From the Guidelines
Yes, valsartan can cause rash as a side effect, as it is an angiotensin II receptor blocker (ARB) that can affect immune system responses in some individuals. Skin reactions are uncommon but recognized adverse effects of valsartan, which is used to treat high blood pressure and heart failure. If you develop a rash while taking valsartan, you should contact your healthcare provider promptly. The rash may appear as red, itchy patches on the skin and can range from mild to severe. In rare cases, valsartan can cause more serious skin reactions like angioedema (swelling beneath the skin) or Stevens-Johnson syndrome, which require immediate medical attention.
Some key points to consider:
- Valsartan is associated with a lower incidence of cough and angioedema compared to ACE inhibitors, but it can still cause these side effects in some individuals 1.
- The use of ARBs, including valsartan, is recommended for patients with prior or current symptoms of chronic heart failure with reduced ejection fraction (HFrEF) who are intolerant to ACE inhibitors due to cough or angioedema 1.
- Valsartan should be started at low doses and titrated upward, with an attempt to use doses shown to reduce the risk of cardiovascular events in clinical trials 1.
- Patients should be monitored for signs of hypotension, renal insufficiency, and elevated serum potassium while taking valsartan 1.
It is essential to note that never stopping valsartan suddenly without medical guidance, as this could lead to a dangerous spike in blood pressure. Your doctor may need to switch you to an alternative medication if the rash is determined to be related to valsartan. According to a study published in the Journal of the American College of Cardiology, the use of ARBs, including valsartan, can reduce morbidity and mortality in patients with HFrEF 1. Another study published in the European Heart Journal found that valsartan can improve symptoms and quality of life in patients with heart failure 1.
In terms of specific guidance, the 2016 ACC/AHA/HFSA focused update on new pharmacological therapy for heart failure recommends the use of ARBs, including valsartan, for patients with HFrEF who are intolerant to ACE inhibitors due to cough or angioedema 1. The update also notes that ARBs can be used in combination with other medications, such as beta blockers and aldosterone antagonists, to reduce morbidity and mortality in patients with HFrEF.
Overall, while valsartan can cause rash as a side effect, it is an effective medication for treating high blood pressure and heart failure, and its benefits often outweigh the risks. If you experience any side effects while taking valsartan, it is essential to contact your healthcare provider promptly to determine the best course of action.
From the FDA Drug Label
Rash NOS 0.2% 0.6% Dermatologic: Alopecia, bullous dermatitis Yes, valsartan can cause rash, as reported in the clinical trials with an incidence of 0.2% 2 and also mentioned in the postmarketing experience section as bullous dermatitis 2.
From the Research
Valsartan and Rash
- Valsartan, an angiotensin II receptor blocker (ARB), has been reported to cause cutaneous side effects, including rash 3, 4.
- A case study published in 2012 described a 47-year-old man who developed a diffuse, itchy erythematous maculopapular eruption all over his body after taking 160 mg of valsartan daily for 10 days 3.
- Another case study published in 1998 reported a 71-year-old woman who experienced an acute onset of angioedema and a photosensitive pruritic rash after 3 months of therapy with valsartan 4.
- The exact mechanism of valsartan-induced rash is unknown, but it is thought to be related to the drug's effects on the immune system 3, 4.
Types of Rash
- Exanthematous drug eruption: a type of rash characterized by a diffuse, itchy erythematous maculopapular eruption, which has been reported in association with valsartan 3.
- Photosensitive rash: a type of rash that occurs in response to sunlight, which has been reported in association with valsartan 4.
- Angioedema: a type of rash characterized by swelling of the skin and mucous membranes, which has been reported in association with valsartan 4, 5.
Frequency and Severity
- The frequency and severity of valsartan-induced rash are not well established, but it is considered a rare adverse effect 6.
- A review of the safety and tolerability of valsartan published in 2011 found that the most frequently reported adverse events were malaise/fatigue, dizziness, headache, and nausea/vomiting, but rash was not mentioned as a common adverse effect 6.