Tablets from high blood pressure Valz. Valz - instructions for use and reviews

Valz is a peripheral vasodilator used in the treatment of diseases of the cardiovascular system. The active ingredient is valsartan.

The drug is a specific blocker of angiotensin II AT1 receptors, which does not inhibit angiotensin-converting enzyme.

Valz has a hypotensive effect, does not affect the content of total cholesterol, thyroglobulin, uric acid and glucose in blood plasma.

Improvement of the patient's condition is observed at least 2 hours after oral administration, maximum - after 4-6 hours. The therapeutic effect persists for 1-2 days.

Maximum reduction blood pressure occurs after 2-4 weeks of regular use. In the event of a sudden discontinuation of treatment with this medication, withdrawal symptoms are not observed.

When taken orally, it is well and rapidly absorbed. Possesses low bioavailability, excellent contact with blood proteins.

Available in the form of film-coated tablets Valz (40, 80 and 160 mg), intended for oral use.

Indications for use

What helps Valz? The drug is prescribed in the following cases:

• Persistent increase in blood pressure;
• As part of complex therapy in the treatment of chronic heart failure;
• Prevention of repeated heart attacks and strokes in patients at risk - with a hereditary predisposition, obesity, atherosclerosis, arterial hypertension;
• Acute myocardial infarction with left ventricular systolic dysfunction or ventricular failure.

Instructions for use Valz (40 \ 80 \ 160), dosage

Tablets are taken orally, regardless of the meal, as a whole, washed down with a sufficient amount of water. Do not chew.

The maximum antihypertensive effect develops after 4 weeks. In the absence of an adequate therapeutic response, it is possible to increase the daily dose of Valz to 160 mg, the maximum daily dose is 320 mg. If necessary, diuretics may be additionally prescribed.

In chronic heart failure, the recommended initial dosage is 40 mg 2 times a day.

The dosage of Valz is gradually increased over 2 weeks to 80 mg twice a day. With good tolerance, an increase to 160 mg \ 2 times a day is possible.

• The maximum daily dose is 320 mg 2 times a day.

For mild and moderate liver dysfunction of non-biliary genesis without cholestasis phenomena: use the drug with caution, the daily dose is not more than 1 tablet of Valz 80 mg.

At severe violations liver function (more than 9 points on the Child-Pugh scale), biliary cirrhosis and cholestasis, the drug is contraindicated.

Side effects

According to the instructions for use, the appointment of Valz may be accompanied by the following side effects:

• bleeding, heart failure, low blood pressure, orthostatic hypotension and vasculitis (cardiovascular system);
• cough (respiratory system);
• diarrhea, abdominal pain and nausea (digestive system);
• postural dizziness, fainting, insomnia, depression, decreased libido, dizziness, neuralgia and headache (central nervous system);
• vertigo (organs of hearing and labyrinth apparatus);
• neutropenia and thrombocytopenia (hematopoietic system);
• back pain, arthritis, muscle cramps, myalgia and arthralgia (musculoskeletal system);
• impaired renal function and acute renal failure (urinary system);
• hyperkalemia (metabolism);
• decrease in hemoglobin and hematocrit levels, increased serum urea nitrogen concentration, hypercreatininemia, increased liver transaminase activity and hyperbilirubinemia (laboratory parameters).

With simultaneous use with other drugs that lower blood pressure, a rapid drop in blood pressure and the development of acute vascular insufficiency are possible.

Contraindications

Valz is contraindicated in the following cases:

• obstruction of the biliary tract due to tumor processes or blockage of the lumen with stones;
• severe damage to the liver and kidneys;
• individual intolerance to the constituent components of the drug;
• galactosemia or lactase deficiency;
• severe hypotension;
• age up to 18 years;
• period of pregnancy and breastfeeding.

With special care, the drug is prescribed for the treatment of patients with increased level potassium in the blood, mitral and aortic stenosis, conditions caused by a decrease in the volume of circulating fluid in the body.

Overdose

Overdose symptoms are a pronounced decrease in blood pressure, which can lead to loss of consciousness and collapse.

Treatment - gastric lavage, taking a sufficient amount activated carbon, in / in the introduction of 0.9% sodium chloride solution. It is not excreted during dialysis due to active binding to plasma proteins.

Valz analogues, price in pharmacies

If necessary, you can replace Valz with an analogue for the active substance - these are drugs:

1. Diovan;
2. Valsaforce;
3. Tantordio;
4. Valsartan;
5. Nortivan;
6. Valsacor;
7. Tareg.

When choosing analogues, it is important to understand that the instructions for use Valz (40 \ 80 \ 160) mg., The price and reviews for drugs of similar action do not apply. It is important to consult a doctor and not to make an independent replacement of the drug.

Price in Russian pharmacies: Valz 80mg tablets 28 pcs. - from 291 to 298 rubles, 40 mg 28 pcs. - from 254 to 270 rubles.

Valz is widely used to treat high blood pressure. Due to the increase in the lumen in the vessels, blood begins to be better distributed and circulate.

The drug is prescribed to patients to normalize the level of blood pressure. Before use, it is important to read the description of the action and the instructions for use. The drug is prescribed to patients who have a high level of pressure.

Valz medicine for the treatment of high blood pressure

Compound

Important! The drug "Valz" contains a strong active substance valsartan.

An antihypertensive agent blocks angiotensin type 1 receptors. One tablet contains no more than 40 mg of the main component. An additional component that improves the effect of the drug is lactose monohydrate.

Release form

"Valz" for patients is presented in the form of small tablets. The manufacturer offers a different dosage of the main potent substance, which is selected individually for each patient. Tablets are round and oval. They are yellow or slightly pink in color.

Covered with a film coating, which quickly dissolves when it enters the stomach. Blisters are packed into a cardboard box on 7 pieces. For hospitals, packages are produced that contain a large number of blisters.

Pharmacodynamics and pharmacokinetics

"Walz" is combination drug. It includes thiazide diuretic and angiotensin receptor blockers. The main component of the composition belongs to the group of peripheral vasodilators, which has a diuretic and hypotensive effect. After entering the body, internal processes and the work of vital organs do not change.

The component does not interact and does not contribute to the blocking of hormones, ion channels. The drug is designed to normalize of cardio-vascular system in the patient's body. If you do not exceed the prescribed dosage, the drug "Valz" will help reduce pressure. This does not change the heart rate.

In the patient's body, the reabsorption of sodium ions decreases. In the convoluted tubules, the production of carbonic anhydrase is blocked. The kidneys begin to intensively excrete potassium, bicarbonates and phosphates. Long-term use of the drug "Valz" does not affect the level of the acid-base state of the body.

Note! The activity of magnesium excretion increases in the body, urates and calcium ions are retained.

The maximum concentration of the potent substance is reached within 5 hours. The duration of this effect is more than 24 hours, after which the effect of the drug begins to weaken. In the body, the glomerular filtration rate decreases, the volume of circulating blood decreases, therefore, pressure decreases.

The hypotensive effect is observed in the first month of treatment. Valsartan is rapidly absorbed in the body, well absorbed by the walls of the stomach. The level of biological activity is 23%. The level of maximum concentration is reached within two hours after application.

Important! The main component is able to bind to plasma proteins by 95%.

Indications for use

The pharmaceutical drug "Valz" is prescribed to patients who have been diagnosed with the following health problems:

1. Arterial hypertension. This is a chronic disease, which in most cases is diagnosed in older or older patients. old age. The patient's blood pressure rises, and is accompanied by painful symptoms. The disease cannot be completely cured, but it is possible to maintain the condition and normalize the pressure. "Valz" helps to eliminate the negative symptoms and causes that led to increased pressure;
2. Comprehensive treatment of chronic heart failure. Patients are not prescribed the simultaneous use of valsartan, beta-blockers and ACE. This combination of potent components can lead to the development serious complications, side effects;
3. "Valz" is prescribed to patients to reduce the mortality rate after the diagnosis of an acute form of myocardial infarction. The drug is prescribed individually, taking into account the state of the body. The duration of admission can vary from 12 hours to 7 days. Such a disease can cause irreparable harm to health. It is complicated by insufficiency of the left ventricle, as well as its dysfunction. In this case, hemodynamics can remain stable.

The drug is strictly forbidden to take on its own, without consulting a doctor. It has dangerous side effects, so it is necessary to use the medicine with caution. Dosage and treatment regimen is selected individually. The doctor will prescribe complex diagnostics, will take into account the characteristics of the body, the severity of the disease.

Contraindications

Note! If the patient has individual intolerance and hypersensitivity to valsartan, as well as to the auxiliary components contained in the composition, the drug is not prescribed.

It is contraindicated in cases where the body has disorders in the liver, biliary tract patency. The most dangerous conditions are cholestasis and biliary cirrhosis, which can cause irreversible consequences in the body.

"Valz" is prohibited for use in patients who have been diagnosed with severe renal failure. During the diagnosis, the doctor takes into account the level of filtration in the kidneys. "Walz" is not prescribed to children who have not reached the age of majority.

Patients who progress arterial hypotension, hyponatremia, hyperkalemia, mitral and aortic valve stenosis, treatment is prescribed with extreme caution. The patient is shown stationary conditions to monitor the condition during therapy. With the progression of renal stenosis, the level of nitrogen in the urea is additionally monitored.

If the patient has an impaired water-salt balance, it is necessary to restore the optimal balance of fluid and electrolyte combinations before treatment. The doctor recommends reducing the dosage of diuretics. Patients with renovascular type of hypertension are prescribed medicinal product"Walz" in certain situations.

The patient needs to take tests once a week to control the level of urea and creatinine in the serum. After taking the drug, you can not drive a car, work with precise mechanisms. There is a possibility that the concentration of attention will be reduced.

Side effects

If the patient does not comply with the established therapy regimen and does not adhere to the recommendations of the attending physician, there is a possibility of developing side effects. The list of the most common actions includes:

• heart failure, internal bleeding, a sharp decrease in blood pressure;
• violations by respiratory system therefore, the patient has severe coughing attacks, which are accompanied by spasms in the bronchi;
• pathology of the gastrointestinal tract, stool is disturbed, there is pressing or acute pain in the abdominal region, vomiting and nausea after eating;
• defeat of the central nervous system, state of dizziness and fainting, depression;
• sleep becomes not strong, so the patient wakes up exhausted, lethargic;
• in men, sexual function is disturbed, frequent headaches cause discomfort;
• on the part of the musculoskeletal system, there are cramps in muscle tissue, arthritis, inflammation of chronic diseases;
• the formation of blood clots in the veins;
• symptoms acute insufficiency kidneys, dysfunction of their activity;
• symptoms viral infection, rhinitis, sinusitis, asthenia, swelling of the upper and lower extremities, increasing the level of bilirubin in the body.

Important! Patients often present with symptoms allergic reaction, there is a skin rash, angioedema, excessive itching and other dermatological problems.

If you notice the first symptoms, you should consult a doctor or call ambulance. You need to take a medicine that will help reduce negative symptoms, increase the body's resistance.

How to take and at what pressure, dosage

Tablets "Valz" are taken orally as a whole. It is strictly forbidden to grind the medicine into powder or divide it into several parts. The potent substance breaks down well and acts regardless of food intake. For patients who have been diagnosed with arterial hypertension, the doctor prescribes 80 mg of the drug per day. This dosage should not be exceeded so as not to encounter serious side effects.

The maximum therapeutic effect is observed after a month with regular use. Further, the dosage should be increased by 2 times. If necessary, you can combine the drug with an antihypertensive drug, diuretics. When a patient has been diagnosed with chronic heart failure, the initial dosage is 40 mg. If the treatment is not effective, then the patient is prescribed 80 mg tablets twice a day.

Patients who tolerate treatment well may take up to 160 mg of the potent agent twice daily. Dosage adjustment is carried out by the attending physician. Once every 2 weeks, the doctor will be able to evaluate the effect of the medicine. It is strictly forbidden to increase the dosage on your own.

The maximum daily dosage is not more than 320 mg of the drug. This dosage must be divided into two doses. If diuretics, antihypertensive drugs are prescribed at the same time, the dosage of valsartan is reduced. "Valz" is prescribed to reduce high blood pressure.

Overdose

Note! If the patient has exceeded the prescribed dosage, blood pressure may drop sharply.

There is a risk of collapse, respiratory arrest, loss of consciousness. At the first signs of an overdose, it is important to call an ambulance. During the first hour, the patient is given a gastric lavage, and sorbents are additionally prescribed. If there is an indication, saline solution should be injected into the vein to reduce the activity of the potent active substance.

During dialysis, the serum concentration of valsartan will not decrease. In case of an overdose, a salty or aluminum taste in the mouth may be felt in the body. The patient is recommended to be treated in a hospital so that doctors can control the level of pressure, assess the general condition.

Interaction

Medicines, the action of which is aimed at increasing potassium, when combined with the drug "Valz", can cause the development of hyperkalemia. Diuretics and antihypertensive drugs, as well as other medications complement the action of "Valz".

The effectiveness of the drug is reduced or completely blocked if the patient simultaneously takes non-narcotic analgesics. The toxicity of lithium increases as a result of the simultaneous use of "Valz" with ACE inhibitors. If indicated, the doctor monitors the level of lithium in the serum.

Analogues

Analogues of the drug "Valz" are selected exclusively in rare cases. They contain the same potent substance. The most effective are Valsakor, Valsartan, Tantordio, Diovan. When choosing analogues, the doctor takes into account individual characteristics organism, the severity of the disease.

"Valz" helps to effectively and gently lower blood pressure. Before use, it is important to consult with a cardiologist who will prescribe a comprehensive diagnosis, take into account the condition, indications and contraindications for the use of Valz. Instructions for use, at what pressure, how to take - these are questions that the attending physician will help you figure out.

What is the drug "Valz" (tablets) for? We will talk about this further. In the materials of the presented article, we will tell you about whether this medicine has analogues, side effects and contraindications. Patient reviews and instructions for using the medication will also be described.

Composition, description and packaging of the medicinal product

What is the composition of the drug "Vals"? The tablets contain such an active substance as valsartan. They also contain additional components in the form of talc, croscarmellose sodium, microcrystalline cellulose, lactose monohydrate, magnesium stearate, povidone K29-32 and silicon dioxide.

The drug at a dosage of 40 mg is film-coated, has a yellow color and an oval biconvex shape. On one side of the tablets there is an engraving "V", and on the other - side risks. Also on sale is the drug in pink (80 and 160 mg each).

The medication in question, Valz tablets, is packaged in blisters that are placed in cardboard boxes.

Pharmacological features

What is the drug "Vals"? Tablets are prescribed as a peripheral vasodilator. This medication is able to block angiotensin II AT1 receptors, but it cannot inhibit ACE.

Under the influence of the active substance of the drug, the content of glucose, total TG, cholesterol and uric acid in the blood does not change.

How quickly does the Vals medication begin to act? The tablets are absorbed fairly quickly. 2 hours after ingestion (maximum 5-6 hours), they begin their action.

The effect of taking the drug "Valz" usually persists throughout the day. With regular therapy, the maximum reduction in blood pressure is observed only after 2-4 weeks. If the patient stops treatment abruptly, it does not occur.

Pharmacokinetic properties of tablets

Is Vals medicine (tablets) rapidly absorbed? Instructions for use states that after taking the drug inside, its rather rapid absorption is noted. The bioavailability of the drug is approximately 23%. At the same time, the linear nature of the pharmacokinetic properties of valsartan is noted.

The active substance of the drug has a fairly high level of binding to plasma proteins. This figure varies between 94-97%.

If the Valz tablets are taken again, then the kinetic indicators will not change in any way. With a single dose of the drug per day, the patient has a slight accumulation of valsartan. In the blood, insignificant concentrations of the inactive hydroxymetabolite are noted.

After taking the medicine inside, approximately 83% of the active substance is excreted through the intestines (with bile), and another 13% is excreted unchanged by the kidneys.

Indications for use

Why is the drug "Vals" prescribed? Tablets from pressure at arterial hypertension act very quickly and efficiently. In addition, they are accepted chronic form heart failure (in complex treatment), as well as to increase the survival rate of people who have experienced acute myocardial infarction.

Contraindications

In what cases should you not take Vals medication (tablets)? Reviews of experts indicate the following contraindications:

• renal failure (severe), including during hemodialysis;
• impaired liver function due to obstruction of the biliary tract;
• period of pregnancy;
• impaired absorption of galactose or glucose, galactosemia;
• breastfeeding the baby;
• age up to 18 years;
• intolerance to the components of the drug.

It should also be noted that the drug "Valz" is used with extreme caution in obstructive hypertrophic cardiomyopathy, arterial hypotension, primary hyperaldosteronism, renal artery stenosis, hyperkalemia, mitral and aortic stenosis, hyponatremia.

The drug "Vals" (tablets): instructions for use

Before taking the medication, the patient should be sure to read the instructions. It is also necessary to consult with your doctor.

How should I take Vals 80? Tablets in this dosage are prescribed to patients with arterial hypertension. The medication should be taken orally, once a day, regardless of the meal.

After the start of treatment, the antihypertensive effect of Valz begins to appear in the first 2 weeks. The greatest effect of the drug is observed after about a month.

If the daily dosage of the drug in 80 mg does not have the desired effect, then it is doubled.

During therapy, the patient may also be prescribed another antihypertensive drug, in particular a diuretic.

How should Vals (tablets) be taken in case of heart failure? The instruction attached to the remedy states that with such a diagnosis, especially in a chronic form, the patient must take 40 mg of the drug twice a day. If such a dosage is ineffective, then it is gradually increased to 80 mg with the same multiplicity.

With good health, the dose can be increased up to 160 mg twice a day. However, from the start of treatment to the time when they switch to the maximum dosage, at least two weeks should pass.

The maximum amount of medication per day is 320 mg. In this case, the dose of the drug "Valz" must be divided into two doses. At joint admission with diuretics, it is sometimes reduced.

In the event that the patient has had a myocardial infarction, and his hemodynamic parameters are stable, treatment with the drug is started no later than 12 hours after the attack.

The first dose of medication should be 20 mg twice a day. Gradually it is increased to 40 mg, and then to 80 mg. By the end of the 3rd month of treatment, the daily dose of the drug should already be 160 mg (divided into 2 doses). At the same time, increasing it, it is necessary to take into account the tolerability of the drug.

Signs of an overdose

What overdose symptoms can occur if Valz is taken incorrectly? In such cases, a person has a strong decrease in blood pressure. Such conditions often cause collapse and loss of consciousness. It is urgent to perform a gastric lavage and give the patient activated charcoal. Also, in case of an overdose, a 0.9% solution of sodium chloride is administered intravenously to the patient.

drug interaction

When taking the drug "Valz", it should be borne in mind that its pronounced interaction with other drugs is not observed. But if the patient simultaneously takes other antihypertensive drugs and diuretics, then the antihypertensive effect of valsartan may increase markedly.

The risk of developing hyperkalemia increases when the tablets in question are taken together with potassium-sparing diuretics, potassium preparations and agents that increase its content in the blood plasma.

When using a drug with NSAIDs, its antihypertensive effect decreases.

It should also be noted that there is evidence of a toxic effect and a reversible increase in the concentration of lithium in the blood during treatment with Valz tablets and ACE inhibitors.

According to the instructions, it is allowed to combine the drug in question and other drugs that are used to treat heart failure. However, this remedy cannot be used simultaneously with beta-blockers.

special instructions

What should the patient be informed about before prescribing Vals medicine to him? (reviews about them will be presented later) should be taken only after the level of fluid and electrolytes in the patient's body has been restored. To do this, it is recommended to reduce the dose of diuretics.

If a person is observed, then regular monitoring of urea and creatinine in the blood should be provided to him.

During therapy with Valz, especially in chronic heart failure, the patient may have a decrease in blood pressure. Therefore, constant monitoring of this indicator is extremely important.

During treatment with this medication, changes in the functioning of the kidneys can be observed.

The drug "Vals" (tablets): analogues and price

Synonyms of the agent under consideration are the following medicines: Valsafors, Valsartan, Diovan, Valsakor, Tantordio, Nortivan, Zentiva, Tareg.

There are also its analogues, similar in the mechanism of action. These include drugs such as Aprovel, Brozaar, Bloktran, Zisakar, Losartan, Irsar, Lakea, Kardosten, Teveten, McLeodz and others.

The price of the medication we are considering is not very high. For 28 tablets (40 mg) you will have to pay about 150 rubles.

Content

Valz is an angiotensin receptor antagonist. Valz is produced by the Icelandic pharmaceutical company Actavis Group and contains valsartan as an active ingredient. This component is a peripheral vasodilator with a hypotensive effect, does not change the levels of hormones and blood glucose. Read the instructions for use of the medicine.

Composition and form of release

There are 4 forms of the drug: Valz 80, 40, Valz 160 and 320 mg (active substance). Their composition is the same:

Pharmacological properties of the drug

The instructions for use of Valz contain information that its mechanism of action is based on the selective blocking of at1 receptors responsible for the effects of angiotensin. Blocking these receptors leads to an increase in the plasma concentration of angiotensin, which stimulates unblocked at2 receptors.

Valsartan has a low risk of coughing due to bradykinin degradation. The drug reduces blood pressure, but does not affect the change in the rhythm of the heartbeat. After taking a single dose of tablets, the antihypertensive effect is observed after two hours, the pressure decreases after 4-6 hours, the effect lasts up to a day. When the drug is combined with hydrochlorothiazide, the pressure decreases more significantly. Abrupt discontinuation of valsartan does not lead to a withdrawal syndrome, a significant increase in pressure.

If the drug is used in patients with hypertension, nephropathy and diabetes the second type, then they have reduced proteinuria. The use of tablets after acute myocardial infarction reduces the mortality rate. The use of valsartan in chronic heart failure is based on the elimination of the negative consequences of hyperactivation of the receptor system, vasoconstriction, fluid retention, and cell proliferation. Taking pills reduces preload, increases cardiac output. Due to the blockade of aldosterone, the active substance of the drug prevents swelling.

Valsartan can reduce the risk of developing diabetes. After taking active ingredient reaches the maximum concentration after three hours, has a 23% bioavailability. Valsartan binds to plasma albumin by 95%, has a slight cumulation. 20% of the dose is metabolized, metabolites are excreted by the kidneys and through the intestines with bile. The half-life is 1-9 hours.

Indications for use of Valz

The main indication for the use of Valz is arterial hypertension.. Other options for using the drug, according to the instructions, are:

• chronic heart failure of 2-4 classes during therapy with diuretics, cardiac glycosides, beta-blockers, angiotensin-converting enzyme inhibitors or without this treatment;
• acute myocardial infarction complicated by insufficiency or systolic dysfunction of the left ventricle;
• Arterial hypertension in children and adolescents aged 6-18 years.

Method of application and dosage

Tablets are taken orally, swallowed, washed down with water, not chewed. For adults, a dosage of 80, 160 or 320 mg per day is prescribed. According to the instructions, the recommended starting dose is 80 mg once a day. During the first two weeks of treatment, an antihypertensive effect develops, after a month it reaches a maximum. In the absence of an adequate therapeutic effect, the dose is increased to 160 mg, with the appointment of 320 mg per day, diuretics are additionally prescribed.

In chronic heart failure, the recommended starting dose of Valz is 40 mg twice a day. The dosage is gradually increased over two weeks to 80 mg twice a day, the maximum daily dose is 320 mg in two doses with a decrease in the dose of diuretics used simultaneously.

After myocardial infarction, treatment begins in the first 12 hours with a dosage of 20 mg (half a 40 mg tablet) twice a day, then every two weeks it can be increased to reach 160 mg twice a day. Dosage adjustment for elderly patients, with impaired renal function is not required. If creatinine clearance is reduced, the patient has type 2 diabetes, do not combine valsartan with aliskiren.

The drug is prescribed with caution for mild and moderate liver dysfunction of non-biliary origin, without cholestasis - the daily dose should not exceed 80 mg. For children 6-18 years of age, the initial daily dosage is 40 mg once with a weight of less than 35 kg and 80 mg once with a weight of over 35 kg. With a weight of over 80 kg, 320 mg is prescribed once a day. Chronic heart failure and heart attack in patients under 18 years of age cannot be treated with medication.

special instructions

Care must be taken when using Valz with supplements, potassium-based salt substitutes, potassium-sparing diuretics, Heparin. This increases the likelihood of hyperkalemia. Other special instructions from the instructions:

1. With sodium deficiency or reduced blood volume, arterial hypotension may develop after the start of drug therapy.
2. A short course of the drug in the treatment of patients with renovascular hypertension that developed against the background of unilateral stenosis of the renal artery does not lead to changes in renal hemodynamics, blood urea nitrogen.
3. The drug does not show the effectiveness of the action for the treatment of arterial hypertension on the background of hyperaldosteronism.
4. Caution should be exercised in drug therapy for aortic, mitral stenosis, hypertrophic obstructive cardiomyopathy.
5. Rarely, treatment with the drug may be accompanied by oliguria, an increase in azotemia, acute kidney failure leading to death.
6. Therapy for myocardial infarction with Valz may be accompanied by the simultaneous administration of acetylsalicylic acid, thrombolytics, antiplatelet agents, reductase inhibitors, beta-blockers, diuretics.
7. During treatment with medication, angioedema of the lips, pharynx, tongue, face may develop.
8. The dosage of 80 mg per day should not be exceeded in patients with hepatic impairment aged 6-18 years.
9. Against the background of therapy, it is possible to develop dizziness, fainting, so it is advisable to refuse to control mechanisms and drive vehicles.
10. Valz is contraindicated in women planning a pregnancy. During the bearing of a child, taking pills is prohibited, because the risk of developing birth defects of the fetus, oligohydramnios, and spontaneous abortions increases.

drug interaction

The instructions for use indicate the possibility drug interaction Valza with other drugs. These are the combinations and effects:

1. The combination of valsartan with angiotensin-converting enzyme inhibitors is prohibited in patients with type 2 diabetes mellitus.
2. The combination of the drug with lithium preparations leads to an increase in the concentration of the metal in the blood and an increase in its toxicity.
3. It is not recommended to combine Valz with potassium-based medicines.
4. The combination of the drug with non-steroidal anti-inflammatory drugs can lead to a decrease in its effect, deterioration of kidney function.
5. Rifampicin, Ritonavir, Cyclosporine increase the systemic exposure of valsartan.
6. The agent does not interact with Warfarin, Atenolol, Furosemide, Cimetidine, Digoxin, Amlodipine.

Side effects of Valza

T therapy with Valz may be accompanied by side effects. Instructions for use highlight the following:

• thrombocytopenia, decrease in hemoglobin, hematocrit, neutropenia;
• serum sickness, hypersensitivity reactions;
• hyperkalemia, hyponatremia, increased activity of hepatic transaminases;
• bleeding;
• convulsions;
• vertigo, orthostatic hypotension, pronounced decrease in pressure;
• vasculitis;
• cough, rhinitis, pharyngitis, sinusitis;
• abdominal pain, diarrhea, nausea;
• hyperbilirubinemia, hypercreatininemia;
• angioedema, skin rash, bullous dermatitis, itching;
• myalgia, arthralgia, asthenia, back pain, rhabdomyolysis, arthritis;
• decreased libido;
• peripheral edema;
• constant fatigue, insomnia, dizziness, fainting, headaches, depression.

Overdose

Symptoms of an overdose of a tablet are a decrease in pressure, depression of consciousness, collapse, shock. For treatment, induce vomiting, gastric lavage. According to the instructions, if the pressure has dropped significantly, saline (sodium chloride 0.95) is administered intravenously, the patient is placed on his back with his legs raised. Hemodialysis is not effective, symptomatic therapy is carried out.

Contraindications

The drug is prescribed with caution for bilateral renal artery stenosis, a diet with salt restriction, mitral or aortic stenosis. Instruction Highlights contraindications:

• hypersensitivity to components;
• severe liver dysfunction;
• biliary cirrhosis;
• cholestasis;
• pregnancy, lactation;
• age up to six years for arterial hypertension and up to 18 years for other indications;
• intolerance to lactose, galactose, galactosemia.

Terms of sale and storage

Valz is sold by prescription, stored at temperatures up to 25 degrees for two years.

Valza's analogs

Drugs with a similar effect and the same or a different active ingredient can replace the medication. These include:

• Valsafors - tablets against high blood pressure based on valsartan;
• Diovan - tablets based on valsartan;
• Valsartan is a direct substitute for the drug with the active ingredient of the same name;
• Tantordio - pressure tablets containing valsartan;
• Valsacor Zentiva - antihypertensive tablets containing hydrochlorothiazide and valsartan;
• Nortivan - tablets against hypertension containing valsartan;
• Losartan - tablets contain losartan potassium, reduce blood pressure;
• Blocktran - tablets for lowering blood pressure, contain losartan and hydrochlorothiazide;
• Aprovel is an antihypertensive tablet based on irbersartan.

Valz price

The cost of Valz depends on the number of tablets in a pack, the concentration of the active substance per piece. Approximate Moscow prices in pharmacies and the Internet will be:

Video

Valz (active ingredient valsartan) is an antihypertensive drug belonging to the group of selective angiotensin II receptor blockers (subtype AT1). To date, the number of people suffering from arterial hypertension has exceeded one billion. This widespread prevalence of arterial hypertension makes a significant contribution to morbidity and mortality from cardiovascular diseases. It is all the more surprising that, despite the existing abundance effective methods its treatment, at least a third of patients do not receive adequate pharmacotherapy. The key role in the pathogenesis of arterial hypertension is played by the renin-angiotensin-aldosterone system (hereinafter - RAAS), which regulates the volume of fluid and blood, as well as electrolyte balance. When the RAAS is activated, its main "tool" - angiotensin II - causes vasoconstriction, stimulates the release of aldosterone and increases sympathetic activity, which in combination contributes to the onset and progression of arterial hypertension. AT1 receptor blockers (ARBs) control the work of the RAAS, disavowing the effects of angiotensin II, which is accompanied by an increase in the lumen of the vessels, suppression of the secretion of antidiuretic hormone (ADH) and aldosterone. ARBs are a relatively “young” group of antihypertensive drugs, which right off the bat has taken one of the leading positions in the treatment of arterial hypertension and chronic heart failure and the prevention of cardiovascular complications. Increasingly, ARBs are being used as first choice drugs, avoiding the negative experience of using ACE inhibitors with the inevitable dry cough and increased risk of angioedema. To date, a solid evidence base has been accumulated on the use of ARBs, and their advantages over other classes of antihypertensive drugs have been demonstrated. Valz is a branded generic of valsartan from the Icelandic pharmaceutical company Actavis. Distinctive feature This drug is considered to have all three registered medical indications, as in Diovan (original valsartan): arterial hypertension, chronic heart failure, and increased survival of post-infarction patients.

On the basis of the State Research Center for Preventive Medicine of the Ministry of Health and Social Development of Russia, a comparative study of the efficacy and safety of valz and the original valsartan (diovan) in patients with arterial hypertension of 1-2 degrees was carried out. An unbiased comparison revealed almost the same efficacy and safety of both drugs.

Valz begins to act 2 hours after oral administration, the maximum of its antihypertensive efficacy is noted at 4-6 hours, the duration of action is more than a day. Subject to regular course intake, stabilization of blood pressure at a given level is achieved in 2-4 weeks. With a sharp cessation of taking the drug, the withdrawal syndrome ("ricochet" jump in blood pressure) is not observed. Valz is rapidly absorbed from the gastrointestinal tract. Its absolute bioavailability is 23%. Eating does not affect the bioavailability of the drug. When Valz is taken once a day, the degree of its accumulation in the body is insignificant. With arterial hypertension, treatment is recommended to begin with a dose of 80 mg. The antihypertensive effect is clearly manifested in the first two weeks of the drug course, reaching its maximum after four weeks of treatment. If the above dose does not cause a proper therapeutic response, a two-fold increase is recommended. In addition to this, an antihypertensive drug of another group can be “connected” to Valz (with the exception of a combination with an ACE inhibitor and a beta-blocker). For persons with chronic heart failure, the drug is prescribed 40 mg 2 times a day with the possibility of increasing the dose to 80, and with good tolerance - up to 160 mg. Valz is well combined with diuretics, statins, beta-blockers, but its combination with ACE inhibitors increases the risk of developing side effects. In patients suffering from chronic heart failure, at the initial stage of treatment, there may be some decrease in blood pressure.

Pharmacology

Peripheral vasodilator, has a hypotensive effect. Specific blocker of AT 1 -receptors of angiotensin II, does not inhibit ACE. Does not affect the content of total cholesterol, TG, glucose and uric acid in the blood.

The onset of the effect is noted 2 hours after ingestion, maximum - after 4-6 hours; duration of action - more than 24 hours. After regular intake maximum reduction BP sets in in 2-4 weeks. There is no withdrawal syndrome with sudden discontinuation.

Pharmacokinetics

Suction

After taking the drug inside, absorption is fast, the degree of absorption is variable. The average value of absolute bioavailability is 23%. When taking the drug with food, the AUC of valsartan decreases by 48%, although, starting from about 8 hours after taking the drug, the concentrations of valsartan in the blood plasma, both in the case of taking it on an empty stomach and in the case of taking it with food, are the same. The decrease in AUC is not accompanied by a clinically significant decrease in the therapeutic effect of valsartan, so the drug can be used regardless of food intake.

In the range of doses studied, the kinetics of valsartan is linear. The pharmacokinetic curve of valsartan has a descending multi-exponential character.

Distribution

Plasma protein binding (mainly albumin) is high - 94-97%. Upon reaching the equilibrium state V d - 17 liters.

With repeated use of valsartan, no changes in kinetic parameters were noted. When taking the drug at a dose of 1 time / day, a slight accumulation of valsartan was observed.

Metabolism

The pharmacologically inactive hydroxymetabolite is found in plasma at low concentrations (less than 10% of the AUC of valsartan).

breeding

T 1/2α -< 1 ч, T 1/2β составляет около 9 ч.

After oral administration, 83% of valsartan is excreted in the bile through the intestines and 13% by the kidneys, mainly unchanged.

Compared to the hepatic blood flow (about 30 l/h), the plasma clearance of valsartan is relatively small (about 2 l/h). At normal level glomerular filtration (120 ml / min) renal clearance is about 30% of the total plasma clearance.

Pharmacokinetics in special clinical situations

The concentration of valsartan in plasma does not differ between men and women.

Release form

Film-coated tablets yellow color, oval, biconvex, marked with a "V" on one side, a notch on the other side and lateral notches.

Excipients: lactose monohydrate - 21.11 mg, microcrystalline cellulose - 18 mg, croscarmellose sodium - 5.4 mg, povidone K29-32 - 3.6 mg, talc - 0.9 mg, magnesium stearate - 0.63 mg, colloidal silicon dioxide - 0.36 mg.

The composition of the film shell: Opadry II 85G32407 yellow - 3.6 mg (polyvinyl alcohol - 1.584 mg, talc - 0.72 mg, titanium dioxide - 0.598 mg, macrogol 3350 - 0.444 mg, iron dye yellow oxide - 0.128 mg, lecithin - 0.126 mg).

7 pcs. - blisters (2) - packs of cardboard.
7 pcs. - blisters (4) - packs of cardboard.
10 pieces. - blisters (1) - packs of cardboard.
10 pieces. - blisters (2) - packs of cardboard.
10 pieces. - blisters (3) - packs of cardboard.
14 pcs. - blisters (4) - packs of cardboard.
14 pcs. - blisters (7) - packs of cardboard.

Dosage

Assign inside, regardless of the meal, drinking plenty of fluids.

With arterial hypertension, the recommended initial dose of Valz is 80 mg 1 time / day. The hypotensive effect develops in the first 2 weeks of therapy. The maximum effect is achieved after 4 weeks of taking the drug. In patients for whom a daily dose of 80 mg does not give the desired therapeutic effect, it is recommended to increase the daily dose to 160 mg. In addition, another antihypertensive agent (for example, a diuretic) may be prescribed.

In chronic heart failure, the recommended initial dose of Valz is 40 mg 2 times / day. With insufficient therapeutic effect a gradual increase in dose to 80 mg 2 times / day is required and, with good tolerance, up to 160 mg 2 times / day. From the moment of initiation of treatment with Valz until the maximum dose is reached, an interval of at least 2 weeks should be observed. The maximum daily dose is 320 mg in 2 divided doses. It is possible to reduce doses while taking diuretics.

Valz can be used in combination with other medicines for the treatment of chronic heart failure. However, Valz should not be given in combination with an ACE inhibitor + a beta-blocker.

After myocardial infarction with stable hemodynamic parameters, treatment can be started within 12 hours after acute myocardial infarction. Initial dose - 20 mg (1/2 tab. 40 mg) 2 times / day, followed by an increase in dose to 40 mg, 80 mg, 160 mg 2 times / day for several weeks, until a maximum daily dose of 160 mg 2 times is reached / day Achieving a dose of 80 mg 2 times / day is recommended by the end of the 2nd week of treatment, 160 mg 2 times / day - by the end of 3 months of therapy. The dose should be increased taking into account the tolerability of the drug. In case of symptomatic arterial hypotension or impaired renal function, the dose of Valz should be reduced.

In patients with mild to moderate hepatic impairment without the development of cholestasis, the maximum daily dose of Valz should not exceed 80 mg.

Overdose

Symptoms: a pronounced decrease in blood pressure, which can lead to loss of consciousness and collapse.

Treatment: gastric lavage, taking a sufficient amount of activated charcoal, intravenous administration of 0.9% sodium chloride solution. Valsartan is not excreted during dialysis due to active binding to plasma proteins.

Interaction

In the treatment of arterial hypertension with valsartan, there was no clinically significant interaction with other concurrently used drugs (eg, cimetidine, warfarin, digoxin, atenolol, amlodipine, glibenclamide, furosemide, indomethacin, hydrochlorothiazide).

Potassium-sparing diuretics, potassium preparations, salts containing potassium, drugs that increase the level of potassium in the blood plasma (such as heparin) increase the risk of developing hyperkalemia.

Other antihypertensive drugs and diuretics enhance the antihypertensive effect of valsartan.

The antihypertensive effect of the drug may be weakened when used together with NSAIDs, incl. with selective COX-2 inhibitors and acetylsalicylic acid at a dose of more than 3 g / day.

When used together with ACE inhibitors, a reversible increase in the concentration of lithium in the blood plasma and the development of toxic effects have been reported.

Very limited experience with valsartan and preparations containing lithium. In the case of the use of drugs containing lithium in patients receiving Valz, it is recommended to control the concentration of lithium in the blood plasma.

Side effects

Frequency detection adverse reactions: very often (≥1/10); often (≥1/100, but<1/10); иногда (≥1/1000, но <1/100); редко (≥1/10 000, но <1/1000); очень редко (<1/10 000).

From the side of the cardiovascular system: often - orthostatic hypotension 2; sometimes - a decrease in blood pressure 1.2, heart failure 1; rarely - vasculitis; very rarely - bleeding.

From the respiratory system: sometimes - cough.

From the digestive system: sometimes - diarrhea, abdominal pain; very rarely - nausea 4 .

From the side of the central nervous system: often - postural dizziness 2; sometimes - fainting 1, insomnia, depression, decreased libido; rarely - dizziness 4, neuralgia; very rarely - headache 4 .

On the part of the organ of hearing and the labyrinth apparatus: sometimes - vertigo.

From the side of the hematopoietic system: often - neutropenia, very rarely - thrombocytopenia.

Allergic reactions: rarely - serum sickness, hypersensitivity; very rarely - angioedema 3, skin rash, itching.

From the musculoskeletal system: sometimes - back pain, muscle cramps, arthritis, myalgia; very rarely - arthralgia.

From the urinary system: very rarely - impaired renal function 3.4, acute renal failure 3.

From the side of metabolism: sometimes - hyperkalemia 1.2.

Infections: often - viral infections; sometimes - infections of the upper respiratory tract, pharyngitis, sinusitis, conjunctivitis; very rarely - rhinitis, gastroenteritis.

On the part of laboratory parameters: a decrease in the level of hemoglobin and hematocrit, hypercreatininemia, hyperbilirubinemia, an increase in the activity of hepatic transaminases, an increase in the concentration of urea nitrogen in serum.

Other: sometimes - a feeling of fatigue, asthenia, nosebleeds, swelling.

1 - reported during treatment after acute myocardial infarction;

2 - reported in the treatment of chronic heart failure;

3 - sometimes reported during treatment after acute myocardial infarction;

4 - the most common during the treatment of chronic heart failure (often - dizziness, impaired renal function, arterial hypotension; sometimes - headache, nausea).

Indications

• arterial hypertension;
• chronic heart failure (II-IV functional class according to the NYHA classification) - as part of complex therapy (excluding the combination of valsartan + ACE inhibitor + beta-blocker);
• in order to increase the survival of patients with acute myocardial infarction (period from 12 hours to 10 days), complicated by left ventricular failure and / or left ventricular systolic dysfunction, in the presence of stable hemodynamic parameters.

Contraindications

• liver dysfunction associated with obstruction of the biliary tract (including biliary cirrhosis, cholestasis);
• severe renal failure (CC less than 10 ml / min), incl. patients on hemodialysis;
• pregnancy;
• lactation period (breastfeeding);
• age up to 18 years (efficacy and safety have not been established);
• lactose intolerance, galactosemia, or glucose/galactose malabsorption syndrome;
• hypersensitivity to the components of the drug.

With caution, the drug should be used in case of arterial hypotension, hyperkalemia, on the background of a diet with restricted sodium intake, with hyponatremia, bilateral stenosis of the renal arteries or stenosis of the artery of a single kidney, with primary hyperaldosteronism, aortic and mitral stenosis, hypertrophic obstructive cardiomyopathy, conditions accompanied by a decrease in BCC (including diarrhea, vomiting).

Application features

Use during pregnancy and lactation

There are no data on the use of valsartan during pregnancy. Renal perfusion of the fetus, which depends on the development of the RAAS, begins to function in the third trimester of pregnancy. The risk to the fetus increases when taking valsartan in the II and III trimesters. When pregnancy is established, therapy with Valz should be discontinued immediately.

There are no data on the allocation of valsartan with breast milk. Therefore, if necessary, the use of the drug during lactation should decide whether to stop breastfeeding or cancel therapy with valsartan, taking into account its importance to the mother.

Application for violations of liver function

The use is contraindicated for violations of liver function associated with obstruction of the biliary tract (including biliary cirrhosis, cholestasis).

In patients with mild to moderate hepatic impairment without the development of cholestasis, the maximum daily dose of Valz is 80 mg.

Application for violations of kidney function

Use is contraindicated in severe renal failure (CC less than 10 ml / min), incl. in patients on hemodialysis.

In patients with impaired renal function with CC more than 10 ml / min, dose adjustment is not required.

Use in children

special instructions

In patients with severe sodium deficiency in the body and / or reduced BCC, for example, due to the use of diuretics in high doses, in rare cases, severe arterial hypotension may develop at the beginning of valsartan therapy. Before starting therapy with Valz, it is recommended to restore the electrolyte and fluid content in the body, in particular by reducing the doses of diuretics.

Valz can be used in conjunction with other drugs intended for the treatment of myocardial infarction, such as thrombolytics, acetylsalicylic acid, beta-blockers, statins and diuretics. Co-administration of ACE inhibitors is not recommended.

With renovascular hypertension, regular monitoring of the content of urea and creatinine in the blood is necessary.

When used together with drugs containing potassium, its salts and drugs belonging to the group of potassium-sparing diuretics, regular monitoring of the level of potassium in the blood plasma is carried out.

In chronic heart failure, at the beginning of treatment with Valz, there may be some decrease in blood pressure, so it is recommended to control blood pressure at the beginning of therapy.

Due to inhibition of the RAAS, some patients may experience changes in renal function. In patients with severe chronic heart failure, in which renal function depends on the activity of the RAAS, treatment with ACE inhibitors and angiotensin receptor antagonists may be accompanied by oliguria and / or an increase in azotemia and (rarely) acute renal failure and / or death.

The combined use of the drug Valz in patients suffering from chronic heart failure with ACE inhibitors and beta-blockers is not recommended due to a possible increased risk of side effects.

In patients with bilateral or unilateral renal artery stenosis, regular monitoring of serum creatinine and urea nitrogen is necessary.

Influence on the ability to drive vehicles and control mechanisms

During the period of treatment, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require an increased concentration of attention and speed of psychomotor reactions.