NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Medicines Update

Valsartan Supply Problem

Valsartan Shortage

There are currently supply problems with valsartan products.  Where a patient is unable to obtain their normal valsartan prescription, prescribers may need to consider switching patients to an alternative Angiotensin-II receptor antagonist (AIIRA).

Valsartan is licensed for:
 
Hypertension – all eight AIIRAs on the UK market are licensed for hypertension. 
Heart Failure - candesartan and losartan are licensed for heart failure and are the preferred list options in the NHSGGC Formulary.
Post-MI with left ventricular failure or left ventricular systolic dysfunction (LVSD) – there are no other AIIRAs licensed for use in the post-MI setting and specialist advice should be sought before switching to an alternative.

There is no information on direct dose-equivalences of AIIRAs, the table below provides approximate conversions for the Formulary preferred list options. When changing from one drug to another, consideration should be given to where on the dosing range the current dose falls, ie bottom, middle or top of range.  If switching from a twice daily valsartan dose to a once daily dose of an alternative such as losartan or candesartan, the patient should be advised of this to reduce the risk of a dosing error.

AIIRA

Approximate Dose conversions (monitor BP following switch and adjust as needed)

Valsartan

40mg DAILY*

80mg DAILY*

160mg DAILY*

320mg DAILY*

Candesartan

4mg DAILY

8mg DAILY

16mg DAILY

16-32mg DAILY

Losartan**

25mg DAILY

50mg DAILY

100mg DAILY

 

* Dose may be given as two divided doses.
** The target dose of losartan for heart failure is 150mg daily if tolerated.

Acknowledgement: Yuet Wan, London and South East Regional Medicines Information Service

 

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