Diovan

Description overdue on 05/12/2014

• Latin name: Diovan
• ATC code: C09CA03
• Active substance: Valsartan (Valsartan)
• Manufacturer: Novartis Pharma (Switzerland)

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• Composition
• Product form
• Pharmacological action
• Pharmacodynamics and pharmacokinetics
• Indications
• Contraindications
• Side effects
• Diovan, instructions for use
• Overdose
• Cooperation
• Terms of sale
• Storage conditions
• Shelf life
• Cautions
• Analogs
• Synonyms
• Babies
• During pregnancy (and lactation)
• Reviews
• Price, where to buy

Composition

One tablet includes 40, 80, 160 or 320 mg valsartan - Active substance.

Additional ingredients: crospovidone, microcrystalline cellulose, macrogol 8000, silicon dioxide, hypromellose, magnesium stearate, E171, E172.

Product form

The drug Diovan (Diovan) is produced in the form of coated tablets.

One pack of the drug 40, 80 and 160 mg may comprise 14, 28, 56 or 98 tablets.

One pack of the drug to 320 mg may comprise 14, 28, 56, 98 and 280 tablets.

Pharmacological action

Hypotensive.

Pharmacodynamics and pharmacokinetics

Diovan (Diovan) is a specific activity angiotensin II receptor antagonist . The active ingredient - valsartan selectively acting on the receptor subtype AT1, responsible for the function Angiotensin II , Blocked, thereby increasing its plasma concentrations , Which in turn stimulates the AT2 receptor subtypes. The drug does not show any significant agonism   with respect to the AT1 receptor, since its affinity for these receptors is much higher than for the AT2 receptor.

Due to the lack of exposure valsartan on angiotensin-converting enzyme   (ACE), responsible for the degradation bradykinin , The possibility of Cough As a side effect is minimal. Valsartan It does not affect ion channels   and does not react with hormone receptors Involved in regulating cardiovascular function . In therapy hypertension   lowers blood pressure ( arterial pressure ) Without changing the heart rate ( heart rate ).

For internal (oral) administration of a single dose valsartan . hypotensive action , Most patients were observed over 2 hours, it reaches its maximum after 4-6 hours and persisted throughout the day, and even more. If readmission maximum   low blood pressure Usually reached within 2-4 weeks regardless of the dose, and maintained at a high level throughout the treatment period. When combined valsartan from T idrohlortiazidom there is a significant additional low blood pressure . In case of sudden discontinuation of treatment Diovanom, its abolition does not lead to a sudden increased blood pressure   or other adverse clinical manifestations.

In the treatment of CHF ( chronic heart failure ) mechanism of action valsartan linked to its ability to eliminate the negative impact of chronic excitation RAAS (the renin-angiotensin-aldosterone ) And Angiotensin II , i.e, - vasoconstriction . Also valsartan   warns cell proliferation , Reduces the amount of fluid in the body, normalizes replication hormones: endothelin . aldosterone . catecholamines . vasopressin And so forth. Diovan reduces preload Decreases in pulmonary embolism diastolic pressure   and in pulmonary capillary wedge pressure Increases cardiac output , Promotes the excretion of water and sodium . It did not significantly affect serum contents Uric acid , Total cholesterol Glucose and triglycerides .

After oral (inner) indicated rapid absorption reception valsartan Although its degree varies within wide limits. Absolute bioavailability averaged 23%. T1 / 2 - about 9 hours.

Valsartan has linear kinetics does not change when re-admission. Cumulation preparation, in single daily administration, negligible.

Relationship to plasma proteins, mainly albumin It occurs at 94-97%. The plasma clearance of approximately 2 liters / hr, liver blood flow, 30 l / h. The volume of distribution of approximately 17 liters.

Excreted in the feces (70%) and urine (30%), mostly unchanged. Food intake reduces the number of suction valsartan That does not affect its efficacy in the daily intake.

The elderly and kidney disease and liver, dose adjustment valsartan not required, except obstruction of the biliary tract   and biliary cirrhosis At which time the suction is increased. There are no data on the use of the drug patients undergoing hemodialysis .

Indications

• CHF   II-IV functional classes according to the NYHA classification, including those already in the therapy using drugs   foxglove . diuretics . beta-blockers   or   ACE inhibitors ;
• sharp myocardial infarction , Aggravated systolic dysfunction   Left ventricular and / or left ventricular failure , With stable hemodynamics, in order to improve survival;
• arterial hypertension   (long-term treatment).

Contraindications

• periods breast-feeding   and pregnancy ;
• hypersensitivity   to valsartan or other additional ingredients Diovan.

Carefully:

• renal artery stenosis ;
• malonatrievaya diet;
• conditions associated with a decrease in the amount of circulating blood;
• hepatic failure   with obstruction of the bile ducts;
• renal disease requiring passage Hemodialysis .

Side effects

CNS:

• postural dizziness;
• insomnia ;
• fainting ;
• lowering libido ;
• dizziness ;
• headache .

The immune system:

• hypersensitivity reactions, including serum sickness.

Hematopoietic system:

• neutropenia ;
• reduced content hematocrit and Hemoglobin ;
• thrombocytopenia ;
• increase of creatinine , Total bilirubin , Potassium and urea nitrogen.

Cardiovascular system:

• orthostatic hypotension ;
• hypotension ;
• heart failure ;
• vasculitis .

Respiratory system:

• cough (rarely).

GI:

• stomach ache;
• diarrhea ;
• nausea .

Skin:

• itch . rash or a combination thereof.

Musculoskeletal system:

• myalgia ;
• back pain;
• arthralgia .

Kidneys:

• impairment of renal function;
• renal failure .

The organs of hearing:

• vertigo .

Infections and infestations:

• respiratory tract infections;
• viral infection;
• sinusitis ;
• pharyngitis ;
• rhinitis .

Metabolism:

• hyperkalemia .

Other:

• feeling tired;
• swelling ;
• asthenia ;
• angioedema .

Diovan, instructions for use

Instructions for use involves Diovan oral (oral) pills, if possible, without dividing them into parts and not liquid.

For the treatment (long) hypertension   recommended dose of 80 mg Diovan. A tablet taken once a day, preferably at the same time of the day. Hypotensive action   It appears in the first 14 days of treatment and reaches a maximum efficiency of about a month. In case of unsatisfactory effect of a given dose, it is possible to increase (by a physician) up to 320 mg, or adherence to therapy diuretics .

Treatment CHF   recommend starting with twice-daily dosing valsartan 40 mg (80 mg / day), with a gradual increase in its half (160 mg / day), and at a sufficient individual tolerance and four times (320 mg / d), this is the maximum dose. In the case of increasing doses of Diovan possible lowering doses diuretics If any have been assigned previously. Evaluation of patients CHF   and undergoing therapy valsartan It should cover renal function.

In the case of appointment of Diovan in   post-infarction period Should begin therapy for 12 hours after the event myocardial infarction . Treatment started with a daily dose of 40 mg, in two divided doses for 24 hours (in this case the tablet is divided into two equal parts). In the future, increasing the practice of daily doses valsartan for from a few weeks to a few months (as recommended by a physician) to achieve a therapeutic dose of 320 mg Diovan, is maximum. All drug daily dosages are divided into two stages, and their rise and the transition to a subsequent dose of individual and depends on the tolerance of Diovan. With the development of clinical manifestations hypotension Or irregularities in the work of the kidneys, you should consider lowering the dose. Evaluation of post-MI patients undergoing therapy valsartan It should cover renal function.

Overdose

The main symptom of an overdose of the drug Diovan is marked reduction in blood pressure , Which may develop as a result of shock and / or collapse .

In the event of an overdose in a short time, you must call vomiting and wash out the stomach . Subsequently recommend intravenous administration, in the form of infusion , 0, 9% solution sodium chloride . Effectiveness Hemodialysis unlikely.

Cooperation

Concurrent use of Diovan and potassium-sparing diuretics   ( Triamterene . Spironolactone . Amiloride ), As well as drugs which include potassium May cause an increased concentration in the blood, and in patients Heart Failure   increase content creatinine . Therefore, caution should be exercised in combination of these drugs.

No other clinically significant interactions with other drugs Diovan, were found.

Terms of sale

Diovan tablets are dispensed from pharmacies upon presentation of a doctor's prescription.

Storage conditions

The drug Diovan does not require special storage conditions and stored at temperatures up to 30 ° C.

Shelf life

The tablets in the original packaging, stored for 3 years.

Cautions

In patients suffering from deficiency BCC   and / or sodium in the body, for example, high doses diuretics At the beginning of therapy Diovanom, in rare cases development hypotension symptomatic. Therefore, before assigning Diovan needs to adjust the concentration BCC and / or sodium Including, by reducing the dosage diuretics .

When diagnosing hypotension Should give the patient supine position, with raised legs and, if necessary, enter in the form infusion , 0, 9% solution sodium chloride . After stabilize blood pressure Diovanom therapy can continue.

Patients with renal artery stenosis Recommend to carry out monitoring of the content creatinine and urea in serum, since some drugs may enhance their concentrations in patients with these complications.

Patients after myocardial infarction   or CHF At the beginning of therapy Diovanom quite often there was some low blood pressure , More often than not leads to the cancellation of treatment, subject to the recommendations of the attending physician.

In sensitive patients, because RAAS inhibition   there may be changes in the kidneys.

At severe CHF Therapy ACE inhibitors   and may be accompanied by an increase Diovanom azotemia and / or oliguria and occasionally severe renal failure Which can lead to death . For these patients requires constant monitoring of renal function.

After myocardial infarction Possibly a combination with Diovan beta-blockers . thrombolytic . statins and acetylsalicylic acid .

When treating CHF , Joint use of Diovan, Beta-blocker   and ACE inhibitor   Be particularly careful.

Reception at Diovan CHF   It may be associated with drug treatment foxglove . diuretics . beta-blockers   or ACE inhibitors .

In therapy hypertension Possibly with the appointment of Diovan diuretics or other antihypertensive drugs.

Analogs

Match code ATC 4th level:

• Mikardis
• Vasari
• Valz
• Lorista
• Losap
• Kandesar

Below are some common counterparts Diovan similar to them in their main action:

• Aprovel ;
• Vazotenz ;
• Ibertan ;
• Kardosal ;
• Losap ;
• Losartan ;
• Mikardis ;
• Teveten ;
• Irbesartan ;
• Kandesar ;
• Edarbi etc.

Synonyms

• Valsacor ;
• Valsartan ;
• Nortivan ;
• Valz ;
• Tager ;
• Tantordio ;
• Valaar .

Babies

Studies on the effects of Diovan children under 18 are not conducted, and therefore it is not possible to provide specific recommendations on the use of the drug in this age.

During pregnancy (and lactation)

Periods pregnancy and breast-feeding   a contraindication to receiving Diovan tablets.

Reviews Diovane

Reviews Diovane, during therapy hypertension In most cases positive. Patients notice improvement in their condition when receiving the drug monotherapy And when the doctor recommended combination with other antihypertensives . The negative effects are manifested at the beginning of treatment, limited nausea and some dizziness . Naturally, the drug is not suitable for everyone, since treatment hypertension It should be individualized.

It is also worth noting the positive reviews about the doctors in the case of Diovane yoke of use for therapy   CHF   and after myocardial infarction . If all the recommendations of its reception, the drug Diovan often shows excellent results of treatment and the minimum number of negative side effects.

Price Diovan where to buy

Pharmacies Russia Diovan price depends on the weight content of valsartan and the number of tablets in the package, such as 80 mg tablets №28 can be purchased for 1100-1300 rubles, and 160 mg tablets №28 of 1300-1600 rubles.

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