Valsartan dosage, forms, and strengths
Valsartan is a generic prescription drug (brand name: Diovan) used alone or in combination with other blood pressure drugs to reduce blood pressure in people with high blood pressure (hypertension). Valsartan is also used to improve cardiovascular function in people with chronic heart failure or who have recently experienced a heart attack. Valsartan can be purchased generically or under the brand name Diovan. It is also commonly combined into a single tablet with other blood pressure medications commonly used with valsartan, such as amlodipine or hydrochlorothiazide.
Valsartan belongs to a class of drugs called angiotensin II receptor blockers (ARBs), or, more technically, angiotensin II receptor antagonists. Valsartan and other ARBs block a protein-like substance, angiotensin, that signals blood vessels to constrict. Besides widening blood vessels and decreasing blood pressure, valsartan also improves vascular health by reducing the stiffness of arteries, improves blood flow to the heart, and helps maintain the proper size and function of heart muscles. Valsartan is taken as a tablet once or twice a day depending on the medical condition being treated.
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Valsartan forms and strengths
Valsartan is taken as a tablet in one of four dose strengths.
Tablets: 40 milligrams (mg), 80 mg, 160 mg, 320 mg
Valsartan dosage for adults
Valsartan is FDA-approved to reduce blood pressure in people with high blood pressure. For heart failure or heart attack, valsartan is used primarily to increase blood flow to the heart when the left ventricle of the heart does not pump enough blood to the body, called “reduced left ventricular ejection fraction” or “left ventricular dysfunction.”
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Valsartan dosage chart |
|||
|---|---|---|---|
| Indication | Starting dosage | Standard dosage | Maximum dosage |
| High blood pressure | 80–160 mg taken once per day | 80–320 mg taken once per day | 320 mg per day |
| Heart failure with reduced ejection fraction | 40 mg taken twice per day | 160 mg taken twice per day | 320 mg per day (in two divided doses) |
| Left ventricular dysfunction following a heart attack | 20 mg taken twice per day | 160 mg taken twice per day | 320 mg per day (in two divided doses) |
Source: Epocrates
Valsartan dosage for hypertension
Valsartan is FDA approved to reduce blood pressure in people 17 years of age and older with hypertension. Valsartan reduces blood pressure by widening blood vessels. It is a first-line treatment for uncomplicated hypertension; other first-line hypertension drugs include thiazide diuretics, ACE inhibitors, and calcium channel blockers. Valsartan only needs to be taken once a day because it works for 24 hours with minimal adverse reactions.
Standard dosage for high blood pressure: 80–320 mg taken orally once per day
Maximum dosage for high blood pressure: 320 mg per day in two divided doses
Valsartan dosage for heart failure with reduced left ventricular ejection fraction
There is more than one type of congestive heart failure. Heart failure in the left side of the heart can be categorized as “left ventricular systolic dysfunction” (LVSD) or “left ventricular diastolic dysfunction” (LVDD). In the case of LVSD, the chamber of the heart known as the ventricle does not contract hard enough to push blood to the rest of the body. The amount of blood that is pushed through this chamber is referred to as “ejection fraction.”
In LVSD, less than 40% of the blood in the chamber is pushed out with each contraction. Another term for this is “heart failure with reduced ejection fraction.” In LVDD, the ventricle never relaxes fully, so it doesn’t receive as much blood from the chamber before it. This also reduces the movement of blood with each contraction, but not to the same degree. In LVDD, the ejection fraction is more than 40%, which is called “heart failure with preserved ejection fraction.”
Valsartan has been shown to reduce hospitalizations and deaths in patients with LSVD. Valsartan benefits patients with LVDD as well, although the data is not quite as strong. High blood pressure is commonly experienced with heart failure and significantly contributes to the degenerative progress of the disease. Valsartan benefits heart failure patients, then, by both increasing blood flow and decreasing blood pressure.
Standard dosage for heart failure: 40-160 mg taken orally twice per day
Maximum dosage for heart failure: 320 mg per day in two divided doses
Valsartan dosage for left ventricular dysfunction after a heart attack
Left ventricular systolic dysfunction (LV dysfunction) and left ventricular failure occur when the left ventricle—the part of the heart that pumps blood to the body—loses the strength to push out all the blood in its chamber. Left untreated, LV dysfunction can lead to chronic heart failure or sudden cardiovascular death. Damage to the heart, such as a heart attack (myocardial infarction), can change the way the heart contracts, which gradually alters the size, shape, and function of the heart, eventually leading to LV dysfunction. This gradual process is called “cardiac remodeling. To prevent or slow down this process, valsartan is given after a heart attack to increase blood flow and prevent the heart from working too hard. LV dysfunction is a serious medical condition that can cause lethal cardiovascular events.
Standard dosage for post-MI left ventricular dysfunction: 20-160 mg taken orally twice per day
Maximum dosage for post-MI left ventricular dysfunction: 320 mg per day in two divided doses.
Valsartan dosage for children
Valsartan is FDA-approved to treat hypertension in children 6 years of age and older for the treatment of hypertension. The use of valsartan in children younger than 6 is not recommended. However, some physicians may use valsartan in children as young as 1 year old or they may use it to treat heart failure in children as young as 6.
Valsartan dosage by age |
||
|---|---|---|
| Age | Standard dosage | Maximum dosage |
| Ages 1-16 | 1–4 mg/kg* of body weight taken orally once per day | 160 mg once per day |
| 17 and under | Start at 80-160 mg once per day | 320 mg once per day |
* 1 kg = 2.2 lbs
Valsartan dosage restrictions
In general, no dose adjustments are required for special medical conditions or specific populations. People with mild to moderate kidney disease or liver impairment will not require a dose adjustment. Dose adjustments have not been defined for people with severe liver impairment or kidney dysfunction, but no supplement is required for people on dialysis.
Doses may need to be lowered for people who are dehydrated or taking diuretics along with valsartan. Because valsartan monotherapy is less effective in black people, valsartan is usually combined with other antihypertensive drugs in that population, particularly beta-blockers (nebivolol), thiazide diuretics (hydrochlorothiazide), or calcium channel blockers (amlodipine).
Pregnant women and people allergic to valsartan should not take valsartan.
How to take valsartan
Valsartan is taken as a tablet once or twice per day with or without food. For easier dosing of young children or people unable to swallow a tablet, a doctor, pharmacist, or other healthcare professional can prepare a 160 milliliter (mL) oral suspension at a concentration of 4 mg/mL.
Take the medicine as directed.
Read and follow the patient instructions that come with this medicine.
Take this medicine at the same time every day.
Store valsartan at room temperature, preferably 20°–25°C (68°–77°F), in a closed container (away from sunlight) in a dry place.
Valsartan oral suspension compounded by a healthcare professional can be stored at room temperature (less than 86ºF) or in a refrigerator (35ºF–46ºF) for up to 14 days. Dispose of any unused oral suspension that is not used within this period.
Tablets
Swallow the tablet whole with a glass of water. Do not crush, chew, or break the tablet.
Oral suspension
Shake the oral suspension well before measuring out a dose.
Use a metered dosing syringe or another dose-measuring device to measure out the liquid. Do not use kitchen spoons, cups, measuring spoons, or measuring cups.
Swallow the full measured dose.
Valsartan dosage FAQs
How long does it take valsartan to work?
When taken orally, the antihypertensive effects of valsartan begin in about two hours and peak in four to six hours. The effects gradually decrease after six hours but continue to lower blood pressure for approximately about 24 hours.
What happens if I miss a dose of valsartan?
Take a missed dose when remembered but not when it’s almost time for the next dose. In that case, skip the missed dose and take the next dose as scheduled. Do not take extra medicine to make up for a missed dose.
What is the maximum dosage for valsartan?
The maximum dose of valsartan for adults 17 and older is 320 mg a day. The maximum dosage for children has not been determined, but the Prescriber’s Desk Reference recommends a maximum daily dose of 2.7 mg/kg that should never exceed a daily total of 160 mg in children between the ages of 6 and 16. The FDA does not recommend valsartan be used in children younger than 6.
Can you overdose on valsartan?
Valsartan is not toxic and high doses have been tested in animals. However, too much valsartan could cause dangerously low blood pressure (severe hypotension), a potentially lethal medical emergency. Hypotension can be managed with supportive care, so get immediate emergency medical care if too much valsartan is taken.
What interacts with valsartan?
Because of possible drug interactions, some medications cannot be used with valsartan or should be used cautiously. Some include:
Other renin-angiotensin-aldosterone system (RAAS) blocking drugs such as ARBs (like candesartan or losartan), ACE inhibitors (such as enalapril, captopril, or lisinopril), and the direct renin-inhibitor aliskiren
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Lithium
Potassium supplements, salt substitutes, or potassium-sparing diuretics
This is not an exhaustive list of all drugs that can potentially interact with valsartan. It is best to consult with a doctor or pharmacist about potential interactions with other medications you are taking.
What happens when you mix valsartan and alcohol?
Alcohol lowers blood pressure, so combining alcohol with drugs that lower blood pressure, like valsartan, can cause blood pressure to fall too low. While alcohol is not strictly forbidden, a good rule of thumb when starting an antihypertensive like valsartan is to avoid alcohol for the first few weeks. This allows you to get a good idea of how the medication affects blood pressure. Watch for symptoms like dizziness, lightheadedness, and fainting to make sure blood pressure isn’t dipping too low. When certain that the medicine isn’t causing hypotension, go easy on drinking alcohol and stop at any signs of low blood pressure.
Is it safe to take valsartan during pregnancy?
Pregnant women should not take valsartan. Immediately inform the doctor or other healthcare professional about any detected or planned pregnancy. Valsartan can harm a fetus, particularly in the second and third trimesters. The primary risks are kidney damage and fetal or newborn death, as well as depletion of amniotic fluid.
It is not known if valsartan is present in breast milk or if valsartan affects lactation or the health of a breastfeeding baby. Nursing women will be advised to either switch medications or discontinue breastfeeding.
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