Caliak sumber untuak Valsartan

{{Pambantahan medis}}
{{Infobox drug
| drug_name =
| INN =
| type = <!-- empty -->
| image = Valsartan skeletal.svg
| width = 
| alt = 
| image2 = Valsartan ball-and-stick.png
| width2 = 
| alt2 = 
| imageL =
| widthL =
| altL = 
| imageR = 
| widthR = 
| altR = 
| caption = 
<!-- Clinical data -->
| pronounce =
| tradename = Diovan, Co Diovan, Valesco, dan lainnyo
| Drugs.com = {{drugs.com|monograph|valsartan}}
| MedlinePlus = a697015
| licence_CA = Sandoz Valsartan
| licence_EU = yes
| DailyMedID = 9402b022-5809-4251-dfef-54f6ef5723fe
| licence_US = Valsartan
| pregnancy_AU = D
| pregnancy_AU_comment = 
| pregnancy_US = D
| pregnancy_US_comment = 
| pregnancy_category = 
| dependency_liability = 
| addiction_liability = 
| routes_of_administration = Muluik
| class = [[Antagonis reseptor angiotensin II]]
<!-- Legal status -->
| legal_AU = <!-- S2, S3, S4, S5, S6, S7, S8, S9 or Unscheduled-->
| legal_AU_comment = 
| legal_BR = <!-- OTC, A1, A2, A3, B1, B2, C1, C2, C3, C4, C5, D1, D2, E, F-->
| legal_BR_comment =
| legal_CA = <!-- OTC, Rx-only, Schedule I, II, III, IV, V, VI, VII, VIII -->
| legal_CA_comment = 
| legal_DE = <!-- Anlage I, II, III or Unscheduled-->
| legal_DE_comment = 
| legal_NZ = <!-- Class A, B, C -->
| legal_NZ_comment = 
| legal_UK = <!-- GSL, P, POM, CD, CD Lic, CD POM, CD No Reg POM, CD (Benz) POM, CD (Anab) POM or CD Inv POM / Class A, B, C -->
| legal_UK_comment = 
| legal_US = Rx-only
| legal_US_comment = 
| legal_UN = <!-- N I, II, III, IV / P I, II, III, IV-->
| legal_UN_comment = 
| legal_status = <!--For countries not listed above-->
<!-- Pharmacokinetic data -->
| bioavailability = 25%
| protein_bound = 95%
| metabolism =
| metabolites =
| onset = 
| elimination_half-life = 6 hours
| duration_of_action =
| excretion = [[Ginjal]] 30%, [[ampadu]] 70%
<!-- Identifiers -->
| verifiedrevid = 470628341
| IUPAC_name = (''S'')-3-methyl-2-(''N''-<nowiki/>{[2'-(2''H''-1,2,3,4-tetrazol-5-yl)biphenyl-4-yl]methyl}pentanamido)butanoic acid
| index_label = <!-- parent -->
| index2_label = tritiated
| CAS_number_Ref = {{cascite|correct|??}}
| CAS_number = 137862-53-4
| CAS_supplemental = 
| ATCvet = 
| ATC_prefix = C09
| ATC_suffix = CA03
| ATC_supplemental =
| PubChem = 60846
| PubChemSubstance = 
| IUPHAR_ligand = 3937
| IUPHAR_ligand2 = 593
| DrugBank_Ref = {{drugbankcite|correct|drugbank}}
| DrugBank = DB00177
| ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}}
| ChemSpiderID = 54833
| UNII_Ref = {{fdacite|correct|FDA}}
| UNII = 80M03YXJ7I
| KEGG_Ref = {{keggcite|correct|kegg}}
| KEGG = D00400
| ChEBI_Ref = {{ebicite|correct|EBI}}
| ChEBI = 9927
| ChEMBL_Ref = {{ebicite|correct|EBI}}
| ChEMBL = 1069
| NIAID_ChemDB =
| PDB_ligand = 
| synonyms = 
<!-- Chemical and physical data -->
| chemical_formula = 
| C=24 | H=29 | N=5 | O=3
| molecular_weight = 435.519 g/mol
| SMILES = O=C(O)[C@@H](N(C(=O)CCCC)Cc3ccc(c1ccccc1c2n[nH]nn2)cc3)C(C)C
| Jmol = 
| StdInChI_Ref = {{stdinchicite|correct|chemspider}}
| StdInChI = 1S/C24H29N5O3/c1-4-5-10-21(30)29(22(16(2)3)24(31)32)15-17-11-13-18(14-12-17)19-8-6-7-9-20(19)23-25-27-28-26-23/h6-9,11-14,16,22H,4-5,10,15H2,1-3H3,(H,31,32)(H,25,26,27,28)/t22-/m0/s1
| StdInChIKey_Ref = {{stdinchicite|correct|chemspider}}
| StdInChI_comment = 
| StdInChIKey = ACWBQPMHZXGDFX-QFIPXVFZSA-N
| density = 
| density_notes = 
| melting_point = 
| melting_high = 
| melting_notes = 
| boiling_point = 
| boiling_notes = 
| solubility = 
| sol_units = 
| specific_rotation = 
}}
'''Valsartan''' adolah [[ubek]] dari golongan [[antagonis reseptor angiotensin II]]. Ubek ko bakarajo maambek reseptor angiotensin II sainggo takanan darah manurun dan baguno dek pandarito takanan darah tinggi ([[hipertensi]]), [[gagal jantuang]] (''heart failure''), jo [[panyakik ginjal diabetik]] (nefropati diabetik).<ref name="AHFS2019">{{cite web|url=https://www.drugs.com/monograph/valsartan.html|title=Valsartan Monograph for Professionals|website=Drugs.com|publisher=American Society of Health-System Pharmacists|accessdate=3 March 2019}}</ref> Valsartan tamasuak ubek kareh nan pamakaiannyo musti manyaratokan resep dokter.<ref>{{Cite web|url=https://www.alodokter.com/valsartan|title=Valsartan|date=2015-01-15|website=Alodokter|access-date=2020-01-08}}</ref> Valsartan tamasuak pulo dalam ubek kategori D nan aratinyo tabukti barisiko untuak janin.<ref name=":0">{{Cite web|url=http://pionas.pom.go.id/monografi/valsartan|title=VALSARTAN {{!}} PIO Nas|website=pionas.pom.go.id|access-date=2020-01-08|archive-date=2020-01-07|archive-url=https://web.archive.org/web/20200107055044/http://pionas.pom.go.id/monografi/valsartan|dead-url=yes}}</ref> 

Valsartan marupokan ubek nan dipakai jo caro diminum (oral) nan babantuak tablet.<ref name="AHFS2019" /> Di Indonesia ubek ko tasadio dalam bantuak generik dan ado juo dalam bantuak paten jo namo dagang tanamo yaitu Diovan.<ref name=":0" /><ref name="BNF76">{{cite book|title=British national formulary : BNF 76|date=2018|publisher=Pharmaceutical Press|isbn=9780857113382|pages=179|edition=76}}</ref> Valsartan tasadio pulo dalam bantuak kombinasi jo [[hidroklorotiazid]], [[amlodipin]], atau [[sakubitril]].<ref name="AHFS2019" /> 

Valsartan dikontraindikasikan pamakaiannyo pado urang nan [[hipersensitif]] jo kanduangan ubek ko sarato pandarito [[Diabetes melitus|diabetes mellitus]] nan mamakai ubek [[aliskerin]]. Valsartan juo indak disarankan pamakaiannyo pado urang jo gangguan ati (hepar) jo gangguan ginjal manangah inggo barek. Efek sampiang nan dapek muncua antaronyo latiah, paniang, kadar potasium tinggi dalam dalam (hiperkalemia), diare, jo sakik di sandi tulang. Efek paliang barek bisa sampai gangguan ginjal, takanan darah randah, jo sambok-sambok badan (angioedema).<ref name="AHFS2019" />

Valsartan alah tamasuak dalam Formularium Nasional (Fornas) nan dikaluakan Kementerian Kesehatan Indonesia. Ubek ko juo alah ditangguang dek BPJS Kesehatan jo syaraik pandarito indak dapek mamakai ubek [[antihipertensi]] golongan paambek ACE (''ACE Inhibitor'').<ref name=":1">{{Cite web|url=https://bpjs-kesehatan.go.id/bpjs/arsip/detail/490|title=BPJS Kesehatan|website=bpjs-kesehatan.go.id|access-date=2020-01-08|archive-date=2020-01-27|archive-url=https://web.archive.org/web/20200127160237/https://bpjs-kesehatan.go.id/bpjs/arsip/detail/490|dead-url=yes}}</ref> Pado taun 2018, babarapo merek dagang valsartan dilarang paredarannyo dek BPOM RI karano bahan bakunyo ado nan tabukti tacemar ''[[Nitrosodimethylamine]]'' (NDMA) nan bapotensi mamicu kanker (karsionogenik) pado pamakaian jangko lamo.<ref name=":3">{{Cite web|url=https://www.cnnindonesia.com/gaya-hidup/20180724122335-255-316537/mengenal-valsartan-bahan-obat-hipertensi-yang-ditarik-bpom|title=Mengenal Valsartan, Bahan Obat Hipertensi yang Ditarik BPOM|last=Setyanti|first=Christina Andhika|website=gaya hidup|language=en|access-date=2020-01-08}}</ref>

== Sediaan ubek ==
Valsartan marupokan ubek nan dipakai jo caro diminum. Ado duo bantuak sediaan nan ado, yaitu tablet jo ''oral solution''. Banntuak tablet marupokan bantuak nan acok dipakai di Indonesia. Tablet valsartan tasadio dalam dosis 40mg, 80 mg, 160 mg, inggo 320mg. Samantaro bantuak ''oral solution'' tasadio dalam dosis 4mg/mL. Bantuak ''oral solution'' ko marupokan bantuak cairan.<ref name=":2">{{Cite web|url=https://reference.medscape.com/drug/diovan-prexxartan-valsartan-342325#10|title=Diovan, Prexxartan (valsartan) dosing, indications, interactions, adverse effects, and more|website=reference.medscape.com|access-date=2020-01-28}}</ref>

==Indikasi==
[[Berkas:Two boxes and a blister pack of Co-Diovan (Valsartan and hydrochlorothiazide), Singapore - 20150210.jpg|jmpl|Duo kotak ubek valsartan kombinasi hidroklorotiazid]]
[[Berkas:Diovan 160 mg.jpg|jmpl|Tablet valsartan dosis 160 mg]]
Valsartan marupokan ubek nan dipakai untuak maubek takanan darah tinggi (hipertensi), gagal jantuang (''heart failure''), jo panyakik ginjal diabetik. Ubek ko dapek pulo manurunkan risiko kamatian pado urang jo gangguan fungsi ventikel kiri (''left ventricular dysfunction'') sasudah takanai sarangan jantuang (''heart attack'').<ref name=G&G>{{cite book |last=Randa |first=Hilal-Dandan |chapter=Chapter 26. Renin and Angiotensin |title=Goodman & Gilman's The Pharmacological Basis of Therapeutics |editor1-last=Brunton |editor1-first=L. L. |editor2-last=Chabner |editor2-first=Bruce |editor3-last=Knollmann |editor3-first=Björn C. | name-list-format = vanc |edition=12th |location=New York |publisher=McGraw-Hill |year=2011 |isbn=978-0-07-162442-8|title-link=Goodman & Gilman's The Pharmacological Basis of Therapeutics }}</ref><ref name="PI">{{cite web|url = http://www.pharma.us.novartis.com/product/pi/pdf/diovan.pdf | title = Diovan prescribing information | publisher = Novartis}}</ref>

Pado panyakik hipetensi, ubek ko bisa manjadi ubek piliahan partamo saroman ubek antihipertensi lainnyo.<ref name="AHFS2019" /> Namun, Di Indonesia pado urang nan hipertensi jo Jaminan Kesehatan Nasional (JKN) BPJS hanyo buliah dapek katiko ubek antihipertensinyo indak sasuai lai di dirinyo.<ref name=":1" />

== Kontraindikasi ==
Valsartan dikontraindikasikan pado urang [[diabetes melitus]] nan mamakai ubek aliskerin.<ref name="PI" />Salain itu, ubek ko dikontraiindikasikan pulo pado urang jo gangguan ginjal. Pado urang manganduang anak baitu pulo. ''Food and Drugs Administration'' (FDA) mamasuakan ubek ko dalam kategori D dek efeknyo nan babahayo pado janin nan dikanduang.<ref name="PI" /><ref name=Preg2019>{{cite web |title=Valsartan Pregnancy and Breastfeeding Warnings |url=https://www.drugs.com/pregnancy/valsartan.html |website=Drugs.com |accessdate=3 March 2019}}</ref> Ubek ko disarankan pulo untuak indak diagiah pado urang nan tangah manyusui.<ref name="lexi">{{cite web|url=http://webprod5.hc-sc.gc.ca/dpd-bdpp/index-eng.jsp|title=DIOVAN Product Monograph|website=Health Canada Drug Product Database|publisher=Novartis Pharmaceuticals Canada Inc.|access-date=5 November 2015|archive-date=23 September 2016|archive-url=https://web.archive.org/web/20160923014338/http://webprod5.hc-sc.gc.ca/dpd-bdpp/index-eng.jsp|dead-url=yes}}</ref>

==Farmakologi==

Valsartan bakarajo jo manyakek karajo angiotensin II nan dapek mampasampik ukuran pambuluah darah sarato maaktivasi aldosteron, sainggo takanan darah dapek turun. Ubek ko ka takabek jo reseptor angiotensin II tipe I nan bakarajo balawanan dari angiotensin II. Salayang, karajo valsartan sarupo jo ubek golongan panyakek ACE (''angiotensin-converting enzyme).'' Namun, nyatonyo babeda. Panyakek ACE bakarajo jo manyakek parubahan angiotensin I manjadi II sainggo dapek maalangi karajo lain dalam tubuah. Samantaro valsartan lansuang pado tampek lakek angiotensin II sainggo efeknyo hanyo pado nan dikandaki sarupo manurunan takanan darah, tapi karajo lain sarupo metabolisme bradikinin indak taganggu.

Valsartan masuak dalam tubuah malalui pamakaian sacaro oral (muluik). Katiko alah masuak dalam tubah, valsartan diedarkan dek protein darah. Ikatan jo protein sangaiklah arek inggo 95%. Efek alsartan dapek muncua dalam duo jam dan batahan inggo 24 jam. Valsartan ka dimetabolisme di hati nan kudian dibuang malalui kotoran (83%) jo urin (13%), jo wakatu paruah 6 jam dalam tubuah.<ref name="VALSARTAN 20172">{{cite web|url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=9402b022-5809-4251-dfef-54f6ef5723fe|title=Valsartan - Valsartan Tablet|date=2017-12-07|website=DailyMed|access-date=2019-02-06}}</ref><ref name=":2" />

== Paredaran ==
Valsartan nan baredar di pasaran tasadio dalam bantuak generik ataupun bantuak paten, baiak hanyo barisi valsartan surang ataupun kombinasi. Valsartan nan baredar dalam bantuak kombinasi ado nan dikombinasikan jo [[amlodipin]] atau [[hidroklorotiazid]] nan baguno untuak maubek hipertensi jo terapi nan kombinasi.<ref name="DailyMed">{{cite web|url=https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=valsartan&pagesize=20&page=1|title=Search Results for valsartan|website=DailyMed|access-date=2019-02-03}}</ref><ref name="DailyMed 2018">{{cite web|url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=2e1d5c9d-f161-45ef-a2b0-702567139dc3|title=Amlodipine, Valsartan And Hydrochlorothiazide- Amlodipine, Valsartan And Hydrochlorothiazide Tablet|date=2018-02-13|website=DailyMed|access-date=2019-02-03}}</ref> Kombinasi lain nan ado yaitu [[valsartan/sakubitril]] (''valsartan/sacubitril'') nan baguno untuak pandarito gagal jantuang jo fraksi ejeksi bakurang (''heart failure with reduced ejection fraction'').<ref name="pmid26557227">{{cite journal|vauthors=Fala L|title=Entresto (Sacubitril/Valsartan): First-in-Class Angiotensin Receptor Neprilysin Inhibitor FDA Approved for Patients with Heart Failure|journal=Ah & Db|volume=8|issue=6|pages=330–334|date=September 2015|pmc=4636283|pmid=26557227}}</ref><ref name="Entresto, a New Panacea for Heart Failure?">{{cite journal|vauthors=Khalil P, Kabbach G, Said S, Mukherjee D|title=Entresto, a New Panacea for Heart Failure?|journal=Cardiovascular & Hematological Agents in Medicinal Chemistry|volume=16|issue=1|pages=5–11|date=2018|doi=10.2174/1871525716666180313121954|pmid=29532764}}</ref>

=== Panarikan ===
Pado 6 Juli 2018, ''Eupopean Medicines Agency'' (EMA) malakukan palarangan edar untuak valsartan tongga atau valsartan kombinasi nan baredar di [[Eropa]] inggo [[Kanada]].<ref name=":22">{{cite news|last1=Christensen|first1=Jen|title=Common heart drug recalled in 22 countries for possible cancer link|url=https://www.cnn.com/2018/07/06/health/valsartan-heart-drug-recall-intl/index.html|website=CNN|access-date=14 July 2018|name-list-format=vanc}}</ref> Palarangan edar ko hanyo balaku untuak valsartan nan manggunokan bahan baku buatan [[Zhejiang Huahai Pharmaceutical Co.]] (ZHP) di [[Linhai|Linhai,]] [[Republik Rakyaik Cino|Cino]]. Hal iko dilakukan dengan pado zat aktif tasabuik takontaminasi jo N-nitrosodimetilamin (NDMA) nan karsinogenik (bapotensi mamicu kanker).<ref name="carcinogen">{{cite news|title=Carcinogens Have Infiltrated the Generic Drug Supply in the U.S.|work=Bloomberg News|date=12 September 2019|url=https://www.bloomberg.com/news/features/2019-09-12/how-carcinogen-tainted-generic-drug-valsartan-got-past-the-fda|access-date=17 September 2019|first1=Anna|last1=Edney|first2=Susan|last2=Berfield|first3=Evelyn|last3=Yu|name-list-format=vanc}}</ref> Diikuti pulo jo FDA (Food and Drug Adminitration; badan ubek Amerika Serikat) untuak malarang paredarannyo.<ref>{{cite press release|url=https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm620499.htm|website=[[Food and Drug Administration]] (FDA)|title=FDA provides update on its ongoing investigation into valsartan products; and reports on the finding of an additional impurity identified in one firm's already recalled products|date=13 September 2018|access-date=14 September 2018}}</ref> Di Indonesia, BPOM malakukan hal nan samo pulo <ref name=":3" /> nan diikuti nagara-nagara lainnyo.<ref>{{cite news|last=Harney|first=Alexandra|first2=Ben|last2=Hirschler|title=Toxin at heart of drug recall shows holes in medical safety net|website=Reuters|date=22 August 2018|url=https://www.reuters.com/article/us-health-pharmaceuticals-china-insight-idUSKCN1L71D8|access-date=23 November 2018|name-list-format=vanc}}</ref>

== Rujuakan ==
{{Reflist|2}}
[[Kategori:Ubek]]
[[Kategori:Antihipertensi]]