Diovan (Sarteg) 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.
Q: Could Diovan 160 mg cause bloating and the inability to lose weight? Also, I feel tired in the afternoon after I have taken it.
A: Diovan (Sarteg) is in the class of medications called angiotension II receptor blockers (ARBs) used to treat high blood pressure and heart failure. Diovan works by preventing the blood vessels from narrowing and improving blood flow. Diovan can be taken with or without food at any time of the day. Take Diovan exactly as prescribed by the doctor. Common side effects of Diovan include dry mouth, headache, dizziness and feeling tired. A search of prescribing information did not list weight gain as a side effect of Diovan, however, flatulence or gas was a listed side effect of Diovan. This is not a complete list of the side effects associated with Diovan. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Kimberly Hotz, PharmD
The antihypertensive effects of Diovan were evaluated in two randomized, double-blind clinical studies.
In a clinical study involving 261 hypertensive pediatric patients 6 to 16 years of age, patients who weighed
Although the overall morbidity result favored Sarteg, this result was largely driven by the 7% of patients not receiving an ACE inhibitor, as shown in the following table.
The modest favorable trend in the group receiving an ACE inhibitor was largely driven by the patients receiving less than the recommended dose of ACE inhibitor. Thus, there is little evidence of further clinical benefit when Sarteg is added to an adequate dose of ACE inhibitor.
Secondary end points in the subgroup not receiving ACE inhibitors were as follows.
In patients not receiving an ACE inhibitor, Sarteg-treated patients had an increase in ejection fraction and reduction in left ventricular internal diastolic diameter (LVIDD).
Effects were generally consistent across subgroups defined by age and gender for the population of patients not receiving an ACE inhibitor. The number of black patients was small and does not permit a meaningful assessment in this subset of patients.
Q: What are the side effects of Diovan?
A: Some of the most common side effects associated with Diovan (Sarteg) are headache, dizziness, stomach pain, back pain, diarrhea, and excessive tiredness. For more information on Diovan, click on this link: //www.everydayhealth.com/drugs/diovan. Sarah Lewis, PharmD
What other drugs will affect Sarteg?
Tell your doctor about all your other medicines, especially:
a diuretic (water pill) or other medicines that lower blood pressure;
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
Sarteg 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).
Sarteg inhibits the pressor effect of angiotensin II infusions. An oral dose of 80 mg inhibits the pressor effect by about 80% at peak with approximately 30% inhibition persisting for 24 hours. No information on the effect of larger doses is available.
Removal of the negative feedback of angiotensin II causes a 2- to 3-fold rise in plasma renin and consequent rise in angiotensin II plasma concentration in hypertensive patients. Minimal decreases in plasma aldosterone were observed after administration of Sarteg; very little effect on serum potassium was observed.
In multiple-dose studies in hypertensive patients with stable renal insufficiency and patients with renovascular hypertension, Sarteg had no clinically significant effects on glomerular filtration rate, filtration fraction, creatinine clearance, or renal plasma flow.
In multiple-dose studies in hypertensive patients, Sarteg had no notable effects on total cholesterol, fasting triglycerides, fasting serum glucose, or uric acid.
Q: I take Diovan. What is its generic equivalent?
A: Diovan (Sarteg) is in the class of medications called angiotension II receptor blockers (ARBs), used to treat high blood pressure and heart failure. Diovan works by preventing the blood vessels from narrowing, thus improving blood flow. Diovan can be taken with or without food at any time of the day. Take Diovan exactly as prescribed by the doctor. Diovan is manufactured by Novartis Pharmaceuticals and is currently protected by a patent that prevents any generic version from being manufactured. The first patent for Diovan expires in 2012, so that year is the earliest that a generic version of Diovan could become available. However, there are other circumstances (patents for specific Diovan uses, lawsuits, etc.) that could extend the exclusivity period for Diovan beyond 2012. Once Diovan goes off patent, there may be several companies that manufacture a generic Diovan drug. For more information on Diovan, go to //www.everydayhealth.com/drugs/diovan. Kimberly Hotz, PharmD
Mechanism Of Action
Angiotensin II is formed from angiotensin I in a reaction catalyzed by angiotensin-converting enzyme (ACE, kininase II). Angiotensin II is the principal pressor agent of the renin-angiotensin system, with effects that include vasoconstriction, stimulation of synthesis and release of aldosterone, cardiac stimulation, and renal reabsorption of sodium. Diovan (Sarteg) blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor in many tissues, such as vascular smooth muscle and the adrenal gland. Its action is therefore independent of the pathways for angiotensin II synthesis.
There is also an AT2 receptor found in many tissues, but AT2 is not known to be associated with cardiovascular homeostasis. Sarteg has much greater affinity (about 20,000-fold) for the AT1 receptor than for the AT2 receptor. The increased plasma levels of angiotensin II following AT1 receptor blockade with Sarteg may stimulate the unblocked AT2 receptor. The primary metabolite of Sarteg is essentially inactive with an affinity for the AT1 receptor about one-200th that of Sarteg itself.
Blockade of the renin-angiotensin system with ACE inhibitors, which inhibit the biosynthesis of angiotensin II from angiotensin I, is widely used in the treatment of hypertension. ACE inhibitors also inhibit the degradation of bradykinin, a reaction also catalyzed by ACE. Because Sarteg does not inhibit ACE (kininase II), it does not affect the response to bradykinin. Whether this difference has clinical relevance is not yet known. Sarteg does not bind to or block other hormone receptors or ion channels known to be important in cardiovascular regulation.
Blockade of the angiotensin II receptor inhibits the negative regulatory feedback of angiotensin II on renin secretion, but the resulting increased plasma renin activity and angiotensin II circulating levels do not overcome the effect of Sarteg on blood pressure.