For patients with mild hepatic impairment (Child-Pugh class A), the usual valsartan dose may be maintained. However, close monitoring of blood pressure and renal function is recommended.
Moderate and Severe Hepatic Impairment
Valsartan is contraindicated in patients with moderate to severe hepatic impairment (Child-Pugh class B and C). The drug is extensively metabolized in the liver, and reduced hepatic function significantly impacts clearance. Administering valsartan to these patients poses a substantial risk of drug accumulation and potentially severe adverse effects. Alternative antihypertensive agents with different metabolic pathways should be considered.
Monitoring and Precautions
Regular monitoring of liver function tests (LFTs) is crucial for patients with any degree of hepatic impairment receiving valsartan, even if the dose is unchanged. Any significant abnormalities in LFTs should prompt a reevaluation of the medication and potentially a switch to an alternative treatment. Remember to always consult current prescribing information and clinical guidelines before making dosage decisions.
