Nonsteroidal anti-inflammatory drugs (NSAIDs)
These drugs can decrease your kidney function when taken with Miten. Examples of these drugs include:
Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
This drug comes with several warnings.
The results from an in vitro study with human liver tissue indicate that Miten is a substrate of the hepatic uptake transporter OATP1B1 and the hepatic efflux transporter MRP2. Coadministration of inhibitors of the uptake transporter (rifampin, cyclosporine) or efflux transporter (ritonavir) may increase the systemic exposure to Miten.
On this page
- About Miten
- Key facts
- Who can and can't take Miten
- How and when to take it
- Side effects
- How to cope with side effects
- Pregnancy and breastfeeding
- Cautions with other medicines
- Common questions
How to take it
You can take Miten tablets with or without food. Swallow the tablets with a drink of water.
If you're taking Miten as a liquid, it will come with a plastic syringe or spoon to help you measure out the right dose. If you don't have one, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not give the right amount of medicine.
Some people take Miten in combination with other medicines:
- with amlodipine (brand name Exforge) to treat high blood pressure
- with hydrochlorothiazide (brand name Co-Diovan) to treat high blood pressure
- with sacubitril (brand name Entresto) to treat a type of long-term heart failure
Excessive hypotension was rarely seen (0.1%) in patients with uncomplicated hypertension treated with Diovan alone. In patients with an activated renin-angiotensin system, such as volume- and/or saltdepleted patients receiving high doses of diuretics, symptomatic hypotension may occur. This condition should be corrected prior to administration of Diovan, or the treatment should start under close medical supervision.
Caution should be observed when initiating therapy in patients with heart failure or post-myocardial infarction patients. Patients with heart failure or post-myocardial infarction patients given Diovan commonly have some reduction in blood pressure, but discontinuation of therapy because of continuing symptomatic hypotension usually is not necessary when dosing instructions are followed. In controlled trials in heart failure patients, the incidence of hypotension in Miten-treated patients was 5.5% compared to 1.8% in placebo-treated patients. In the Miten in Acute Myocardial Infarction Trial (VALIANT), hypotension in post-myocardial infarction patients led to permanent discontinuation of therapy in 1.4% of Miten-treated patients and 0.8% of captopril-treated patients.
If excessive hypotension occurs, the patient should be placed in the supine position and, if necessary, given an intravenous infusion of normal saline. A transient hypotensive response is not a contraindication to further treatment, which usually can be continued without difficulty once the blood pressure has stabilized.
Which drugs or supplements interact with Miten?
Combining Miten with potassium-sparing diuretics (for example., spironolactone (Aldactone), triamterene, amiloride), potassium supplements, or salt substitutes containing potassium may lead to hyperkalemia (elevated potassium in the blood) and in heart failure patients, it increases serum creatinine, a blood test used for monitoring function of the kidneys.
Combining Miten or other ARBs with nonsteroidal anti-inflammatory drugs (NSAIDs) in patients who are elderly, fluid-depleted (including those on diuretic therapy), or with poor kidney function may result in reduced kidney function, including kidney failure. These effects are usually reversible. There have been reports that aspirin and other NSAIDs such as ibuprofen (Advil, Children's Advil/Motrin, Medipren, Motrin, Nuprin, PediaCare Fever, etc.), indomethacin (Indocin, Indocin-SR), and naproxen (Anaprox, Naprelan, Naprosyn, Aleve) may reduce the effects of ARBs.
Diovan (Miten) Dosage
Diovan tablets come in doses of 40 mg, 80 mg, 160 mg, and 320 mg. For high blood pressure, doses range from 80 mg to 160 mg per day, but once your doctor finds the dose that is right for you, you might take up to 320 mg per day.
If you have congestive heart failure, you may take 40 mg twice a day. Adults should take no more than 320 mg of Diovan once your doctor has found the dose that works best for you and your condition.
Diovan can be taken with or without food, but taking Diovan with food may actually decrease the absorption of the drug by nearly 50 percent. For best results, try to take Diovan on an empty stomach.
But the agency also said that anyone taking medication that contains Miten should continue to take it unless told to stop by their doctor or pharmacist.
Nardine Nakhla, from the School of Pharmacy at the University of Waterloo in Ontario, emphasized that point in an email to CBC News.
"Patients should not stop taking their medicine if it contains Miten unless they've been specifically instructed to do so by their prescriber or pharmacist," Nakhla said. "Patients should contact their pharmacist(s) to see if the drugs they're taking are indeed the affected, recalled Miten products. The pharmacist can then figure out alternative medications that are unaffected by the recall."
Mina Tadrous, with the pharmacy faculty at the University of Toronto, said Miten is a commonly used drug for people with high blood pressure. He said that in announcing the recall, Health Canada is being "extra cautious, because there was some sort of negative lab result."
Still, if patients are responding well to the medication and the blood pressure is well controlled with the drug, "I would not suggest that anyone switch," Tadrous said.
"Don't suddenly stop this medication, especially if it works for you. Go talk to your pharmacist, check if your lot is even part of their , and if it is, they'll just switch you to a lot that's outside of it."
Some side effects can be serious. If you experience any of these symptoms or those listed in the SPECIAL PRECAUTIONS section, call your doctor immediately:
- swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
- difficulty breathing or swallowing
- unexplained weight gain
Miten may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).
What other information should I know?
Keep all appointments with your doctor and the laboratory. Your blood pressure should be checked regularly to determine your response to Miten.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.