Popular and cheap substitutes for Valz: TOP 4 analogues

Most of you, pharmacy visitors, contact a specialist with a specific request. You are looking for medications prescribed by a doctor or self-medication. There are usually several options for the same drug to choose from. Among them may be original drugs

- they went through a full cycle of research and were registered first, and
generics
are copies of the original drug, registered after it.

When choosing between analogue drugs, pay attention to the equivalence of the active ingredients, dosages, release forms, the name of the manufacturer and whether the product is a medicine or dietary supplement.

Brief instructions for choosing analogue drugs:

• Analogs must have equivalent active ingredients. To find a drug, use the service for selecting analogues by INN.
• The dosage of the analogue should be either the same or less. If the dosage is less, the medication regimen changes.
• The packaging of analogues may differ. Before purchasing, calculate how much of the drug is needed for the course of treatment.
• Analogs must have the same dosage form and route of administration. That is, you should not buy tablets instead of suppositories.
• Keep in mind that not all generic drugs are equally similar to the original drug.
• Do not replace the medicine with a dietary supplement.

Read more below.

The cheapest drugs: Valsartan and the drug Hydrochlorothiazide

When faced with a particular disease, people try to choose not only effective, but also relatively cheap medications. Especially if we are talking about a long course of treatment. Most often, specialists prescribe Valz, containing 40 mg of valsartan, to patients with hypertension. But, despite its relatively cheap cost, people are trying to find more profitable analogues.

The table presents 2 drugs that are prescribed for high blood pressure, but they belong to different drug groups and radically differ in their mechanism of action.

Valsartan is the cheapest and closest substitute for Valza, therefore it has an identical list of contraindications, except that this analogue is approved for children over 6 years old. Country of origin: India.

Hydrochlorothiazide is the most accessible of all thiazide diuretics. And it is an excellent substitute for antihypertensive drugs. But, despite a number of advantages, it, like other medications, has a number of contraindications and possible adverse reactions. Contraindications include:

1. Hypersensitivity to thiazide diuretics.

2. 
   Lactose intolerance.

3. Impaired glucose metabolism.
4. Anuria.
5. Liver dysfunction.
6. Severe kidney disease.
7. Pancreatitis.
8. Systemic lupus erythematosus.
9. Diabetes.
10. Gout.

The drug has a number of advantages, but due to the complexity of administration, it has not gained much popularity among residents of the Russian Federation. Frequent urge to empty the bladder, taking pills hourly and depending on meals, causes some discomfort in people and forces them to abandon the medicine, despite its effectiveness and low cost.

Active substance

Each medicine has several names:

• trade
• international nonproprietary (INN) or grouping, or chemical

Trade name

unique for each manufacturer. It is necessary to distinguish drugs from different manufacturers.

Example of trade names of drugs containing the active substance ibuprofen:

• Dolgit
• Nurofen
• Ibuprofen-Akrikhin
• Faspik
• Mig and others

INN

is the name of the active substance.

An example of an active substance and a preparation containing it:

• ibuprofen (Nurofen, Mig)
• doxycycline (Unidox Solutab, Doxylan)
• acetylsalicylic acid (Aspirin, Upsarin UPSA)

Group name

assigned to a medicinal product if it does not have an INN or several of them.

Examples of group names:

• chondroitin sulfate
• tolperisone + lidocaine
• cod liver oil

Chemical name

- the name of the active substance, reflecting its composition and chemical structure.

The doctor must write a prescription in Latin using the INN. If there is no INN, the prescription is written by generic or chemical name. The drug is prescribed by its trade name if it does not have an INN, generic or chemical name.

The pharmacy employee offers you medications with the active ingredient that the doctor indicated in the prescription. Drugs with the same active ingredient can be produced by different factories. In this case, they will have different trade names.

Analogs must have equivalent active ingredients. To find a drug, use the service for selecting analogues by INN.

Dosage

In the prescription, in addition to the name, the doctor indicates the required dose of the drug. Drugs with the same INN are available in different dosages. The dosage depends on the underlying and concomitant diseases, age, body weight of the patient and other factors.

For example: medications with the active ingredient amoxicillin can be produced in dosages of 125 mg, 250 mg, 500 mg and 1000 mg.

The effect of treatment also depends on the correct dosage. The dosages of analogue drugs should be the same.

If the pharmacy does not have the required dosage, you can recalculate it. By law, this is allowed if the pharmacy has drugs with a lower dosage than prescribed in the prescription. At the same time, the reception regimen will change.

Valz

Hyperkalemia

When used simultaneously with dietary supplements containing potassium, potassium-sparing diuretics, potassium-containing salt substitutes, or with other drugs that may cause an increase in potassium levels in the blood (for example, heparin), caution should be exercised and regular monitoring of potassium levels in the blood should be carried out.

Renal dysfunction

There is no experience of safe use in patients with creatinine clearance less than 10 ml/min and in patients on hemodialysis, so valsartan should be used with caution in such patients. In patients with CC more than 10 ml/min, no dose adjustment is required.

Liver dysfunction

In patients with mild or moderate hepatic impairment without cholestasis, valsartan should be used with caution.

Sodium deficiency in the body and/or decreased blood volume

In patients with severe sodium deficiency in the body and/or reduced blood volume, for example, those receiving high doses of diuretics, in rare cases, after starting therapy with valsartan, arterial hypotension may develop, accompanied by clinical manifestations.

Before starting treatment with Valz, it is necessary to adjust the sodium content in the body and/or replenish the blood volume, including by reducing the dose of the diuretic.

Renal artery stenosis

The use of the drug in a short course in patients with renovascular hypertension, which developed secondary to unilateral stenosis of the artery of a single kidney, does not lead to any significant change in renal hemodynamics, serum creatinine concentration or blood urea nitrogen.

However, given that other drugs that affect the RAAS may cause an increase in serum urea and creatinine concentrations in patients with bilateral renal artery stenosis or stenosis of the artery of a solitary kidney, monitoring these indicators is recommended as a precautionary measure.

Kidney transplant

There are no data on the safety of using Valz in patients who have undergone kidney transplantation.

Primary hyperaldosteronism

The drug is not effective for the treatment of arterial hypertension in patients with primary hyperaldosteronism, since activation of the RAAS is not observed in this category of patients.

Aortic and mitral stenosis, obstructive hypertrophic cardiomyopathy

As with other vasodilating agents, caution should be exercised when taking Valz in patients with aortic or mitral stenosis and obstructive hypertrophic cardiomyopathy.

Pregnancy

Taking angiotensin II receptor antagonists is contraindicated during pregnancy. Patients planning a pregnancy should choose treatment with alternative medications that have a proven safety profile when used during pregnancy.

If pregnancy is diagnosed during treatment with Valz, it should be discontinued as soon as possible and alternative treatment prescribed (see sections “Contraindications” and “Use during pregnancy and breastfeeding”).

CHF/period after myocardial infarction

In patients with CHF or after myocardial infarction who begin treatment with valsartan, a slight decrease in blood pressure is often observed, and therefore it is recommended to monitor blood pressure at the beginning of therapy. If you follow the recommendations for changing the dosage regimen, there is usually no need to discontinue the drug due to arterial hypotension. Evaluation of patients with CHF should include assessment of renal function.

Due to inhibition of the RAAS, renal dysfunction may occur in some patients. In patients with CHF functional class II-IV according to the NYHA classification, treatment with ACE inhibitors and angiotensin II receptor antagonists may be accompanied by oliguria and/or an increase in azotemia and, in rare cases, the development of acute renal failure and/or death. Therefore, in these categories of patients, before using the drug Valz, as well as periodically during treatment, it is necessary to assess renal function.

Combination therapy for arterial hypertension

For arterial hypertension, the drug Valz can be used in monotherapy, as well as in combination with other antihypertensive drugs, in particular with diuretics.

Combination therapy in the period after myocardial infarction

It is possible to use the drug Valz in combination with other drugs used after myocardial infarction, namely: thrombolytics, acetylsalicylic acid as an antiplatelet agent, beta-blockers, HMG-CoA reductase inhibitors and diuretics. In this category of patients, it is not recommended to use Valz simultaneously with ACE inhibitors, since this combination therapy does not have advantages over valsartan or ACE inhibitor monotherapy in terms of overall mortality from any cause.

Combination therapy for CHF

For CHF, the drug Valz can be used both in monotherapy and simultaneously with other drugs - diuretics, cardiac glycosides, as well as ACE inhibitors or beta-blockers.

In this category of patients, the use of triple combination therapy with an ACE inhibitor, a beta-blocker and the drug Valz is not recommended.

Angioedema (Quincke's edema)

During treatment with valsartan, there have been reports of the development of angioedema, accompanied by swelling of the larynx and vocal cords, leading to airway obstruction, and/or swelling of the face, lips, pharynx and/or tongue. Some patients in this group had previously experienced angioedema while taking other medications, including ACE inhibitors.

If angioedema develops, Valz should be discontinued immediately, after which drugs containing valsartan should not be taken in the future.

Double blockade of the RAAS

When treated with drugs that affect the RAAS, especially when they were combined, a marked decrease in blood pressure, syncope, stroke, hyperkalemia and changes in renal function (including acute renal failure) have been reported in sensitive patients.

Caution is required when combining angiotensin II receptor antagonists, including valsartan, with other drugs that block the RAAS, such as ACE inhibitors or aliskiren.

Concomitant use of angiotensin II receptor antagonists, including valsartan, with drugs containing aliskiren is contraindicated in patients with diabetes mellitus and/or with moderate or severe renal impairment (GFR less than 60 ml/min/1.73 m body surface area) and is not recommended in other patients. Concomitant use of angiotensin II receptor antagonists with ACE inhibitors is contraindicated in patients with diabetic nephropathy and is not recommended in other patients.

Other RAAS stimulation conditions (320 mg dose only)

In patients in whom renal function may be dependent on the activity of the RAAS (for example, patients with severe congenital heart failure), treatment with ACE inhibitors is associated with the occurrence of oliguria and/or progressive azotemia and, in rare cases, acute renal failure and/or death. Since valsartan is an angiotensin II receptor antagonist, it cannot be excluded that its use may be associated with impaired renal function.

Children and teenagers under 18 years of age

Renal dysfunction

The use of the drug has not been studied in patients aged 6 to 18 years with impaired renal function with creatinine clearance <30 ml/min, as well as in patients on hemodialysis, so its use in this group of patients is not recommended.

In patients from 6 to 18 years old with CC more than 30 ml/min, no dose adjustment is required. While taking Valz, renal function and serum potassium levels should be carefully monitored. In particular, these precautions must be observed when taking the drug Valz against a background of elevated temperature or decreased blood volume, since in this case the development of renal dysfunction is possible.

Liver dysfunction

As for adult patients, the use of Valz is contraindicated for patients from 6 to 18 years of age with severe liver dysfunction, biliary cirrhosis and cholestasis. Experience with the use of valsartan in patients with mild to moderate liver dysfunction is limited. The dose should not exceed 80 mg in this group of patients.

Release form

When choosing analogues, you need to take into account the amount of the drug per course of treatment. Preparations with the same active ingredient in equal dosages can be produced in different packaging. The doctor writes a prescription, indicating how much medication the patient will need for the entire course of treatment.

For example: paracetamol is available in the form of tablets of 10 pieces, 20 pieces, and the drug Panadol with the same active ingredient is available in 12 tablets.

The doctor also indicates the dosage form of the drug

: tablets, capsules, oral solution, ointment, suppositories (suppositories). Analogs must have the same dosage form and route of administration.

This means that you should not replace tablets with suppositories without consulting your doctor. The method of administration of the drug determines the therapeutic effect, the speed of its onset, as well as the likelihood of developing adverse side reactions. The doctor selects the dosage form taking into account the patient’s characteristics.

For example: the doctor prescribed the drug in the form of rectal suppositories, and you decided to use tablets. Such a replacement may change the speed of onset of the therapeutic effect, since the drug from suppositories reaches the bloodstream faster than from a tablet.

Russian-made substitutes

Russian analogues of the drug Valz are relatively cheap drugs, have an identical active ingredient (valsartan) and a similar scope of application. The most popular Russian substitutes are Applodipine + Valsartan and Valaar.

Amlodipine+Valsartan

It consists of a combination of 2 active ingredients – amplodipine and valsartan. Both components have a hypotensive effect and help with high blood pressure, complement each other.

Drug group – antihypertensive drug. Release form: tablets. The recommended dose is 80 mg per day. The drug should not be taken if there is obstructed blood circulation in the kidneys, recent transplantation, as well as for children, pregnant women and women who are breastfeeding.

Efficiency of lowering blood pressure with a fixed combination of amlodipine + valsartan

Main differences from the main drug:

1. It is a more effective remedy due to the effect of two antihypertensive substances at once.
2. It is used exclusively for high blood pressure as part of complex therapy.

Valaar

It has similar properties and has the same active substance and indications for use as Valz. Refers to antihypertensive drugs. Available in the form of film-coated tablets, the frequency of which is 1-2 pieces per day. Contraindications – intolerance to the substances included in the composition, pregnancy and lactation.

Difference from Valz:

1. A short list of contraindications.
2. Allowed for persons over 12 years of age with high blood pressure.

Russian analogues are more affordable medicines for residents of the Russian Federation, which is why they have gained wide popularity.

Medicine or dietary supplement

Prescribed medications cannot be replaced with dietary supplements. Dietary supplements do not have a therapeutic effect, but are indicated for use as an additional source of any substances for consumption along with food.

Dietary supplements should not be used as primary treatment. They may contain the same ingredients as medications. However, medicines and dietary supplements undergo different tests for state registration.

When choosing drug analogues, you should pay attention to the name of the drug, namely the active substance. The analogue should be selected taking into account the dosage, course of treatment and dosage form. It is important to pay attention to the manufacturer and whether the chosen product is a medicinal product.

There are contraindications. Possible side effects. Before use, you should consult a specialist.

Prices for the medicine and its analogues

The medication can have a large number of adverse reactions, so many people prefer to use Valza analogues with identical effects, but with a shorter list of unwanted side effects.
Pharmaceutical companies producing analogs of Valz are trying to reduce possible negative consequences by introducing additional shells, adding new components and changing the concentration of active substances. Each manufacturer, as a rule, focuses on one thing, thereby reducing the list of adverse reactions and contraindications.

Most analogues in composition have an identical amount of the active component in their composition. But if the maximum concentration of Valza reaches 160 mg of valsartan, then some manufacturers of similar products include only 80 mg of this component in their drug.

Price also plays an important role when choosing a medication. Average prices for the drug and its analogues are shown in the table.

Prices for analogues depend on the manufacturer. Russian and Ukrainian substitutes are, as a rule, cheaper than their foreign counterparts.