From the Guidelines
Valsartan should be held if systolic blood pressure is less than 90 mmHg, serum potassium levels exceed 5.5 mEq/L, or if there is acute kidney injury with a serum creatinine increase of more than 30% from baseline, as recommended by the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults 1.
The hold parameters for Valsartan are crucial to prevent potential adverse effects, particularly hypotension, hyperkalemia, and acute kidney injury.
- Hypotension can occur if the patient's systolic blood pressure is less than 90 mmHg, and valsartan should be held to avoid further decreasing blood pressure.
- Hyperkalemia is a concern if serum potassium levels exceed 5.5 mEq/L, as valsartan can increase potassium levels by blocking angiotensin II receptors.
- Acute kidney injury with a serum creatinine increase of more than 30% from baseline is another indication to hold valsartan, as the medication can alter kidney function in certain clinical situations.
Additionally, valsartan should be temporarily discontinued before major surgery and in situations of severe volume depletion, such as excessive vomiting, diarrhea, or diuretic overuse.
- If a patient is pregnant or planning pregnancy, valsartan must be discontinued immediately, as it can cause fetal harm, especially in the second and third trimesters, as stated in the guideline 1.
- When holding valsartan, patients should monitor their blood pressure regularly and contact their healthcare provider for guidance on when to resume the medication.
It is essential to note that these hold parameters are based on the most recent and highest-quality studies, including the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Hold Parameters for Valsartan
The hold parameters for Valsartan are not explicitly stated in the provided studies. However, the following information can be gathered:
- Valsartan is an angiotensin II receptor antagonist used to treat hypertension and heart failure 2, 3, 4, 5, 6.
- The dosage of Valsartan varies depending on the condition being treated, with common dosages ranging from 80 mg/day to 320 mg/day 2, 3, 4, 5, 6.
- Hold parameters may include:
- Hypotension: Valsartan can cause a decrease in blood pressure, and patients with hypotension may need to have their dosage adjusted or discontinued 2, 3, 4, 5, 6.
- Renal impairment: Valsartan can affect renal function, and patients with renal impairment may need to have their dosage adjusted or discontinued 2, 3, 4, 5, 6.
- Hyperkalemia: Valsartan can cause an increase in potassium levels, and patients with hyperkalemia may need to have their dosage adjusted or discontinued 3, 4, 5, 6.
- Orthostatic dizziness or fatigue: Valsartan can cause dizziness or fatigue, and patients experiencing these symptoms may need to have their dosage adjusted or discontinued 2, 3, 4, 5, 6.
- Monitoring parameters may include:
- Blood pressure: Regular monitoring of blood pressure is necessary to assess the effectiveness of Valsartan and to adjust the dosage as needed 2, 3, 4, 5, 6.
- Renal function: Regular monitoring of renal function is necessary to assess the safety of Valsartan and to adjust the dosage as needed 2, 3, 4, 5, 6.
- Potassium levels: Regular monitoring of potassium levels is necessary to assess the safety of Valsartan and to adjust the dosage as needed 3, 4, 5, 6.