药品英文名
Valsartan
药品别名
代文、Diovan
药物剂型
胶囊：80mg，160mg。
药理作用
本品为非杂环类AngⅡ受体拮抗剂，作用机制与氯沙坦相似。对AT1受体的选择性比氯沙坦强2倍，亲和力比氯沙坦强5倍，较之氯沙坦优越之处为：
1.非前体药。
2.不依赖肝脏细胞色素P450代谢。
3.在体内不需代谢。
4.无活性代谢产物。
5.量效关系显著。
6.发挥最大疗效时间为2～4周，短于氯沙坦。
7.靶器官保护作用强
8.改善男性高血压患者性生活质量。
药动学
为非前体药，不需要经过肝脏的生物转化而直接具有药理活性。口服吸收快，进食影响其吸收，生物利用度为25%，与血浆蛋白结合率为95%。药物起效快，作用强，口服后2h血药浓度达峰值，作用持续24h以上。半衰期为5～9h，以原形经胆道(70%)及肾脏(30%)排出。
适应证
高血压、心力衰竭。
禁忌证
对该药过敏者、妊娠期及哺乳期妇女禁用。
注意事项
1.慎用：
(1)血管神经性水肿。
(2)主动脉瓣或左房室瓣狭窄。
(3)胆汁淤积或胆管阻塞。
(4)哺乳期。
(5)冠状动脉疾病。
(6)老年。
(7)肝功能障碍。
(8)肥厚性心肌病。
(9)低血钠或血容量减少，如大剂量使用利尿药。
(10)单侧或双侧肾动脉狭窄。
(11)需要全身麻醉的外科手术患者。
2.服药患者在驾驶和操纵机器时应注意。
3.给药剂量须遵循个体化原则，按疗效调整剂量。
4.严重缺钠和(或)血容量不足的患者，如服用大剂量利尿药的患者，用本药治疗偶可出现症状性低血压。因此在治疗前应先纠正患者的低血钠和低血容量状况。
5.如果出现喉喘鸣或面部、舌或声门的血管性水肿，则应停药。
6.本药无过量的经验，药物过量可能出现的症状主要是明显低血压，可采取催吐治疗，必要时可静脉滴注生理盐水。血液透析不能清除。
不良反应
水肿、头痛，对血钾的影响较小。其他少见的不良反应还有疲劳、上呼吸道感染、消化不良、关节痛等。
用法用量
一般剂量80mg，每天1次，口服。如疗效不佳，可增加至每天320mg或与利尿剂同时服用。
药物相应作用
与下列药物之间尚未发现明显的药物相互作用：西咪替丁、华法林、地高辛、阿替洛尔、氨氯地平、格列本脲。与保钾利尿剂、补钾药或使用含钾药物合用可使血钾升高。可与氢氯噻嗪合用以加强降压。
专家点评
AngⅡ受体阻滞剂用于临床时间不久。据临床研究证实其能有效地降压和控制血压，并能防止高血压合并肾脏病或糖尿病性肾病进展。不能耐受ACEⅠ的收缩性心衰患者可换用本品，应用β受体阻滞剂禁忌的收缩性心衰患者，可考虑本品与ACEⅠ合用，缬沙坦疗效显著，可作为首选药。

Diovan is a combination medication that contains both hydrochlorothiazide, a diuretic, and valsartan, an angiotensin II receptor antagonist. Hydrochlorothiazide helps prevent the body from absorbing too much salt, which can cause fluid retention. Valsartan keeps blood vessels open, which improves blood flow in the body and lowers blood pressure.
Diovan is used to control high blood pressure and cardiovascular disease, but it is not a cure. Doctors generally prescribe the drug for long-term treatment in conjunction with a low salt diet. It is recommended that patients take Diovan at the same time each day for maximum benefit. The medication can be taken with our without food, although taking it with meals can help establish a routine that is easy to maintain.
Since it is used as a preventative measure, the medication should be taken even if you do not feel ill. Doctors will monitor the effects of Diovan over time and may increase or decrease your dosage as necessary. Doctors may also prescribe Diovan in tandem with other blood pressure medications for better control of cardiovascular problems.
Many people do not realize that taking Diovan can increase the risk of heat exhaustion and dehydration. Diovan inhibits the body?s ability to produce salt and slows sweat glands, making it difficult for the body to produce enough sweat to keep cool. The imbalance in electrolytes caused by reduced salt production can also worsen dehydration at an alarmingly fast pace. Anyone taking Diovan should take extra care to drink enough water to stay hydrated at all times, and avoid alcohol.
In rare cases, Diovan can cause skeletal muscle tissue to break down. If signs of this unusual side effect appear, the medication should be discontinued and a doctor notified right away. Symptoms include muscle pain or weakness accompanied by fever and intense vomiting, with a noticeable darkening of urine color.
Your doctor needs a complete medical history to avoid possible adverse interactions and side effects. Always keep a list of current and past medications handy so that medical professionals may check for negative interactions. Tell your care provider if you have a history of allergies to medications or to the drugs contained in Diovan, asthma or allergies, low or high potassium or magnesium in your blood, gout, lupus, diabetes, allergy to sulfa drugs, a heart condition, liver problems or kidney problems. Your doctor may adjust the dosage or take other precautions when these conditions are present.
Diovan should generally not be used in pregnancy because there is animal evidence of teratogenicity (causing birth defects). Specifically, there is evidence of increased frequency of fetal injury or death in infants born to mothers taking Diovan. If you are pregnant or plan to become pregnant, tell your doctor. It is not known if Diovan passes to the infant in breast milk, however, other drugs do pass to the infant so the decision to breastfeed an infant while taking this drug should be very carefully considered with your doctor.
Diovan is well tolerated by most patients. General side effects include:
•Headache
•Back pain
•Dizziness
•Sinus congestion
•Skin rash
•Stomach pain, diarrhea
•Persistent dry cough
Some side effects of taking Diovan are more serious and may need immediate medical attention. Serious, less common side effects can include:
•Severe allergic reaction (rash, hives, difficulty breathing, swelling of face, lips, tongue or throat)
•Fainting
•Change in frequency of urination, or not at all
•Yellowing of the skin or eyes
•Rapid weight gain or excessive swelling
•Confusion
•Increased heart rate
•Seizure
Patients experiencing any severe side effect should stop taking the medication and consult with a physician immediately.
Take this medication as prescribed by your doctor. Take any missed dose as soon as you remember. Do not double your dose. If you are unsure what to do, call your doctor or pharmacist. If you take too much of the medication, overdose may occur. Extreme overdose symptoms can resemble severe side effects, and can also include: Pounding heartbeat. In case of an accidental or suspected overdose, contact poison control at 1-800-222-1222 or call 911 for immediate medical attention.
Patients and physicians should report hazardous or unusual side effects to the FDA. The agency keeps a hotline called the MedWatch Adverse Event Reporting program. In case of a bad reaction, call 1-800-332-1088 or go online to http://www.fda.gov/Safety/MedWatch to report it.