5 Valsartan Interactions You Should Know About
Key takeaways:
Valsartan (Diovan) is a prescription angiotensin II receptor blocker (ARB) medication. It’s commonly used to treat high blood pressure and heart failure. It can also help lower the risk of death after a heart attack.
Valsartan can interact with medications that increase potassium and certain blood pressure medications. Examples include lisinopril (Zestril, Qbrelis), spironolactone (Aldactone), and potassium supplements. It can also interact with lithium (Lithobid) and ibuprofen (Advil, Motrin).
Some valsartan interactions can be managed with close monitoring. Others should generally be avoided altogether. Your prescriber can determine how best to manage any potential interactions.
Table of contents
Whether you’re taking valsartan (Diovan) for high blood pressure, heart failure, or after a heart attack, it’s good to know the basics. Knowing how to take it and what side effects to expect is important. But potential interactions are another factor to consider.
Valsartan belongs to a class of medications called angiotensin II receptor blockers (ARBs). It has several important interactions. Common examples include certain over-the-counter (OTC) pain relievers and blood pressure medications.
Before starting valsartan — or adding a new medication to your regimen while you’re taking it — be aware that there can be potential interactions. Your healthcare team will be checking for interactions as well, but it’s still good to know what to look for. Here’s what you should know about valsartan interactions.
Valsartan interactions
The following medications and foods can interact with valsartan:
Angiotensin-converting enzyme (ACE) inhibitors, such as lisinopril (Zestril, Qbrelis) and benazepril (Lotensin)
Aliskiren (Tekturna)
Potassium-sparing diuretics, such as amiloride (Midamor) or triamterene (Dyrenium)
Mineralocorticoid receptor antagonists, such as spironolactone (Aldactone), eplerenone (Inspra), or finerenone (Kerendia)
Potassium-rich foods, such as avocados
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn)
Lithium (Lithobid)
This isn’t a complete list. So be sure to check with your healthcare team before starting a new medication with valsartan. Below, we’ll dig deeper into what you should know about five common valsartan interactions.
1. Medications that increase potassium
All ARBs, including valsartan, can increase potassium levels in your blood. When your potassium levels get too high, this is called hyperkalemia. Taking valsartan with other medications that also increase potassium can increase this risk. Examples of these medications include:
ACE inhibitors
Aliskiren
Potassium-sparing diuretics
Mineralocorticoid receptor antagonists
Potassium supplements
Hyperkalemia doesn’t always cause obvious symptoms. Your healthcare team may find it during a routine follow up. But you should let them know if you develop symptoms such as muscle weakness, tingling or numbness, and fatigue.
Valsartan side effects: Do you feel dizzy after taking valsartan? Learn more about potential valsartan side effects and how to manage them.
How much to take: What’s a normal valsartan dosage? Here’s what you should know about valsartan dosages, plus what to do if you miss your dose.
How they compare: Valsartan and losartan are similar medications for high blood pressure. Learn more about how valsartan and losartan compare.
A fast or irregular heartbeat can be a sign of serious hyperkalemia, which can become life-threatening. Get immediate medical attention if this develops while you’re taking valsartan.
2. NSAIDs like ibuprofen
NSAIDs are commonly taken for pain and fever. But taking an NSAID with valsartan can worsen your kidney function. Older adults, people with kidney problems, and those taking diuretics (water pills) may be at higher risk. What’s more, NSAIDs may prevent valsartan from working as well.
Several NSAIDs are available OTC, such as ibuprofen and naproxen. Ask your prescriber or pharmacist before taking an NSAID with valsartan. You can also ask if an alternative pain reliever may be a better choice.
Good to know: If you have heart failure or have recently had a heart attack, it’s generally recommended to avoid NSAIDs altogether.
3. ACE inhibitors like lisinopril
ACE inhibitors, such as lisinopril and benazepril, are very similar to ARBs. They both work on the same system that helps regulate blood pressure, but at different places along the pathway. However, you’ll typically be prescribed one or the other — not both.
Combining valsartan with an ACE inhibitor isn’t expected to have additional benefits. And taking them together can actually increase your risk of side effects. This can include low blood pressure (hypotension), hyperkalemia, and kidney problems. So this combination is usually avoided.
4. Aliskiren
Aliskiren is another blood pressure medication. Like ACE inhibitors, it also works by acting on the same system as valsartan. Similarly, taking valsartan with aliskiren isn’t expected to provide any extra benefits. Instead, this combination can increase your risk of side effects.
Because of this, it’s generally recommended to avoid taking valsartan and aliskiren together. This is especially the case if you have diabetes or kidney problems.
5. Lithium
Lithium is a medication used to treat bipolar disorder. Taking it with valsartan can increase lithium levels in your body. This can raise the risk of lithium side effects and toxicity. Mild toxicity symptoms can include tremors, blurry vision, and coordination or balance problems.
It’s possible that you may be prescribed lithium and valsartan together. Your healthcare team will likely monitor your lithium levels during follow-up appointments. If your levels are too high, they may need to lower your lithium dose.
If any lithium toxicity symptoms develop, contact your healthcare team right away. Symptoms such as confusion, a fast heart rate, and seizures require immediate medical attention.
When should you contact your prescriber about a valsartan interaction?
First, ensure that your prescriber and pharmacist have a current list of your medications. They can help identify potential valsartan interactions before they occur. And be sure to inform them of any medication changes if you’re already taking valsartan.
Some medications are prescribed with valsartan, even if they interact. In this case, your prescriber may want to monitor your blood work more closely during treatment. But it’s still important to let them know if any new or worsening symptoms develop.
Frequently asked questions
Based on clinical trial data, the most common valsartan side effect is dizziness. Dizziness may be more likely shortly after you start valsartan and when your dose is increased. See how valsartan affects you before driving or doing tasks where dizziness is dangerous. Sit or lie down if you’re feeling dizzy. Change positions slowly, such as going from sitting to standing, to avoid falls.
There aren’t specific foods that you need to avoid entirely while taking valsartan. But it’s a good idea to be cautious with potassium-rich foods and salt substitutes that contain potassium. For your heart health, it’s best to minimize the following foods and drinks while taking valsartan:
Salty foods, such as chips, ready-made meals, jerky, and cured meats
Foods high in saturated fats, such as fried foods and breakfast sausage
Sugary foods and drinks, such as ice cream and soda
Caffeine-containing beverages, such as energy drinks
It may not be safe for certain people to take valsartan. This might include you if you’re:
Allergic to valsartan or any of its ingredients
Taking aliskiren and you have diabetes
Pregnant
Your healthcare team will determine if valsartan is safe for you to take.
The bottom line
Valsartan (Diovan) can interact with other medications that also increase potassium levels. And taking it with angiotensin-converting enzyme (ACE) inhibitors, aliskiren (Tekturna), or nonsteroidal anti-inflammatory drugs (NSAIDs) can increase your risk of side effects. Valsartan can also increase lithium (Lithobid) levels, which can raise the risk of lithium toxicity.
Talk to your prescriber and pharmacist before starting valsartan. They can check to see if it interacts with any of your other medications.
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References
A-S Medication Solutions. (2024). Valsartan- valsartan tablet [package insert].
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