Diovan (Valsartan) - Oral

What Is Diovan?

Diovan (valsartan) is a common prescription drug used to treat hypertension (high blood pressure) and heart failure. It can also increase your chances of living longer after a heart attack.

This medication, classified as an angiotensin II receptor antagonist, works by reducing the action of angiotensin II. Angiotensin II is a hormone that causes blood vessels to narrow and contributes to water and salt retention in the body. By countering these effects, valsartan can help lower blood pressure and make it easier for the heart to pump blood.

Diovan is available by prescription in tablet form. It is also sold as a generic, usually at a lower cost. 

What Is Diovan Used For?

Diovan has been around since the 1990s. Along with its generic versions, it is one of the 100 most prescribed drugs in the United States.

The Food and Drug Administration (FDA) approved Diovan to treat:

• Hypertension: Used in adults and children aged 6 years and older to help lower blood pressure and, in turn, reduce the risk of a heart attack or stroke
• Heart failure: A condition in which the heart can’t pump enough blood to meet the body’s needs
• Heart attack: Used immediately after a heart attack to improve heart function, minimize damage, and reduce the risk of death

How to Take Diovan

Take Diovan by mouth with or without food. It is taken once each day for people with hypertension and twice each day for people with heart failure or who have just had a heart attack.

The dose of Diovan is usually titrated, meaning that you will start with a lower dose and gradually increase to the optimal dose, as tolerated.

Storage

Store Diovan tablets at room temperature (around 77 degrees F). If traveling, it is OK to expose the medication to temperatures between 59 F and 86 F. Keep the tablets in a dry, cool cabinet or drawer in their original airtight container. Discard any drugs that have expired.

Off-Label Uses

Diovan is often used off-label in people with diabetic kidney disease. Off-label use means that a healthcare provider prescribes the medication to treat a different medical condition than the FDA approved if they feel it will benefit the patient.

Diabetic kidney disease is a progressive condition that can worsen under the stress of high blood pressure. This is because hypertension is associated with increased chemicals called reactive oxygen species (ROS) which can directly damage the kidneys. Reducing hypertension can help slow the progression to end-stage kidney disease.

What Are the Side Effects of Diovan?

This is not a complete list of side effects, and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at www.fda.gov/medwatch or 1-800-FDA-1088.

As with all drugs, Diovan may cause side effects. Most are mild and manageable, with few people stopping treatment due to intolerance.

Common Side Effects

Common side effects of Diovan vary by the condition being treated.

When used for hypertension, common side effects of Diovan include:

• Headache
• Dizziness
• Upper respiratory infection
• Dry cough
• Diarrhea
• Nasal congestion (stuffy nose)
• Runny nose
• Sinusitis (inflammation of the sinuses)
• Nausea
• Sore throat
• Swelling of the feet or ankles
• Joint pain

When used for heart failure, common side effects include:

• Dizziness
• Diarrhea
• Joint pain
• Fatigue
• Back pain
• Nausea
• Muscle weakness
• Heart palpitations

When used after a heart attack, common side effects include:

• Dizziness
• Nausea
• Fatigue
• Loss of concentration
• Blurred or fading vision

Severe Side Effects

Severe side effects from Diovan are rare and mainly affect people with certain underlying medical conditions.

Rare kidney impairment and kidney failure cases have been reported among Diovan users, often in those with chronic kidney disease (CKD). Symptoms include difficulty urinating, shortness of breath, fatigue, nausea, weakness, confusion, and abnormal heart rhythms.

Cases of drug hypersensitivity are equally rare. When it occurs, it usually manifests with a mild, generalized swelling of the face and eyelids known as angioedema. People who have had angioedema with other drugs are at greater risk.

Although angioedema from ARB use is rare, there have been isolated reports of death due to the excessive swelling of the throat.

Call your healthcare provider right away if you have serious side effects while taking Diovan. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Long-Term Side Effects

Studies evaluating the long-term safety of valsartan reported that side effects were infrequent. The most common included dizziness, headache, and diarrhea.

Dosage: How Much Diovan Should I Take?

Modifications

People with kidney or liver disease should use Diovan with caution.

Adults with kidney disease who have a creatinine clearance (CrCl) of less than 10 milliliters per minute (mL/min) may need a dosing adjustment. CrCl correlates to kidney function.

The normal CrCl range is:

• 110 to 150 mL/min in adult males
• 100 to 130 mL/min in adult females
• 75 to 125 mL/min in children

ARB dosing recommendations are to the maximally tolerated dose for each patient.

Missed Dose

If you miss a Diovan dose, take it as soon as you remember. If it is almost time for your next dose, skip the original dose and continue as normal. Never double up doses to “catch up.”

Overdose: What Happens If I Take Too Much Diovan?

If you take more than the recommended dose of Diovan, you may experience symptoms of hypotension (low blood pressure), including:

• Dizziness
• Sleepiness
• Nausea
• Heart palpitations
• Confusion
• Cold, clammy skin
• Muscle cramps
• Fainting

The amount of the drug needed to overdose can vary from person to person. To date, there are few reported cases of Diovan overdose in medical studies. When they occur, the events are rarely life-threatening.

This should not suggest that a Diovan overdose poses no risk, particularly if you are driving, operating heavy machinery, or are of older age. Keep medications out of reach of children to avoid accidental overdose.

Precautions

What Are Reasons I Shouldn’t Take Diovan?

Do not use Diovan if you have a known hypersensitivity to valsartan or any other ingredient in the drug. People who have experienced angioedema with other drugs, especially ACE inhibitors, should take extreme caution when using this medication.

Diovan use can raise liver enzymes and potentially lead to liver injury or cholestasis (decreased bile flow).

The FDA offers no recommendation for the “safe” dose of Diovan in people with severe liver disease. Your healthcare provider will determine your treatment based on a review of the benefits and potential risks.

Do not take Diovan during pregnancy, and immediately stop taking it if you become pregnant. Animal studies have shown that it can cause fetal harm. This includes bone deformity, lung or kidney defects, and cranial bone hypoplasia (underdeveloped skull). When used during the second or third trimester, Diovan increases the risk of death in both fetuses and newborns.

What Other Medications Interact With Diovan?

You should not use Diovan with Tekturna (aliskiren) if you have diabetes. This also includes the combination drug Valturna (aliskiren and valsartan). The combination of these drugs can lead to kidney problems, hypotension, and hyperkalemia (high blood potassium) in people with diabetes.

Several other medications may interact with Diovan. In some cases, a drug may reduce the effectiveness of Diovan and, in others, lead to side effects or toxicities.

Diovan may interact with:

• ACE inhibitors, like Lotensin (benazepril) and Vasotec (enalapril): These medications can increase the risk of kidney problems, hypotension, and hyperkalemia when used with Diovan
• Lithium
• Nonsteroidal anti-inflammatory drugs (NSAIDs), like Celebrex (celecoxib) and naproxen: Combined NSAID and Diovan use can cause kidney problems, especially in people aged 65 years and older or those on diuretics
• Potassium-sparing diuretics, including Aldactone (spironolactone) and Inspra (eplerenone): Using these drugs with Diovan can lead to hyperkalemia
• Potassium supplements, including salt substitutes: These supplements can also lead to hyperkalemia when used with Diovan

These interactions do not necessarily mean your dose will be adjusted or you need to stop taking one of the medications. Instead, your healthcare provider might routinely monitor your kidney function and serum potassium levels to avoid harm. Your provider might recommend a dose reduction or change of treatment if a problem arises.

To avoid interactions, always tell your healthcare provider about any drugs you take.

What Medications Are Similar?

There are seven other ARBs approved for use in the United States:

• Atacand (candesartan)
• Avapro (irbesartan)
• Benicar (olmesartan)
• Cozaar (losartan)
• Edarbi (azilsartan)
• Micardis (telmisartan)
• Teveten (eprosartan)

These drugs all have similar mechanisms of action and side effects but different approved uses. For example, all seven ARBs are approved for the treatment of hypertension. However, only Diovan, Atacand, and Cozaar are used to treat heart failure. Similarly, only Cozaar and Avapro are approved to treat diabetic kidney disease.

Of the seven drugs, Diovan is the only ARB approved to reduce the risk of death following a heart attack.

How Can I Stay Healthy While Taking Diovan?

Hypertension is a major cause of stroke, coronary artery disease, heart failure, and many other chronic illnesses. Medications like Diovan can be an important part of the treatment plan, but they shouldn’t be the only part.

You can make a few key lifestyle changes to better control your blood pressure and decrease your risk of heart attack and stroke. This includes lowering your salt intake, losing excess body weight, limiting alcohol use, and quitting cigarettes. By working with your healthcare team, including nutritionists and personal trainers, you can learn how to improve your diet and create an appropriate exercise plan for you.

If you are on antihypertensive drugs like Diovan, it is important to take them as prescribed. While missing an occasional dose is human, try not to make it a habit or take breaks from treatment. If a drug doesn’t agree with you or you are faced with a heavy pill burden, ask your health provider if any alternatives can make your treatment easier.