.O. b.i.d., followed by titration to 40 mg P.O. b.i.d., with subsequent titration to a target maintenance dosage of 160 mg P.O. b.i.d., as tolerated

Dosage adjustment

• Symptomatic hypotension
• Renal dysfunction

Off-label uses

• Left ventricular hypertrophy
• Diabetic nephropathy


• None


Use cautiously in:
• severe heart failure; volume or sodium depletion; hepatic or renal impairment; obstructive biliary disorders; angioedema; aortic, mitral valve, or renal artery stenosis; hyperkalemia, hypotension
• pregnant or breastfeeding patients
• children younger than age 6 (safety not established).


• Give with or without food.
• For children who can't swallow tablets or children for whom calculated dosage doesn't correspond to available tablet strength, use a suspension but be aware that exposure to the suspension is 1.6 times greater than the tablet.
• To prepare 160 ml of a 4-mg/ml suspension, add 80 ml of Ora-Plus to bottle containing eight valsartan 80-mg tablets and shake for at least 2 minutes. Allow suspension to stand for at least 1 hour. Then shake for at least 1 additional minute. Add 80 ml of Ora-Sweet to bottle and shake for at least 10 seconds before giving appropriate dose. May store suspension for 30 days at room temperature or up to 75 days if refrigerated.

Be aware that drug isn't recommended for children with glomerular filtration rate of less than 30 ml/minute/1.732.

Adverse reactions

CNS: dizziness, fatigue, headache

CV: hypotension, palpitations

EENT: sinus disorders, rhinitis, pharyngitis

GI: nausea, diarrhea, constipation, abdominal pain, dry mouth

GU: albuminuria, renal impairment

Hematologic: neutropenia

Metabolic: hyperkalemia

Musculoskeletal: back pain, joint pain, muscle cramps

Respiratory: cough, upper respiratory tract infection

Skin: alopecia, angioedema

Other: dental pain, fever, viral infection, edema


Drug-drug.Nonsteroidal anti-inflammatory drugs including selective cyclooxygenase-2 inhibitors: increased risk of renal impairment including acute renal failure in elderly patients, volume-depleted patients, or those with compromised renal function; loss of valsartan antihypertensive effect

Other antihypertensives: increased risk of hypotension

Potassium-sparing diuretics, potassium supplements: increased risk of hyperkalemia

Drug-diagnostic tests.Serum creatinine, serum and urine albumin, urine potassium: increased levels

Drug-food.Salt substitutes containing potassium: increased risk of hyperkalemia

Drug-herbs.Ephedra (ma huang): reduced hypotensive effect of valsartan

Drug-behaviors.Alcohol use: increased CNS depression

Patient monitoring

• Monitor blood pressure closely, especially during initial therapy and dosage adjustments.
• Assess potassium level. Stay alert for hyperkalemia.
• Be aware that in black patients, drug may be ineffective when used alone. Additional agents may be required.

Patient teaching

• Tell patient he may take with or without food.
• For children who can't swallow tablets or children for whom calculated dosage doesn't correspond to available tablet strength, show caregiver how to prepare a suspension.

Instruct female of childbearing age to report pregnancy immediately.
• Advise breastfeeding patient to avoid breastfeeding while taking drug.
• Advise patient to avoid potassium-containing salt substitutes.
• Caution patient to avoid alcohol.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, foods, herbs, and behaviors mentioned above.


/val·sar·tan/ (-sahr´tan) an angiotensin II antagonist used as an antihypertensive.


An angiotensin II receptor blocker drug, C24H29N5O3, used to treat hypertension and heart failure.


an antihypertensive.
indications It is used to treat hypertension, either alone or in combination with other agents.
contraindications Factors that prohibit its use are known hypersensitivity to valsartan, pregnancy, severe hepatic disease, and bilateral renal artery stenosis.
adverse effects Life-threatening effects are cerebrovascular accident, myocardial infarction, hepatotoxicity, and nephrotoxicity. Other adverse effects are depression, drowsiness, vertigo, angina pectoris, second-degree atrioventricular block, hypotension, conjunctivitis, abdominal pain, nausea, impotence, neutropenia, cramps, myalgia, musculoskeletal pain, and stiffness. Common side effects are dizziness, insomnia, arrhythmias, diarrhea, anemia, and cough.


A drug that interferes with the action of ANGIOTENSIN II and is used to treat high blood pressure (HYPERTENSION). A brand name is Diovan.
References in periodicals archive ?
Diovan HCT and Exforge are approved to treat high blood pressure and are not approved to treat or prevent stroke, heart attack, heart failure, kidney failure or eye problems.
Diovan HCT combines in one tablet Diovan (valsartan), the world's number one selling branded high blood pressure medication, and hydrochlorothiazide, a high blood pressure treatment from the diuretics drug class.
The Diovan HCT and Exforge first-line approvals were based on several clinical trials in approximately 2,000 and 3,500 patients, respectively, in which both products demonstrated efficacy and tolerability in patients with mild-to-severe high blood pressure.
Val-MARC is the largest study to investigate whether blood pressure medications, specifically Diovan or Diovan HCT, can lower hsCRP in addition to effectively treating stage 2 hypertension.
There was no consistent effect observed with Diovan HCT on levels of hsCRP.
Val-MARC also demonstrated that Diovan HCT, including two new higher strengths recently approved by the FDA, produced double-digit blood pressure reductions up to 27 mmHg in systolic and 14 mmHg in diastolic blood pressure (p<0.
Diovan and Diovan HCT should be discontinued as soon as pregnancy is detected because they may cause harm or even death to the unborn child.
Diovan and Diovan HCT are contraindicated for patients who are allergic to any of the ingredients of the products.
A leading fixed-dose combination of two effective high blood pressure medicines, Diovan HCT combines a diuretic (water pill) and Diovan in a convenient once-a-day tablet.
AADVANCE was a prospective, double-blind, randomized, head-to-head comparison of Diovan HCT and amlodipine, a calcium channel blocker, in 482 African Americans with mild to moderate high blood pressure.
Diovan, Diovan HCT, and/or Lotrel, should be discontinued as soon as pregnancy is detected because they may cause harm or even death to the unborn child.
Diovan and Diovan HCT are contraindicated for patients who are hypersensitive to any components of the products.