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Walsakor - instructions for use, analogs, reviews and release forms (tablets 40 mg, 80 mg, 160 mg and 320 mg, H80 and H160, ND160) drugs to treat heart failure and reduce pressure in adults, children and pregnancy. Composition

Walsakor - instructions for use, analogs, reviews and release forms (tablets 40 mg, 80 mg, 160 mg and 320 mg, H80 and H160, ND160) drugs to treat heart failure and reduce pressure in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Walsakor. There are reviews of visitors to the site - consumers of this medication, as well as opinions of physicians specialists on the use of Valsakor in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Valsakor in the presence of existing structural analogs. Use for the treatment of heart failure, hypertension and depression of pressure in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

 

Walsakor antihypertensive agent. It is a specific antagonist of angiotensin receptors 2. It has a selective antagonistic effect on AT1 receptors, which are responsible for the realization of the effects of angiotensin 2.

 

Due to the blockade of AT1 receptors, the plasma concentration of angiotensin 2 increases, which can stimulate unblocked AT2 receptors. Has no agonistic activity against AT1 receptors. The affinity of Valsartan for AT1 receptors is about 20,000 times higher than that of AT2 receptors.

 

Does not inhibit ACE. It does not interact and does not block the receptors of other hormones or ion channels, which are important for the regulation of the functions of the cardiovascular system. Has no effect on the level of total cholesterol, TG, glucose and uric acid in the blood plasma.

 

The onset of antihypertensive action of valsartan after its administration inwards in a single dose is observed within 2 hours after administration, the maximum effect is achieved within 4-6 hours.

 

Hydrochlorothiazide (in the composition of Valsakor H80 and H160, ND160) is a thiazide diuretic whose diuretic effect is associated with a disruption of the reabsorption of sodium, chlorine, potassium, magnesium,water in the distal nephron; delays the excretion of calcium ions, uric acid. Has hypotensive effect, which is due to the expansion of arterioles. Virtually no effect on normal BP.

 

Diuretic effect develops 1-2 hours after taking the drug inside, reaches a maximum after 4 hours and persists for 6-12 hours. Antihypertensive effect occurs in 3-4 days, but it may take 3-4 weeks to achieve the optimal therapeutic effect.

 

Composition

 

Valsartan + excipients.

 

Valsartan + Hydrochlorothiazide + auxiliary substances (Valsacor H80 and H160, ND160).

 

Pharmacokinetics

 

Valsartan

 

After oral administration, Valsacor is rapidly absorbed from the digestive tract, the degree of absorption is characterized by individual differences. Absolute bioavailability averages 23%. With the course application of changes in pharmacokinetic parameters were not noted. When taking valsartan with food, AUC is reduced by 48%, with about 8 hours after taking valsartan in plasma are the same in patients who took it with food and fasting. The decrease in AUC is not accompanied by a clinically significant decrease in the therapeutic effect.When taking valsartan once a day, the cumulation is not very pronounced. The concentrations of valsartan in the blood plasma in women and men were the same. The binding with plasma proteins, mainly with albumins, is 94-97%. It is excreted with feces - 70% and with urine - 30%, mostly unchanged. With biliary cirrhosis or obstruction of the bile ducts, the vascartan AUC increases approximately 2-fold.

 

Hydrochlorothiazide

 

After oral intake of hydrochlorothiazide is 60-80%. Binding to plasma proteins - 40-70%. Hydrochlorothiazide is not metabolized and is quickly excreted in the urine (more than 95%).

 

Indications

  • treatment of hypertension (pressure reduction);
  • treatment of chronic heart failure (2-4 functional class according to NYHA classification) in patients receiving traditional therapy with diuretics, digitalis preparations, as well as with ACE inhibitors or beta-blockers.

 

Forms of release

 

Tablets coated with 40 mg, 80 mg, 160 mg and 320 mg (Valsakor).

 

Tablets coated with 80 mg + 12.5 mg, 160 mg + 12.5 mg (Valsacor H80 and H160).

 

The tablets covered with a cover 160 mg + 25 mg (Valsakor ND160).

 

Instructions for use and dosage

 

Pills Valsacor

 

Take inside at a dose of 80 mg 1 time per day or 40 mg 2 times a day, daily. If there is no adequate effect, the daily dose can be gradually increased.

 

The maximum daily dose is 320 mg in 2 divided doses.

 

H80 and H160 tablets

 

The drug is taken orally, regardless of food intake, the frequency of intake is 1 time per day.

 

Valsacor H160 can be combined with other antihypertensive agents. Treatment should be started with minimal doses of the drug.

 

Patients who did not achieve the target level of BP against monotherapy (valsartan 160 mg or hydrochlorothiazide at a dose of 12.5 mg) are recommended a fixed combination of doses - Valsacor H160 (160 / 12.5 mg) 1 time per day.

 

The maximum antihypertensive effect of the preparation Valsacor H160 (160 / 12.5 mg) develops within 2-4 weeks. If necessary (the level of diastolic blood pressure above 100 mm Hg on the background of monotherapy with valsartan), in order to achieve a more pronounced effect, it is possible to increase the dose to 160/25 mg (not earlier than 4-8 weeks) (1) once a day.

 

Patients with impaired renal function (QC more than 30 ml / min (0.5 ml / s)) do not need to change the dose of the drug.

 

Valsacor H160 is not recommended for patients with impaired liver function.The maximum recommended daily dose of valsartan in patients with mild or moderate impairment of liver function of non-biliary origin is 80 mg (1 tablet per day of the preparation Valsacor H80).

 

Older patients are not required to adjust the dose.

 

ND160 tablets

 

The drug is taken orally, regardless of food intake, the frequency of intake is 1 time per day.

 

Valsacor ND160 can be combined with other antihypertensive agents. Treatment should be started with minimal doses of the drug.

 

Patients who did not achieve the target level of BP against monotherapy (valsartan 160 mg or hydrochlorothiazide 25 mg) recommended a fixed combination of doses - Valsacor ND160 (160/25 mg) once a day.

 

The maximum antihypertensive effect of the drug Valsacor ND160 (160/25 mg) develops within 2-4 weeks.

 

Side effect

  • general weakness;
  • increased fatigue;
  • asthenia;
  • dizziness, incl. postural;
  • insomnia;
  • headache;
  • depression;
  • paresthesia;
  • neuralgia;
  • fainting (when used after a heart attack);
  • nasopharyngitis;
  • upper respiratory infections;
  • rhinitis;
  • sinusitis;
  • cough;
  • respiratory distress syndrome with pneumonitis and pulmonary edema;
  • chest pain;
  • marked decrease in blood pressure and orthostatic hypotension;
  • arrhythmias;
  • peripheral edema;
  • diarrhea, constipation;
  • nausea;
  • dyspepsia;
  • abdominal pain;
  • decreased appetite;
  • pancreatitis;
  • intrahepatic cholestasis;
  • jaundice;
  • skin rash;
  • photosensitivity;
  • alopecia;
  • pain in the back, limbs;
  • stretching and tearing of ligaments and muscles or muscle tendons;
  • arthritis;
  • arthralgia;
  • myalgia;
  • muscle weakness;
  • muscle cramps;
  • decreased libido;
  • impotence (less than 1%);
  • urinary tract infection;
  • increased frequency of urination;
  • impaired renal function;
  • impaired vision;
  • noise in ears;
  • conjunctivitis;
  • angioedema;
  • hives;
  • skin rash;
  • itching;
  • hypersensitivity reactions, including serum sickness and necrotizing vasculitis;
  • toxic epidermal necrolysis (Lyell's syndrome);
  • lupus-like reactions;
  • exacerbation of SLE flow;
  • anemia, incl. hemolytic, leukopenia, agranulocytosis, neutropenia, thrombocytopenia (sometimes with purpura);
  • bone marrow suppression;
  • increased sweating;
  • nose bleed.

 

Contraindications

  • severe liver dysfunction;
  • biliary cirrhosis and obstruction of the biliary tract (cholestasis);
  • light and moderate violations of the liver function of non-biliary origin (for a given dose of the drug);
  • anuria, marked renal dysfunction (CC less than 30 ml / min (0.5 ml / s));
  • hemodialysis;
  • hypokalemia, hyponatremia, hypercalcemia or hyperuricemia with clinical manifestations refractory to adequate therapy;
  • intolerance to galactose, lactase deficiency lapp or syndrome of impaired glucose / galactose absorption;
  • age under 18 years (effectiveness and safety of valsartan in children not established);
  • pregnancy;
  • lactation period;
  • increased sensitivity to valsartan, hydrochlorothiazide, sulfonamide derivative and to other components of the drug.

 

Application in pregnancy and lactation

 

The use of angiotensin 2 receptor antagonists is not recommended in the first trimester of pregnancy. The drug is contraindicated in the 2nd and 3rd trimesters of pregnancy, as the use of 2 and 3 trimesters of pregnancy can cause fetotoxic effects (decreased kidney function, low blood pressure, slowing ossification of the fetal bones) and neonatal toxic effects (kidney failure, arterial hypotension, hyperkalemia).If, however, the drug was used in the 2nd and 3rd trimester of pregnancy, it is necessary to carry out ultrasound of the kidneys and bones of the fetal skull.

 

When planning pregnancy, it is recommended that the patient be transferred to alternative antihypertensive therapy, taking into account the safety profile.

 

When confirming the pregnancy, the drug Valsakor must be canceled as soon as possible.

 

There is no data on the isolation of valsartan in breast milk. However, it is known that valsartan penetrates the milk of lactating rats. Hydrochlorothiazide is excreted in breast milk. Therefore, if you need therapy with the drug Valsakor ND160 during lactation, breastfeeding should be abolished.

 

Use in children

 

Contraindicated in children and adolescents under the age of 18 years (effectiveness and safety of valsartan in children is not proven).

 

Application in elderly patients

 

Older patients are not required to adjust the dose.

 

special instructions

 

With hyponatremia and / or a decrease in BCC, as well as against the background of therapy with high doses of diuretics in rare cases, Valsacor can cause severe arterial hypotension. Before the start of treatment should be done correction of water-salt metabolism.

 

In patients with renovascular hypertension, which developed again due to stenosis of the renal artery, the level of urea and creatinine in the serum should be regularly monitored during the treatment period. Data on safety of use in patients with SC less than 10 ml / min are absent.

 

With extreme caution apply in patients with violations of patency of the biliary tract.

 

Patients with impaired liver function are recommended to take no more than 80 mg of valsartan per day.

 

Valsacor N160 is not recommended for patients with primary hyperaldosteronism.

 

There are reports of an exacerbation of the systemic lupus erythematosus (SLE) with the use of thiazide diuretics.

 

Due to the inhibition of RAAS in susceptible patients, changes in renal function are possible. With the use of ACE inhibitors and angiotensin receptor antagonists, oliguria and / or augmentation of azotemia were observed in patients with chronic heart failure of severe course, and acute renal failure with a risk of death was rare.

 

Impact on the ability to drive vehicles and manage mechanisms

 

When using valsartan, it is advisable to use caution when driving and controlling machinery.

 

Drug Interactions

 

With the simultaneous use of diuretics in high doses, it is possible to develop arterial hypotension.

 

With the simultaneous use of potassium-sparing diuretics, heparin, biologically active additives or substitutes for salt containing potassium, the development of hyperkalemia is possible.

 

With simultaneous use with indomethacin, a decrease in the antihypertensive effect of Valsakor is possible.

 

At simultaneous application with lithium carbonate the case of development of lithium intoxication is described.

 

With thiazide diuretics, medicines such as ethanol (alcohol), barbiturates and opioid analgesics, can potentiate the risk of developing orthostatic hypotension.

 

Analogues of the drug Valsakor

 

Structural analogs for the active substance:

  • Artinova;
  • Valaar;
  • Wales;
  • Valsartan;
  • Valsartan Zentiva;
  • Valsartan N;
  • Valsafors;
  • Valsakor H80;
  • Valsakor H160;
  • Valsakor ND160;
  • Diovan;
  • Nortivan;
  • Tantordio;
  • Tareg.

 

Analogues on the pharmacological group (angiotensin 2 receptor antagonists:

  • Amsaar;
  • Amosartan;
  • Angiakand;
  • Aprovel;
  • Artinova;
  • Atacand;
  • Bloktran;
  • Vasotensis;
  • Wales;
  • Valsartan;
  • Vylloset;
  • Gisaar;
  • Gizortan;
  • Duopress;
  • Zisakar;
  • Ibertan;
  • Irbesartan;
  • Candecor;
  • Candesartan;
  • Cardomin;
  • Cardosal;
  • Cardosten;
  • Cardostine;
  • Karzartan;
  • Ko Exforge;
  • Co-span;
  • Lacka;
  • Lozap;
  • Lozarel;
  • Losartan;
  • Lorist;
  • Lorista H;
  • Lortense;
  • Losakor;
  • Mycardis;
  • Mykardis Plus;
  • Naviten;
  • Nortivan;
  • Olimestra;
  • Ordiss;
  • Prezartan;
  • Renikard;
  • Tareg;
  • Twentieth;
  • Teveten;
  • Firmas;
  • Edarby;
  • Exforge;
  • Eprosartan mesylate.

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Reviews (16):
Visitors
Genretta
I am 80 years old. Recently started taking the drug, there were intestinal problems, bloating, discomfort in the stomach. The appetite is lowered. Slightly thin. What to do?
Administrators
admin
GenrettaIf the side effects of Valsakor cause real inconvenience, there is only one way out - to change the drug to a similar one or to select a medicine to treat a particular disease from another pharmacological group. Contact your doctor for this, who appointed Valsakor.The truth is to establish that the problems started at the same time or almost immediately after the beginning of taking the drug, while there were no other changed factors, and it often happens that they nod at medicines, and something else is to blame for the problems. However, if after the drug cancellation the side effects disappear, then the answer is unambiguous and the medicine is to blame.
Visitors
Tatiana
Hello! An elderly patient with long-standing severe hypertension has been taking drugs for many years according to scheme 1:
1. Diroton 10 mg, morning.
2. Amlodipine Sandoz 5 mg, lunch.
3. Cordinorm 5 mg 1/2 table, evening.
4. Diroton 10 mg, at night.
The result of treatment is more or less acceptable except for night cough, mild bradycardia, edema of the ankles and severe joint pain.
The therapist insists on the new scheme 2:
1. Valsacor 80 mg (once daily)
2. Amlodipine Sandoz 5 mg
3. Concor 5 mg.
I would like to understand:
1. How effective is the (theoretically) scheme 2 in comparison with scheme 1?
2. Will Scheme 2 completely replace Scheme 1 (is it possible to use valsacor H or valsartan with a diuretic)?
3. Is it possible to change scheme 1 to scheme 2 in one day?
4.If the scheme 2 takes place, how correctly to distribute the medication during the day (what to take in the morning, what to take for sure at night, as strongly recommended everywhere: at night do not forget to take antihypertensive drugs to avoid a nightly rise in blood pressure)?
5. If Scheme 2 does not give the expected result, how much can it be abolished in favor of Scheme 1?
Thank you.
Administrators
admin
Tatiana, Scheme 2 can be replaced by Scheme 1 abruptly and, so to speak, without warning. Also how then to return the scheme number 1, if the second scheme of therapy is ineffective. I understand that one of the motivating actions of replacing one scheme with another is patient intolerance to ACE inhibitors (Diroton), as indicated by the cough that occurs when using drugs of this group. Edema is also not good, it is quite possible that they are caused by the action of Amlodipine, but you can first consult with your doctor using Valsakor with a diuretic (Valsakor N) and see what will become of the swelling. If it does not help, then you will have to change the dosage or cancel taking Amlodipine.

And with bradycardia, there are questions. If in the first scheme of therapy, we have a bradycardia on the half of the Cordinorma blocker tablet, it is quite possible that there is a need to reduce the dosage of Concor from the second scheme or even to cancel it, but this requires dynamic observation and selection according to the situation. It is possible that blockers are indicated by concomitant diseases of the patient.

Regarding the daily intake schedule: Valsakor and Concor from Scheme 2 are taken in the morning, Amlodipine at night.

In general, the patient must work. Observe with the attending physician, you will need his help in the future.
Visitors
QWER
Hello. To me 54 years, a hypertension 2 degrees more than 7 years. Started to take the following medicines: daily Kvadropril 1 tab. per day and Captain as soon as possible. But suddenly my throat began to swell, the doctor canceled my old medicines and appointed a new Valsakor daily from a dosage of 80 mg., From 01.07.16, but the pressure does not decrease at all, the dose may be small, and the accumulation period may not have come yet, you have to take Physiotense, that not desirable.Can dosage increase Valsakora, so do not buy a new dosage I can drink two tablets of 80 mg. Concomitant disease I have an autoimmune thyroiditis, I take Eutirox. When I receive Valsakor, I feel slightly dizzy and not very well, after some time it passes. My first scheme suited me better, now I do not know what to do? Tell me, if possible. Thank you in advance.
Administrators
admin
QWER, Maybe dosage is too small. If the break between the old and new treatment regimen was not, the cumulative effect should not have been so quick to leave, so it seems, the dosage of the new drug is too small, or it is not effective in your case, in principle, require a change of regimen. Try a double dose of Valsacor 80 mg (total 160 mg), because the allowable dosage of this drug is up to 320 mg, so there is room for maneuver. Only frequently monitor their blood pressure during the first two weeks of the new scheme, in order not to miss the opportunity to sharp pressure drop (which would require an adjustment of therapy), or the pressure will remain the same, and then you can put in front of the attending physician the question of replacing the drug to another.

The first treatment regimen, I so understood you canceled because of a possible allergic edema, which can be life-threatening, so you will have to choose another treatment.
Guests
Olga
Hello. I am 44 years old. The doctor diagnosed 2 years ago hypertension 1 degree. She took bromocran at 50 mg. 2 times a day. It helped badly, the pressure still jumped. Have appointed Valsakor on 80 mg. 2 times a day. I have been drinking for 3 weeks, my head is very dizzy, but I still do not feel pressure. What to do?
Administrators
admin
Olga, Go to the doctor and select the drugs further, from other pharmacological groups. I usually start with a simpler group, for example, ACE inhibitors (Enalapril, lisinopril and other analogues) to start. This issue is to be solved with the doctor internally, there can be many nuances here.
Guests
a guest
Can this medicine have a low pulse?
Administrators
admin
a guest, Valsakor preparation for heart rate does not affect and in the side effects of such changes is not described.So look for the cause of bradycardia (decrease in heart rate) in something else. As an option, we can assume an individual reaction to the drug, but this is too rare for one person per million, and I would not bet on it.
Guests
Galina
To me of 47 years, a hypertonia of 2 degrees. A year ago, the doctor appointed Valsakor H160. Three weeks after receiving, my back and legs began to hurt. Now my feet aches and my ankles are swelling.
Administrators
admin
Site visitor question beetle moved to the required section:
Hello! Advise, please, a preparation from a hypertension for my mum of 79 years? Pressure 160 and with the reception of the walsakor 80 and without it. Accepted the Valsakor 80 for several years. The drug stopped helping. I tried to take amlodipine, but there was dryness in the throat and deterioration of vision. It takes always anastrozole.
beetle, It's better to ask your mother's doctor about this. I can see from the treatment that a patient with a history of a burdensome anamnesis as a tumor disease, so there may be nuances with external appointments, plus possible additional concomitant diseases. Groups of drugs to reduce high blood pressure are many now.Depending on the indications and contraindications, ACE inhibitors (Enalapril, Lysinopril and many other drugs), beta-blockers (bisoprolol, Atenolol, Metoprolol and others), calcium channel blockers (Nifedipine, Amlodipine), angiotensin 2 receptor antagonists Valsakor, Losartan, Telmisartan and others). You can use these drugs in combination with each other.
Guests
Lyudmila
Hello. I take Valsakor 160 ND, the drug suits me, I drink it at 4 pm, and in the morning the fourth part of the Tonorm. Are these medications compatible? I have a stone in the gall, can I take Valsakor?
Administrators
admin
LyudmilaThe combination can not be considered successful due to the entry of diuretics into the preparations of Valsakor ND160 and Tonorma. So I would replace the latter with a one-component drug, for example, Atenolol (part of the Tonomy) or any ACE inhibitor (Enalapril, Lysinopril, Perindopril and many others) or in the evening, instead of Valsakor, ND160 appointed a simple Valsacor without a diuretic component and additional alphabetic codes in the name .

If the stone in the gallbladder does not affect the functioning of the liver, the drug Valsacor ND160 is permissible to use in treatment.
Guests
Galina
Hello. I was prescribed a drug Valsakor to lower the pressure the most minimal dose of 80 mg. I take it for the night, in the morning the pressure drops very much and it is necessary to drink coffee to raise it slightly, because it feels weak and dizzy, only after dinner the pressure is slightly leveled, I feel "not at ease" all day, I tried 2 days to divide the pill into 2 parts and drink accordingly 40 mg at night and in the morning.This option seems to be better.I accept the walsakor for 9 days.It reduces the pressure very well.Here now the question is: to change the walsakor to the former Enap or drink until it will not be 2 weeks since the instructions say that the accumulation comes only after 2 weeks. It reduces the pressure very much.
Administrators
admin
Galina, I can guess from the description of the problem that Valsakor is too strong a medicine for your pressure.Go to something simpler, the same Enap mentioned, and leave Valsakor for later, say, if there is a moment when the old medicine stops holding the prescribed figures of blood pressure.

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