To lower the pill pressure

In this article, you can read the instructions for use of the drug. Valsacor. Presented reviews of visitors to the site – the consumers of this medicine, as well as the opinions of medical specialists on the use of Valsakor in their practice. A big request to add your feedback on the drug more actively: the medicine helped or did not help to get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Analogs Valsakora in the presence of available structural analogues. Use for the treatment of heart failure, hypertension and pressure reduction in adults, children, as well as during pregnancy and breastfeeding. The composition of the drug.

Valsacor – antihypertensive agent. It is a specific angiotensin 2 receptor antagonist. It has a selective antagonistic effect on AT1 receptors, which are responsible for the realization of the effects of angiotensin 2.

Due to the blockade of AT1 receptors, the plasma concentration of angiotensin 2 increases, which can stimulate unblocked AT2 receptors. Does not possess agonistic activity against AT1 receptors. The affinity of valsartan for AT1 receptors is approximately 20,000 times higher than that for AT2 receptors.

Does not inhibit ACE. Does not interact or block the receptors of other hormones or ion channels, which are important for the regulation of the functions of the cardiovascular system. It does not affect the level of total cholesterol, TG, glucose and uric acid in the blood plasma.

The onset of the antihypertensive effect of valsartan after its oral administration in a single dose is observed within 2 hours after administration, the maximum effect is achieved within 4-6 hours.

Hydrochlorothiazide (composed of Valsakor H80 and H160, ND160) is a thiazide diuretic, the diuretic effect of which is associated with impaired reabsorption of sodium, chlorine, potassium, magnesium, water in the distal nephron; delays the excretion of calcium ions, uric acid. It has a hypotensive effect, which is caused by the expansion of arterioles. Virtually no effect on normal blood pressure.

The diuretic effect develops within 1-2 hours after taking the drug inside, reaches a maximum after 4 hours and lasts for 6-12 hours. The antihypertensive effect occurs after 3-4 days, but it may take 3-4 weeks to achieve the optimal therapeutic effect.

Composition

Valsartan + excipients.

Valsartan + Hydrochlorothiazide + excipients (Valsakor H80 and H160, ND160).

Pharmacokinetics

After ingestion Valsakor is rapidly absorbed from the gastrointestinal tract, the degree of absorption is characterized by individual differences. Absolute bioavailability averages 23%. With course application, changes in pharmacokinetic parameters were not observed. When taking valsartan with food, the AUC is reduced by 48%, and approximately 8 hours after taking the plasma valsartan concentration is the same in patients who took it with food and on an empty stomach. AUC reduction is not accompanied by a clinically significant decrease in therapeutic effect. When taking valsartan 1 time per day, cumulation is expressed slightly. Plasma concentrations of valsartan in women and men were the same. Binding to plasma proteins, mainly albumin, is 94-97%. Excreted in the feces – 70% and with urine – 30%, mostly unchanged. With biliary cirrhosis or obstruction of the biliary tract, the AUC of valsartan increases approximately 2 times.

After oral administration, the absorption of hydrochlorothiazide is 60-80%. Plasma protein binding – 40-70%. Hydrochlorothiazide is not metabolized and is rapidly excreted in the urine (more than 95%).

Indications

  • treatment of hypertension (pressure reduction);
  • treatment of chronic heart failure (NYHA class 2-4 functional class) in patients receiving traditional diuretic therapy, digitalis preparations, and ACE inhibitors or beta-blockers.

To lower the pill pressure

Forms of release

Tablets, coated 40 mg, 80 mg, 160 mg and 320 mg (Valsakor).

Tablets, coated 80 mg + 12.5 mg, 160 mg + 12.5 mg (Valsakor H80 and H160).

Tablets, coated 160 mg + 25 mg (Valsakor ND160).

Instructions for use and dosage

Is taken orally at a dose of 80 mg 1 time per day or 40 mg 2 times per day, daily. In the absence of an adequate effect, the daily dose may be gradually increased.

To lower the pill pressure

The maximum daily dose is 320 mg in 2 divided doses.

Tablets H80 and H160

The drug is taken orally, regardless of the meal, the multiplicity of reception – 1 time per day.

Valsakor H160 can be combined with other antihypertensive drugs. Treatment must begin with minimal doses of the drug.

Patients who have not reached the target level of blood pressure on the background of monotherapy (valsartan at a dose of 160 mg or hydrochlorothiazide at a dose of

Maximum antihypertensive effect of the drug Valsakor H160 (160 /

To lower the pill pressure

Patients with impaired renal function (CC more than 30 ml / min (

Valsakor H160 is not recommended for patients with impaired liver function. The maximum recommended daily dose of valsartan in patients with mild or moderate liver dysfunctions of nonbiliary origin is 80 mg (1 tablet per day of Valsakor H80).

Elderly patients do not require dose adjustment.

The drug is taken orally, regardless of the meal, the multiplicity of reception – 1 time per day.

Valsakor ND160 can be combined with other antihypertensive drugs. Treatment must begin with minimal doses of the drug.

For patients who have not reached the target level of blood pressure on the background of monotherapy (valsartan at a dose of 160 mg or hydrochlorothiazide at a dose of 25 mg), a fixed combination of doses – Valsakor ND160 (160/25 mg) is recommended once a day.

The maximum antihypertensive effect of the drug Valsakor ND160 (160/25 mg) develops within 2-4 weeks.

Side effect

  • general weakness;
  • increased fatigue;
  • asthenia;
  • dizziness, in

Contraindications

  • severe liver dysfunction;
  • biliary cirrhosis and obstruction of the biliary tract (cholestasis);
  • mild and moderate abnormal liver function of non-biliary origin (for a given dose of the drug);
  • anuria, pronounced renal dysfunction (CC less than 30 ml / min (

Use during pregnancy and lactation

The use of angiotensin 2 receptor antagonists is not recommended in the first trimester of pregnancy. The drug is contraindicated in 2 and 3 trimesters of pregnancy, because the use in 2 and 3 trimesters of pregnancy can cause fetotoksicheskie effects (reduced renal function, oligohydramnios, delayed ossification of the fetal bones) and neonatal toxic effects (renal insufficiency, hypotension, hyperkalemia). If, nevertheless, the drug was used in the 2nd and 3rd trimesters of pregnancy, then an ultrasound of the kidneys and bones of the fetal skull must be performed.

When planning a pregnancy, it is recommended to transfer the patient to alternative antihypertensive therapy taking into account the safety profile.

If pregnancy is confirmed, Valsakor should be canceled as soon as possible.

No data on the allocation of valsartan in breast milk. However, it is known that valsartan penetrates the milk of lactating rats. Hydrochlorothiazide is excreted in breast milk. Therefore, if necessary, therapy with Valsakor ND160 during lactation should be canceled breastfeeding.

Use in children

Contraindicated in children and adolescents under the age of 18 years (the effectiveness and safety of the use of valsartan in children has not been proven).

Use in elderly patients

Elderly patients do not require dose adjustment.

special instructions

When hyponatremia and / or reduction of the BCC, as well as during therapy with high doses of diuretics, in rare cases, Valsacor can cause severe arterial hypotension. Before starting treatment should be a correction of violations of water-salt metabolism.

In patients with renovascular hypertension, which developed secondarily due to renal artery stenosis, the level of urea and serum creatinine should be regularly monitored during the treatment period. Data on the safety of use in patients with QA less than 10 ml / min are not available.

With extreme caution used in patients with impaired biliary tract.

Patients with impaired liver function is recommended to take no more than 80 mg of valsartan per day.

Valsakor H160 is not recommended for patients with primary hyperaldosteronism.

There are reports of exacerbation of systemic lupus erythematosus (SLE) with thiazide diuretics.

Changes in renal function are possible due to inhibition of the RAAS in predisposed patients. When using ACE inhibitors and angiotensin receptor antagonists in patients with chronic severe heart failure, oliguria and / or an increase in azotemia was observed, and acute renal failure rarely developed with the risk of death.

Influence on ability to drive motor transport and control mechanisms

When using valsartan, it is recommended to be careful when driving a car and controlling mechanisms.

Drug interaction

With the simultaneous use of diuretics in high doses may develop arterial hypotension.

With the simultaneous use of potassium-sparing diuretics, heparin, dietary supplements or salt substitutes containing potassium, hyperkalemia may develop.

With simultaneous use with indomethacin, a decrease in the antihypertensive effect of Valsakor is possible.

When used simultaneously with lithium carbonate, a case of lithium intoxication has been described.

With thiazide diuretics, drugs such as ethanol (alcohol), barbiturates and opioid analgesics can potentiate the risk of developing orthostatic hypotension.

Analogues of the drug Valsakor

Structural analogues of the active substance:

  • Artinova;
  • Valaar;
  • Walz;
  • Valsartan;
  • Valsartan Zentiva;
  • Valsartan H;
  • Valsafors;
  • Valsakor H80;
  • Valsakor H160;
  • Valsakor ND160;
  • Diovan;
  • Norstian;
  • Tantordio;
  • Tareg.

Analogs for the pharmacological group (angiotensin 2 receptor antagonists):

  • Amzaar;
  • Amozartan;
  • Angiakand;
  • Aprovel;
  • Artinova;
  • Atacand;
  • Block octane;
  • Vazotenz;
  • Walz;
  • Valsartan;
  • Vamloset;
  • Gizaar;
  • Gizortan;
  • Duopress;
  • Zisacar;
  • Ibertan;
  • Irbesartan;
  • Candecor;
  • Candesartan;
  • Cardomine;
  • Cardosal;
  • Cardosten;
  • Cardostin;
  • Karzartan;
  • Co Exforge;
  • Coaprovel;
  • Lakea;
  • Lozap;
  • Lozarel;
  • Losartan;
  • Lorista;
  • Lorista H;
  • Lawtenza;
  • Losacor;
  • Mikardis;
  • Mikardis Plus;
  • Naviten;
  • Norstian;
  • Olimestra;
  • Order;
  • Prezartan;
  • Renicard;
  • Tareg;
  • Twinsta;
  • Teveten;
  • Firmasta;
  • Edarby;
  • Exforge;
  • Eprosartan Mesylate.
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