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Hypertension: The recommended dose is 80 mg once a day, regardless of race, age, or gender. Antihypertensive effects appear substantially after 2 weeks and maximum effects are seen after 4 weeks. Patients with blood pressure are not well controlled, the daily dose can be increased to 160 mg, or can be added a diuretic. Valsartan can be combined with other antihypertensive drugs.
Heart failure: The recommended starting dose is 40 mg twice daily. Titration of doses to 80 mg and 160 mg twice daily should be carried out until the highest dose is reached, which can be tolerated by the patient. Considerations for reducing diuretics given together should be done. The maximum daily dose given in clinical trials is 320 mg in divided doses. Concomitant use with ACE inhibitors and beta blockers is not recommended. Evaluation in patients with heart failure must always be accompanied by an examination of the assessment of kidney function.
Post myocardial infarction: Therapy can be started as early as possible 12 hours after myocardial infarction. After an initial dose of 20 mg twice daily, valsartan must be titrated to 40 mg, 80 mg, 160 mg twice daily for the next few weeks. The initial dose is 40 mg which can be divided.
The achievement of a target dose of 160 mg twice daily must be based on the tolerability of the patient during dose titration. If symptomatic hypotension or renal dysfunction occurs, dose reduction must be considered. Valsartan can be used in post-myocardial infarction patients treated with other therapies, such as thrombolytic, acetylsalicylic acid, beta blockers and statins. Evaluation in patients after myocardial infarction must always be accompanied by an examination of kidney function.
Note for all indications: No dose adjustment is needed for patients with renal impairment or for patients with nonbiliary liver insufficiency and without cholestasis.
Use in children and adolescents: The efficacy and safety of Valsartan has not been established in children and adolescents at under the age of 18.
