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Renal Insufficiency: There is no apparent correlation between renal function (measured by creatinine clearance) and exposure (measured by AUC) to valsartan in patients with different degrees of renal impairment.
Hepatic Insufficiency: On average, patients with mild-to-moderate chronic liver disease have twice the exposure (measured by AUC values) to valsartan of healthy volunteers (matched by age, sex and weight). In general, no dosage adjustment is needed in patients with mild-to-moderate liver disease. Care should be exercised in patients with liver disease.
Concomitant Therapy in Patients with Heart Failure: In patients with heart failure, concomitant use of Tensar, an ACE inhibitor, and a beta blocker is not recommended. In the Valsartan Heart Failure Trial, this triple combination was associated with an unfavorable heart failure.
