Valsartan

Generic name
Valsartan
Brand name
ATC Code
C09CA03
Dosages
Side effects in children
Warnings & precautions in children
Contra-indications in children

Interactions
PK
Renal impairment
References

Pharmacokinetics in children

The systemic exposure and peak plasma concentration of valsartan using the solution are about 1.7 times and 2.2 times higher than with the tablets

A study of 26 hypertensive paediatric patients (aged 1 to 16 years) receiving a single dose of the liquid formulation of valsartan (average 0.9 to 2.0 mg/kg, with 80 mg as the maximum) showed that the valsartan clearance (in litres/hour/kg) was similar over the age group 1 to 16 years and similar to clearance in adults after administration of the same formulation.

dose recommendation of formulary compared to licensed use (on-label versus off-label)

No information is present at this moment.

Available formulations

No information is present at this moment.

Dosages

Hypertension
  • Oral
    • Liquid solution
      • 6 years up to 18 years and < 35 kg
        • Initial dose: 20 mg/day in 1 dose
        • Maintenance dose: Depending on the blood pressure, increase as required to a maximum of 40 mg/day in 1 dose
      • 6 years up to 18 years and ≥ 35 kg
        • Initial dose: 40 mg/day in 1 dose
        • Maintenance dose: Depending on the blood pressure, increase the dose as required to a maximum of 80 mg/day in 1 dose
      • 1 year up to 6 years
        • Initial dose: 1 mg/kg/day in 1 dose
        • Maintenance dose: Depending on the bloodpressure, increase as required to a maximum of 4 mg/kg/day in 1 dose
    • Tablet
      • 6 years up to 18 years and 18 up to 35 kg
        • Initial dose: 40 mg/day in 1 dose
        • Maintenance dose: Depending on the blood pressure, increase the dose as required to a maximum of 80 mg/day in 1 dose
      • 6 years up to 18 years and 35 up to 80 kg
        • Initial dose: 80 mg/day in 1 dose
        • Maintenance dose: Depending on the blood pressure, increase the dose as required to a maximum of 160 mg/day in 1 dose
      • 6 years up to 18 years and ≥ 80 kg
        • Initial dose: 80 mg/day in 1 dose
        • Maintenance dose: Depending on the blood pressure, increase the dose as required to a maximum of 320 mg/day in 1 dose

Renal impaiment in children > 3 months

GFR ≥10 ml/min/1.73m2: Dose adjustment not required.

GFR <10 ml/min/1.73m2: A general recommendation on dose adjustment cannot be provided.

Use in pediatric patients with creatinine clearance <30 ml/min and pediatric patients undergoing dialysis was not investigated. Therefore, valsartan is not recommended in these patients. No dose adjustment is required for pediatric patients with creatinine clearance > 30 ml/min. Kidney function and potassium levels should be closely monitored during treatment with valsartan. Especially in the presence of other conditions (fever, dehydration) that may affect renal function. (SmPC Diovan Liquid formulation)

The complete list of all undesirable drug reactions can be found in the national Summary of Product Characteristics (SmPC) – click here

Side effects in children

Abdominal pain, nausea, vomiting and dizziness are reported In children and adolescents more often than in adults. Hyperkalaemia has been reported more often in cases where there is underlying chronic renal disease.

In children aged 1-6 years, the most commonly reported side effects were vomiting, diarrhea, decreased appetite and hyperkalemia.

The complete list of all contra-indications can be found in the national Summary of Product Characteristics (SmPC) – click here

Contra-indications in children

Severe hepatic impairment, billiary cirrhosis or cholestasis.

The complete list of all warnings and precautions can be found in the national Summary of Product Characteristics (SmPC) – click here

Warnings & precautions in children

Diovan liquid solution is not bio-equivalent to the tablets. Switching over from Diovan tablets to the liquid formulation of Diovan is therefore not recommended unless clinically necessary. The dose should be halved when switching from tablets to the liquid formulation. When switching from the liquid formulation to the tablet, the dose should be left unchanged. Make allowances for underdosing.
The blood pressure must be monitored carefully when switching either way and the dose must be titrated depending on the blood pressure and tolerance.
 
The risk of hyperkalemia may be higher in children aged 1-6 years compared with children aged 6-18 years.

Interactions

The complete list of all interactions can be found in the national Summary of Product Characteristics (SmPC) – click here

ANGIOTENSIN II RECEPTOR BLOCKERS (ARBs), PLAIN

This pages provides a list of drugs from the same ATC class for comparison. This does not necessarily mean that these drugs are interchangeable.

Angiotensin II receptor blockers (ARBs), plain
C09CA06
C09CA01
C09CA08

References

  1. Novartis Pharma BV, SPC Diovan drank (RVG 107481) 16-09-2019, www.geneesmiddeleninformatiebank.nl
  2. Novartis Pharma BV, SmPC Diovan tabletten (RVG 32137) 09-04-2015, www.geneesmiddeleninformatiebank.nl

Changes

Therapeutic Drug Monitoring


Overdose