Diovan (Valsartan) is the ARB in This Medication List
Diovan, which contains valsartan, is an angiotensin receptor blocker (ARB) and is the medication from your list that blocks the renin-angiotensin system. 1
Medication Classification
From the provided list, here is the breakdown:
- Diovan (Valsartan): ARB - the answer to your question 1
- Metformin: Biguanide antidiabetic agent 1
- Amaryl (Glimepiride): Sulfonylurea antidiabetic agent 1
- Lipanthyl (Fenofibrate): Fibrate lipid-lowering agent 1
- Crestor (Rosuvastatin): Statin lipid-lowering agent 1
- Vitamin D3: Nutritional supplement 1
- Vitamin B complex: Nutritional supplement 1
- Finerenone: Nonsteroidal mineralocorticoid receptor antagonist (ns-MRA) 1, 2, 3
- Veltassa (Patiromer): Potassium binder 4
Clinical Context for Stage 3B CKD with Type 2 Diabetes
In this patient with Stage 3B CKD (eGFR 30-44 mL/min/1.73 m²) and type 2 diabetes, continuing valsartan is appropriate and guideline-recommended. 1, 5
Key Management Points:
Continue the ARB (valsartan) even with Stage 3B CKD, as KDIGO guidelines explicitly recommend continuing ACE inhibitors or ARBs even when eGFR falls below 30 mL/min/1.73 m², with consideration for discontinuation only at eGFR <15 mL/min/1.73 m² if symptomatic hypotension, uncontrolled hyperkalemia, or uremic symptoms develop 1, 5
Monitor serum creatinine and potassium within 2-4 weeks after any dose adjustment of valsartan 1
Accept up to 30% creatinine rise after initiating or increasing valsartan dose, as this reflects the desired hemodynamic effect of reducing intraglomerular pressure and is not acute kidney injury 1, 5
The combination of finerenone with valsartan is appropriate for this patient with CKD and type 2 diabetes, as finerenone reduces cardiovascular events and CKD progression when added to standard RAS blockade 1, 2, 3
Veltassa (patiromer) enables continuation of both valsartan and finerenone by managing hyperkalemia without requiring discontinuation of these cardiorenal protective agents 4, 6
Critical Caveat:
Never combine valsartan with an ACE inhibitor or direct renin inhibitor, as dual RAS blockade markedly increases hyperkalemia risk without improving outcomes and is potentially harmful 1, 7