Valsartan: analogues and substitutes for blood pressure, which is better

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Hypertension is one of the main problems of modern cardiology and medicine in general. Every year there are more and more patients with high blood pressure, and if previously almost all of them belonged to the older age group, now you can also find younger patients with the same pathology. The danger of this disease is that with its long-term uncontrolled course, many vital organs and systems are gradually affected (heart, peripheral and central vessels, brain, visual analyzer, kidneys).

Despite the fact that a huge number of different antihypertensive drugs have been developed, it is not always possible to normalize blood pressure numbers even with a qualified treatment regimen. This may occur due to drug intolerance or due to a high degree of resistance of the underlying disease. In such cases, selection of an adequate replacement is required, which becomes the main task of the cardiologist.

Who is prescribed valsartan?

Valsartan and other drugs based on it are antihypertensive drugs (lowering blood pressure). There are many medications with similar effects, but it is valsartan-containing tablets that doctors most often prescribe:

• patients with heart failure;
• those who have recently suffered a myocardial infarction;
• hypertensive patients.

Doctors choose valsartan-based drugs because they are more effective than many other drugs, and also have fewer contraindications and side effects. After many manufacturers' valsartan was withdrawn from the market, some patients stopped taking their antihypertensive medications in confusion. This is strictly forbidden.

In case of hypertension, heart failure, or after a myocardial infarction, tablets to lower blood pressure must be taken continuously; treatment cannot be interrupted on your own.

Violations of the schedule for taking antihypertensive drugs can cause an uncontrolled increase in blood pressure and provoke dangerous conditions such as hypertensive crisis, myocardial infarction, ischemic or hemorrhagic stroke.

To avoid these vascular accidents, you should not refuse to take antihypertensive drugs, no matter what caused this refusal. If the drug you are taking is on the list of those withdrawn from the pharmacy network due to its poor quality, you must immediately find a replacement for it. Your doctor or pharmacist at the pharmacy will help you with this.

General information about Valsartan tablets

Valsartan is a drug from the group of angiotensin receptor antagonists that reduces blood pressure by reducing vascular tone.

It is used mainly in cardiology and is prescribed for primary and secondary arterial hypertension, for chronic functional heart failure, as well as in the post-infarction period to reduce post- and preload on the myocardium.

This drug should not be prescribed if you are allergic to its components, during pregnancy and lactation.

How does the drug work?

The principle of action of valsartan is based on blocking angiotensin II. This hormone causes the following physiological effects:

• vasoconstriction;
• decreased sodium excretion from the body;
• proliferation of connective tissue;

• release of the adrenal hormone aldosterone, the action of which leads to an increase in blood pressure in the arteries.

Valsartan binds to angiotensin II receptors, thereby displacing it from biochemical processes, as a result of which it cannot do its job, and blood pressure decreases.

In addition to its hypotensive effect, valsartan is also able to slow down kidney damage in people with type II diabetes mellitus. However, in hypertensive patients who do not have this disease, the risk of kidney damage, on the contrary, increases. But the increase in this risk is insignificant - only 1-2% for 1 year of use.

Since valsartan acts on a hormone secreted by the kidneys, it should not be used in persons with compression of the renal arteries and severe renal failure.

After taking valsartan, the maximum decrease in blood pressure occurs after 4-6 hours, the hypotensive effect lasts about 24 hours.

With regular use, the greatest reduction in blood pressure is achieved after 14-28 days and remains stable throughout the entire duration of treatment.

How to enhance the hypotensive effect of valsartan?

When valsartan is taken in combination with certain drugs, its effect is enhanced. The most common combinations of valsartan with:

• hydrochlorothiazide;
• amlodipine;
• aliskiren
• sacubitril.

These substances enhance the effect of valsartan, resulting in a greater reduction in blood pressure than when taken separately. In addition, in combination with amlodipine, better tolerability of the drug and a reduction in side effects are achieved.

Russian substitutes

Domestic pharmaceutical companies offer analogues of Valsartan. Russian analogues are several times cheaper than the original, but they do not differ in quality and efficiency.

Valaar

Valaar is a Russian analogue based on the active drug valsartan. The drug is an angiotensin 2 antagonist, which promotes mild adjustment of blood pressure.

Medicines are prescribed for the following diseases:

• hypertension of various etiologies, the drug is prescribed from 6 years of age;
• post-infarction and post-stroke period;
• complex treatment with other groups of antihypertensive drugs;
• dysfunction of the left cardiac ventricle.

Types of hypertension

It is not prescribed to women during pregnancy and breastfeeding, and it is also prohibited to prescribe to children under 6 years of age or if they are allergic to the components of the medicine.

Regardless of age, Valaar should be taken once a day, 1 tablet with a dosage of 80 mg. If a different dosage is needed, then consult a doctor. The therapeutic effect of taking the medication occurs after 2 weeks of therapy. The maximum permissible dosage per day is 320 mg.

Duopress

Duopress is a combination antihypertensive drug. The drug contains an angiotensin 2 antagonist (valsartan) and a diuretic (hydrochlorothiazide).

With the help of valsartan, blood pressure decreases, but myocardial contractions remain the same. After a single dosage, the therapeutic effect can be felt after 2-3 hours from taking the tablet. The hypotensive effect of one tablet taken lasts throughout the day. With a course of treatment, a stable hypotensive effect occurs after 15-30 days.

Hydrochlorothiazide has a hypotensive effect on the blood flow system, and also helps to reduce the tone and dilate the arteriolar membranes. Diuretic properties begin to appear after 1-2 hours and last from 6 to 12 hours.

The drug is prescribed once a day, 1 tablet with a dosage of 80 mg + 12.5 mg or 160 mg + 12.5 mg. The maximum dosage of 160+25 mg is prescribed for malignant hypertension with persistent high blood pressure.

Amlodipine+Valsartan

The drug Amlodipine + Valsartan is a combined medication of a calcium channel antagonist (amlodipine) and an angiotensin 2 receptor antagonist (valsartan).

Both components complement the action of each other, which enhances the hypotensive effect of the drug and helps to quickly reduce high blood pressure. In combination, both components are more effective than each in monotherapy.

The drug is prescribed for the following pathologies:

• hypertension;
• disturbance of myocardial rhythm – tachycardia, arrhythmia;
• heart failure;
• disturbances in cerebral and peripheral blood flow.

The drug is taken once a day, 1 tablet 5/80, 5/160 or 10/160 mg in the morning. The dosage is determined by the doctor, as well as the duration of therapy.

Why was valsartan withdrawn from sale?

By themselves, drugs containing valsartan do not pose a threat to health, excluding rare cases of side effects. This product was patented by the Swiss corporation Novartis under the brand name Diovan and annually brought the manufacturer more than five billion euros in profit.

After the patent expired in 2012, the production of valsartan became available to other pharmaceutical companies, and generics appeared in pharmacies around the world - cheap copies of the drug produced in China, India and other countries.

The statement that valsartan causes cancer is not entirely true, because the problem with the content of carcinogens has its roots not in the valsartan formula, but in poor-quality production.

The main blame for dangerous impurities getting into drugs lies with the large Chinese pharmaceutical company Zhejiang Huahai Pharmaceutical. Due to violations of the production technology of valsartan by this company, carcinogenic and toxic substances penetrated into the composition of the drug:

• dimethylnitrosamine;
• diethylnitrosamine.

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The most unpleasant thing was that this Chinese company produced valsartan in huge quantities and supplied its low-quality products to drug manufacturers around the world. As a result, drugs from many manufacturers who purchased raw materials from the guilty Chinese company Zhejiang Huahai Pharmaceuticals were withdrawn from retail chains.

What drugs were seized in the Russian Federation?

In Russia, the list of prohibited valsartan-containing drugs includes the following products:

• Atoll LLC - Valsartan, Sartavel, Sartavel Amlo, Disartan, Diupress;
• CJSC Northern Star - Valsartan-SZ;
• JSC "Medisorb" - Valsartan MS;
• JSC Pharmaceutical Enterprise Obolenskoye - Valaar;

• Actavis Group JSC - Valz, Valz N;
• JSC "Gedeon Richter" - Nortivan;
• Pharmaplant Fabrication Hemischer Product GmbH - Valsafors;
• "Zentiva K.S." - Valsartan Zentiva.

Anyone who has taken these pills should go to pharmacies, where prohibited drugs will be exchanged for safe ones. Those who have taken medications from the list below do not need to worry and continue treatment with these medications.

Safe Valsartan in Russian pharmacies

Safe valsartan-containing drugs include products from the following companies:

• LLC "KRKA-RUS" - Ko-Vamloset, Vamloset;
• Novartis Pharma - Inresto, Exforge, Co-Exforge, Diovan, Co-Diovan;

• JSC "POLFARMA" - Vanatex Combi, Valsartan-hydrochlorothiazide-Akrikhin;
• JSC "KRKA, d.d., Novo mesto" - Valsakor, Valsakor ND160, Valsakor N160, Valsakor N80, Valsakor N320;
• "Sun Pharmaceutical" - Artinova;
• Sandoz Pharmaceuticals d.d. - Uperio;
• "Pharmstandard-Tomskkhimpharm" - Exfotanz;
• Torrent Pharmaceuticals Ltd - Tantordio;
• "Teva" Pharmaceutical Enterprises Ltd. - Diotensin.
• "Ranbaxy Laboratories Limited" - Artinova;

The pharmaceutical companies listed above purchased raw materials from reliable, trusted manufacturers; no toxic or carcinogenic substances were found in the Valsartan and its analogues produced by them.

Prices for the drug and its analogues

The cost of Valsartan substitutes directly depends on the country of origin. Russian-made drugs are cheaper than their foreign counterparts. List of prices for Valsartan analogs and substitutes:

What is the danger of harmful impurities?

The dangerous components dimethylnitrosamine and diethylnitrosamine, found in the products of a major supplier of valsartan, Zhejiang Huahai Pharmaceutical, are toxic and classified by the World Health Organization as carcinogenic substances (capable of causing the development of malignant tumors). The carcinogenic properties of these substances have long been studied:

• Diethylnitrosamine is a known component of tobacco smoke. Its presence in tobacco is considered one of the reasons why smoking causes lung cancer.
• Dimethylnitrosamine is used in laboratories to induce the development of malignant tumors in experimental rats for scientific purposes.

This information may come as a shock to people who have taken low-quality valsartan. However, it should be taken into account that dimethylnitrosamine was administered to laboratory animals in large doses, not commensurate with the amount of these harmful substances that ended up in drugs due to a violation of technology.

Is there any reason for concern?

Low-quality valsartan was sold in pharmacies around the world for 5 years. Those who have been taking it for a long time may quite naturally have a fear of getting cancer. However, the likelihood of developing this disease due to taking pills is not very high.

The long-term effects on the human body of low doses of diethylnitrosamine and dimethylnitrosamine, found in low-quality valsartan, have not been studied. Examples of regular use of small amounts of diethylnitrosamine include smokers, but the incidence of lung cancer in smokers with a five-year history is relatively low. Risk factors for developing cancer include:

• bad ecology;
• bad habits;

• harmful production factors;
• chemicalization of food and household products;
• promiscuity.

Different people are exposed to these factors to varying degrees, and it is not known who has a greater risk of getting sick - a patient who has been receiving microdoses of dangerous substances in tablets for some time, or a smoker, a worker in hazardous production, or a fast food lover.

How to get rid of anxiety?

A body examination will help get rid of the fear of getting cancer due to taking low-quality valsartan. Now there are accurate diagnostic methods that allow you to detect cancer in the early stages. From a certain age, it is recommended for all people to regularly undergo these examinations for preventive purposes. Preventive cancer screening includes:

• gastroscopy;

• colonoscopy;
• computed tomography of the lungs;
• Ultrasound of internal organs;
• mammography and Pap test for women.

All these types of diagnostics are carried out free of charge under the compulsory medical insurance policy or as prescribed by a doctor, some of them are included in the mandatory medical examination. So, if there is a fear that long-term use of valsartan could provoke the development of malignant processes in the body, it is better to undergo an examination to make sure that everything is in order, or to start treatment in a timely manner.

What can replace Valsartan?

Valsartan tablets have many analogues, but most of these drugs are based on the active substance - the same valsartan. So, if you want to replace prohibited pills with a similar drug, you can safely buy it in pharmacies - today all dangerous medications have been removed from sale. For greater confidence, you can check the list of safe valsartan in Russian pharmacies located on this page.

Antihypertensive drugs with a different mechanism of action are also used in the treatment of patients with arterial hypertension, heart failure and after myocardial infarction. Most often, doctors prescribe antihypertensive drugs of five groups, which are presented in the table.

There are many drugs that can lower blood pressure no less effectively than Valsartan. To choose the most suitable one, you should listen to the opinion of your doctor, and then take the chosen remedy, keeping your blood pressure and well-being under control. If the drug is intended for long-term use, effectively lowers blood pressure and causes minimal side effects, then it can be used for long-term therapy.

Analogues and substitutes

The modern pharmaceutical market can provide a huge variety of medications that can be a worthy replacement for Valsartan. You can choose a medicine from the same group. You can choose medications with completely different mechanisms of action. The tactics in this case are mainly determined by the reasons why the patient had to abandon the main medication. Also, when selecting analogues, the cost of drugs can be taken into account, since for many patients this is an important aspect due to the fact that antihypertensive medications must be taken on an ongoing basis.

It must be remembered that if a drug is not suitable for a patient, analogues and substitutes for a new treatment regimen must be selected together with the attending physician. Replacing it yourself can be hazardous to your health.

Valsacor or Valsartan: which is better?

Valsacor contains the same active ingredient. This fact determines that the indications and contraindications for both medications are almost identical. A persistent angiotensive effect from Valsacor develops within half a month after the start of treatment. Valsacor can be called a good substitute for foreign-made Valsartan. Despite the fact that the medicine is imported, its cost is more than affordable.

Lozap or Valsartan: what to choose

The main active ingredient of the drug Lozap is the chemical compound losartan potassium, which also realizes its antihypertensive effects by blocking type 2 receptors for angiotensin. Both medications help lower blood pressure due to a decrease in total peripheral resistance due to diffuse vasodilation.

Lozap is available in tablet form and has three standard dosages (12.5, 50 and 100 milligrams). This range of concentrations of the active substance makes it easy to select the most convenient daily and single doses for the patient.

Lozap is contraindicated in patients with hypersensitivity to the components of this drug. It is also not prescribed for liver failure and during pregnancy and breastfeeding.

Valz and Valsartan: comparative characteristics

Valz is a substitute for Valsartan with a similar composition (it also contains the chemical compound valsartan), however, in addition to the antihypertensive substance, Valz N tablets contain a thiazide diuretic. This allows the drug to affect more than just peripheral resistance. It depends on the tone of the vascular wall of small arteries and arterioles. The medicine also works on circulating blood volume, which can also affect blood pressure. The presence of a diuretic in the composition can be an undoubted advantage in some cases, and in some cases a contraindication for use.

For patients who need intensive treatment with several medications at once, Valz N can make life easier, since they can take one tablet instead of several different ones. But for patients whose clinical course of the underlying disease does not require combination therapy, Valz cannot be prescribed.

Telmisartan or Valsartan: which is better?

Telmisartan has very similar therapeutic effects and indications for use. This is due to the similarity of their chemical composition and belonging to the same pharmacological group. The main indication for prescribing both medications is hypertension. There have been no studies that could say for sure which medication is more effective against high blood pressure.

Important! The diuretic drug hydrochlorothiazide can enhance the effect of Telmisartan when administered simultaneously, which must be taken into account when selecting doses and developing a treatment regimen.

Losartan or Valsartan: what to choose

Losartan potassium can be prescribed for both primary and secondary arterial hypertension. This drug belongs to the group of angiotensin receptor blockers. When prescribing it, you need to remember that Losartan, taken simultaneously with potassium-sparing diuretics and potassium supplements, increases the risk of developing hyperkalemia. Both medications have a good hypotensive effect. And what exactly to choose can only be decided taking into account the individual susceptibility of the patient’s body.

Edarbi as an analogue

The main biologically active component of the drug Edarbi is azilsartan medoxomil. The main indication for its use is essential (primary) hypertension. This drug combines well with other antihypertensive medications, and therefore, if the effect of Edarbi is insufficient, the treatment regimen can be supplemented.

Edarbi is produced abroad (Japan), which determines the high quality and safety of this drug.

List of other analogues

There are a huge number of other substitutes, so everyone can find a drug that is suitable for price and effectiveness.

Analogs of Valsartan:

• Nortivan
• Amlovas
• Norvask
• Enalapril
• Lisinopril
• Presartan
• Blocktran
• Enap.

What to do with the remaining packages?

Anyone who has taken or continues to take valsartan should act in the following way:

• Find out whether the drug you are taking is included in the list compiled by the State drug control authorities.
• If the medicine being taken is on the list of drugs withdrawn from the market, then the patient has the right to contact the pharmacy to exchange the tablets for an equivalent drug of similar effect, even if the package is opened and incomplete.
• If you still have a valid prescription for valsartan. You can use it to buy another safe drug with a similar effect.

• If pharmacies do not have valsartan from the approved list, then it is better to discuss the issue of replacing the antihypertensive drug with your doctor and get another prescription.

Diseases of the cardiovascular system are too serious a topic that cannot be taken lightly. It is not easy to choose an antihypertensive drug for long-term use that will effectively normalize blood pressure and have a minimum of side effects. Therefore, it is better to consult a cardiologist with the problem of replacing a low-quality valsartan-containing drug.

Drugs with similar therapeutic effects

Angiotensin 2 antagonists, in addition to the active component valsartan, can be produced on the basis of the active substances candesartan and losartan. The drugs are produced for monotherapy, and these active ingredients are also included in combination medications in combination with diuretics. With different active components, the mechanism of action is identical. These medications can be substitutes for valsartan.

Advant

Advant contains the active component candesartan, which has an antagonistic effect on the angiotensin 1 and 2 receptor.

Advant is used to treat the following diseases:

• impaired functionality of the left ventricle;
• essential hypertension;
• myocardial failure;
• sensitivity to ACE inhibitors.

Essential hypertension

If you are allergic to components and in pediatrics, Advant is not prescribed, and it is also prohibited to take pills during pregnancy and lactation, and even during the period when a woman plans to conceive a child.

The tablets must be taken without attachment to food; the dosage is calculated by the doctor personally. The daily dosage can range from 8 to 32 mg. The first sustainable therapeutic effect can be noticed after 2 weeks of treatment. During this period, the doctor may double the dosage of the medication or replace Advant with another medication.

Candecor

This is a combination antihypertensive drug with candesartan and the diuretic hydrochlorothiazide. The effectiveness of the medicine continues for 24 hours from the moment of taking the tablet, and diuretic effects occur after 1-1.5 hours.

The drug, acting on receptors, prevents blood pressure from rising above normal and heart rate from increasing. Under the influence of the drug, peripheral arteries reduce their resistance, which improves blood flow in the renal and coronary arteries, as well as in the cerebral vessels.

Candecor is available only in tablet form and is prescribed for the treatment of hypertension. The drug is not used to treat children, pregnant and lactating women, as well as patients with severe liver and kidney pathologies. Allergy to components, gout are also reasons not to take the medicine.

The dosage and duration of treatment for hypertension is prescribed by the attending physician in accordance with the tonometer and ECG readings. The medication is prescribed as standard - 1 tablet once a day, in the morning. A persistent hypotensive effect can be noted a month after the start of therapy.

Angizar

A medication with an active ingredient is losartan potassium. The medicine helps reduce high blood pressure. The drug also has the properties to act on the smooth muscle fibers of the arterial membranes, reducing tone and increasing elasticity, which leads to their expansion and lowering blood pressure.

Losartan selectively binds to the AT1 receptor and does not bind to other hormones. Losartan is not an ACE inhibitor.

The drug is used for hypertension when the tonometer reading is higher than 140/90 mm. Hg Art. Not prescribed for children, nursing and pregnant women, as well as for serious liver pathologies.

Angizar is taken once a day, regardless of meal time. The recommended dosage per day is 50 mg. After 2 weeks of use, the doctor may double the dosage.

Lozap

Lozap is a combination drug with losartan and a diuretic (hydrochlorothiazide).

Both components complement each other's antihypertensive properties, which contributes to a sustained reduction in blood pressure even with malignant hypertension. The drugs affect the smooth muscle fibers of the arterial membranes of the renal and main arteries in the bloodstream. The peripheral resistance of arterioles decreases, coronary and cerebral blood flow improves.

Properties of the drug

Lozap is prescribed for severe hypertension, when antagonists cannot reduce blood pressure in monotherapy. Not used in childhood, pregnancy and lactation, as well as in acute pathologies of the kidneys and urinary system.

The drug is taken once a day in the morning, 1 tablet (50/12.5 mg). The treatment regimen and dosage are prescribed by the doctor personally to each patient.