natgillin/translations-raw huggingface dataset:
Daily oral dosing of neonatal/juvenile rats (from a postnatal day 7 to postnatal day 70) with valsartan at doses as low as 1 mg/kg/day (about 10-35% of the maximum recommended paediatric dose of 4 mg/kg/day on systemic exposure basis) produced persistent, irreversible kidney damage. 
Vsakodnevno peroralno odmerjanje valsartana novorojenim/mladim podganam (od 7. do 70. dne po porodu) v višini samo 1 mg/kg/dan (kar je približno 10-35 % najvišjega priporo enega pediatri nega odmerka 4 mg/kg/dan glede na sistemsko izpostavljenost zdravilu) je povzro ilo persistentno neozdravljivo okvaro ledvic.
MARKETING AUTHORISATION NUMBER [To be completed nationally] 
ŠTEVILKA DOVOLJENJA ZA PROMET [Izpolni država lanica]
• elevation of liver function values (which can indicate liver damage) including an increase of bilirubin in the blood (which can trigger yellow skin and eyes in severe cases) 
• zvišane vrednosti jetrnih testov (kar lahko kaže na poškodbo jeter), vklju no z zvišano koncentracijo bilirubina v krvi (ki lahko v hudih primerih povzro i porumenelost kože in o i)
• to treat symptomatic heart failure in adult patients. 
• Za zdravljenje simptomatskega sr nega popuš anja pri odraslih bolnikih.
The antihypertensive effect of valsartan have been evaluated in four randomized, double-blind clinical studies in 561 paediatric patients from 6 to 18 years of age and 165 paediatric patients 1 to 6 years of age. 
Antihipertenzivno delovanje valsartana so ocenjevali v štirih randomiziranih, dvojno slepih klini nih študijah s 561 pediatri nimi bolniki v starosti od 6 do 18 let in s 165 pediatri nimi bolniki v starosti od 1 leta do 6 let.
In controlled clinical studies in adult patients with hypertension, the overall incidence of adverse reactions (ADRs) was comparable with placebo and is consistent with the pharmacology of valsartan. 
V kontroliranih klini nih študijah pri odraslih bolnikih s hipertenzijo je bila pogostnost vseh neželenih u inkov primerljiva s tisto pri placebu in v skladu s farmakologijo valsartana.
• If you have any further questions, ask your doctor or pharmacist. 
e imate dodatna vprašanja, se posvetujte z zdravnikom ali s farmacevtom.
This combination apparently increases the risk for adverse events and is therefore not recommended. 
Kaže, da ta kombinacija pove uje tveganje za neželene u inke, zato ni priporo ena.
Treatment of clinically stable adult patients with symptomatic heart failure or asymptomatic left ventricular systolic dysfunction after a recent (12 hours-10 days) myocardial infarction (see sections 4.4 and 5.1). 
Zdravljenje klini no stabilnih odraslih bolnikov s simptomatskim sr nim popuš anjem ali asimptomatsko sistoli no disfunkcijo levega prekata po nedavnem miokardnem infarktu (12 ur10 dni) (glejte poglavji 4.4 in 5.1).
In a study of 26 paediatric hypertensive patients (aged 1 to 16 years) given a single dose of a suspension of valsartan (mean: 0.9 to 2 mg/kg, with a maximum dose of 80 mg), the clearance (litres/h/kg) of valsartan was comparable across the age range of 1 to 16 years and similar to that of adults receiving the same formulation. 
V študiji s 26 pediatri nimi hipertenzivnimi bolniki (v starosti od 1 leta do 16 let), ki so prejeli en sam odmerek valsartana v obliki suspenzije (povpre no 0,9 do 2 mg/kg, pri emer je bil najvišji odmerek 80 mg), je bilo izlo anje valsartana (v litrih na uro na kilogram) primerljivo pri vseh starostih od 1 leta do 16 let, in podobno izlo anju pri odraslih, ki uporabljajo isto obliko zdravila.
With the exception of isolated gastrointestinal disorders (like abdominal pain, nausea, vomiting) and dizziness, no relevant differences in terms of type, frequency and severity of adverse reactions were identified between the safety profile for paediatric patients aged 6 to 18 years and that previously reported for adult patients. 
Razen posameznih prebavnih motenj (kot so bole ine v trebuhu, navzea, bruhanje) in omoti nosti, med varnostnimi lastnostmi zdravila pri pediatri nih bolnikih, starih 6 do 18 let, in že opisanimi varnostnimi lastnostmi pri odraslih, niso ugotovili bistvenih razlik glede vrste, pogostnosti ali izraženosti neželenih u inkov.
In a clinical trial of patients with a history of dry cough during ACE inhibitor therapy, 19.5% of trial subjects receiving valsartan and 19.0% of those receiving a thiazide diuretic experienced cough compared to 68.5% of those treated with an ACE inhibitor (p<0.05). 
V klini nem preskušanju pri bolnikih, ki so imeli v anamnezi suh kašelj v asu zdravljenja z zaviralcem ACE, je do kašlja prišlo pri 19,5 % preiskovancev, ki so dobivali valsartan, pri 19,0 % tistih, ki so prejemali tiazidni diuretik, in pri 68,5 % preiskovancev, ki so dobivali zaviralec ACE (p < 0,05).
In patients receiving the low dose of valsartan, systolic blood pressure at trough was similar to that of patients who received the placebo treatment. 
Pri bolnikih, ki so prejemali nizke odmerke valsartana, je bila najnižja vrednost sistoli nega krvnega tlaka podobna vrednosti pri bolnikih, ki so prejemali placebo.
However, other agents that affect the renin-angiotensin system may increase blood urea and serum creatinine in patients with unilateral renal artery stenosis, therefore monitoring of renal function is recommended when patients are treated with valsartan. 
Vendar pa lahko druga zdravila, ki vplivajo na renin-angiotenzinski sistem, pove ajo vrednosti dušika se nine v krvi in kreatinina v serumu pri bolnikih z enostransko stenozo ledvi ne arterije, zato je med zdravljenjem bolnikov z valsartanom priporo eno spremljanje ledvi ne funkcije.
Side effects include: 
Navodilo vsebuje:
The use of Angiotensin II Receptor Antagonists (AIIRAs) is not recommended during the first trimester of pregnancy (see section 4.4). 
Uporaba antagonistov angiotenzina II v prvem trimese ju nose nosti ni priporo ljiva (glejte poglavje 4.4).
As valsartan is an angiotensin II antagonist, it cannot be excluded that the use of Diovan may be associated with impairment of the renal function. 
Ker je valsartan antagonist angiotenzina II, ni mogo e izklju iti, da je uporaba zdravila Diovan lahko povezana z okvaro delovanja ledvic.
The ADRs reported from clinical studies, post-marketing experience and laboratory findings are listed below according to system organ class. 
Neželeni u inki, o katerih so poro ali v klini nih študijah, na podlagi izkušenj po za etku trženja zdravila in laboratorijskih izvidov, so po organskih sistemih našteti v spodnji preglednici.
• if you have severe kidney disease or if you are undergoing dialysis. 
• e imate hude težave z ledvicami ali e se zdravite z dializo,
In another clinical study involving 300 hypertensive paediatric patients 6 to 18 years of age, eligible patients were randomized to receive valsartan or enalapril tablets for 12 weeks. 
V drugi klini ni študiji, v katero je bilo vklju enih 300 hipertenzivnih pediatri nih bolnikov v starosti od 6 do 18 let, so bolnike, ki so bili primerni za vklju itev, randomizirali tako, da so 12 tednov prejemali tablete z bodisi valsartanom ali enalaprilom.
The combination with ACE inhibitors is not recommended (see sections 4.4 and 5.1). 
Kombinacija z zaviralci ACE ni priporo ljiva (glejte poglavji 4.4 in 5.1).
• breathlessness, difficulty breathing when lying down, swelling of the feet or legs (signs of cardiac failure) 
• zadihanost, težave z dihanjem v ležeem položaju, oteklina stopal in nog (znaki srnega popušanja)
In this subgroup all-cause mortality was significantly reduced with valsartan compared to placebo by 33% (95% CI: -6% to 58%) (17.3% valsartan vs. 27.1% placebo) and the composite mortality and morbidity risk was significantly reduced by 44% (24.9% valsartan vs. 42.5% placebo). 
V tej podskupini je bila umrljivost iz vseh vzrokov z valsartanom statisti no zna ilno manjša za 33 % v primerjavi s placebom (95 % IZ: -6 % do 58 %) (17,3 % pri valsartanu v primerjavi s 27,1 % pri placebu), tveganje glede sestavljene umrljivosti in obolevnosti pa je bilo statisti no zna ilno manjše za 44 % (24,9 % pri valsartanu v primerjavi z 42,5 % pri placebu).
Paediatric heart failure and recent myocardial infarction Diovan is not recommended for the treatment of heart failure or recent myocardial infarction in children and adolescents below the age of 18 years due to the lack of data on safety and efficacy. 
Sr no popuš anje in nedavni miokardni infarkt pri pediatri nih bolnikih Zaradi pomanjkanja podatkov o varnosti in u inkovitosti uporaba zdravila Diovan ni priporo ljiva za zdravljenje sr nega popuš anja ali nedavnega miokardnega infarkta pri otrocih in mladostnikih, ki so mlajši od 18 let.
Discontinuations due to various types of renal dysfunction occurred in 1.1% of valsartan-treated patients, 1.3% in valsartan+captopril patients, and 0.8% of captopril patients. 
Do prekinitve zdravljenja zaradi razli nih vrst ledvi ne disfunkcije je prišlo pri 1,1 % bolnikov, ki so se zdravili z valsartanom, pri 1,3 % bolnikov, ki so se zdravili s kombinacijo valsartana in kaptoprila, in pri 0,8 % bolnikov, ki so se zdravili s kaptoprilom.
For maximum doses studied in clinical trials please refer to the table below. 
Najvišji odmerki, ki so jih prou evali v klini nih preskušanjih, so navedeni v spodnji preglednici.
In the second study, higher doses of valsartan were associated with greater BP reductions, but the dose response trend did not achieve statistical significance and the treatment difference compared to placebo was not significant. 
V drugi študiji se je pokazala povezava med višjimi odmerki in ve jim znižanjem krvnega tlaka, vendar trend odvisnosti odziva od odmerka ni dosegel statisti ne zna ilnosti, pa tudi razlika zaradi zdravljenja v primerjavi s placebom ni bila statisti no zna ilna.
If this applies to you, the use of Diovan is not recommended. 
e pride do tega pri vas, uporaba zdravila Diovan ni priporo ena,
- Hypersensitivity to the active substance or to any of the excipients. 
- Preob utljivost za zdravilno u inkovino ali katerokoli pomožno snov.
At 24 weeks, UAE was reduced (p <0.001) by 42% (-24.2 µg/min; 95% CI: -40.4 to -19.1) with valsartan and approximately 3% (-1.7 µg/min; 95% CI: -5.6 to 14.9) with amlodipine despite similar rates of blood pressure reduction in both groups. 
Po 24 tednih se je izlo anje albumina z urinom zmanjšalo (p < 0,001) za 42 % (-24,2 µg/min; 95 % IZ: -40,4 do -19,1) z valsartanom in približno za 3 % (-1,7 µg/min; 95 % IZ: -5,6 do 14,9) z amlodipinom kljub podobnemu obsegu zmanjšanja krvnega tlaka pri obeh skupinah.
Because of these inconsistencies, valsartan is not recommended in this age group (see section 4.8). 
Zaradi navedenih neskladnosti v rezultatih uporaba valsartana ni priporo ena za to starostno skupino (glejte poglavje
No children below the age of 1 year were enrolled in these studies. 
V ti dve študiji niso vklju evali otrok, ki bi bili mlajši od 1 leta.
Use in children under 6 years of age. 
Klini ne izkušnje pri otrocih, mlajših od 6 let
• Restart the cycle of PSUR submission for Diovan as follows: o Six-monthly PSURs until two full years of experience with the paediatric indication in the EU has been gained o Yearly PSURs for the following two years o Thereafter submission at 3-yearly intervals The PSURs should focus on the use in the paediatric population. 
• ponovno za el cikel rednega predlaganja posodobljenih poro il o varnosti zdravila Diovan, kot sledi: o enkrat na 6 mesecev je treba predložiti posodobljena poro ila o varnosti zdravila, dokler ne bodo na voljo izkušnje s pediatri no indikacijo v EU za obdobje dveh celih let,
Dose adjustment is therefore not required in patients with renal impairment (creatinine clearance >10 ml/min). 
Zato pri bolnikih z okvarjenim delovanjem ledvic odmerka ni treba prilagajati (o istek kreatinina > 10 ml/min).
Diovan and associated names (see Annex I) 40 mg film-coated tablets Diovan and associated names (see Annex I) 80 mg film-coated tablets Diovan and associated names (see Annex I) 160 mg film-coated tablets Diovan and associated names (see Annex I) 320 mg film-coated tablets [See Annex I - To be completed nationally] 
Diovan in sorodna imena (glejte Dodatek I) 40 mg filmsko obložene tablete Diovan in sorodna imena (glejte Dodatek I) 80 mg filmsko obložene tablete Diovan in sorodna imena (glejte Dodatek I) 160 mg filmsko obložene tablete Diovan in sorodna imena (glejte Dodatek I) 320 mg filmsko obložene tablete [Glejte Dodatek I - Izpolni država lanica]
In severely sodium-depleted and/or volume-depleted patients, such as those receiving high doses of diuretics, symptomatic hypotension may occur in rare cases after initiation of therapy with Diovan. 
Bolniki s pomanjkanjem natrija in/ali hipovolemijo Pri bolnikih s hudim pomanjkanjem natrija in/ali hipovolemijo, ki prejemajo velike odmerke diuretikov, lahko v redkih primerih po za etku zdravljenja z zdravilom Diovan pride do simptomatske hipotenzije.
It was concluded that 160-320 mg of valsartan produced clinically relevant reductions in UAE in hypertensive patients with type 2 diabetes. 
Zaklju ili so, da je 160-320 mg valsartana doseže klini no pomembno zmanjšanje izlo anja albumina z urinom pri hipertenzivnih bolnikih s sladkorno boleznijo tipa 2.
DATE OF FIRST AUTHORISATION/RENEWAL OF THE AUTHORISATION [To be completed nationally] 
DATUM PRIDOBITVE/PODALJŠANJA DOVOLJENJA ZA PROMET [Izpolni država lanica]
See section 4.2 for information on paediatric use. 
Za podatke o uporabi pri pediatri ni populaciji glejte poglavje 4.2.
Valsartan may be used in patients treated with other post-myocardial infarction therapies, e.g. thrombolytics, acetylsalicylic acid, beta blockers, statins, and diuretics. 
Valsartan lahko uporabljajo bolniki, ki se zdravijo z drugimi zdravili po miokardnem infarktu, npr. s trombolitiki, z acetilsalicilno kislino, z antagonisti adrenergi nih receptorjev beta, s statini in z diuretiki.
Diovan and associated names (see Annex I) 40 mg film-coated tablets Diovan and associated names (see Annex I) 80 mg film-coated tablets Diovan and associated names (see Annex I) 160 mg film-coated tablets Diovan and associated names (see Annex I) 320 mg film-coated tablets [See Annex I -To be completed nationally] Valsartan 
Diovan in sorodna imena (glejte Dodatek I) 40 mg filmsko obložene tablete Diovan in sorodna imena (glejte Dodatek I) 80 mg filmsko obložene tablete Diovan in sorodna imena (glejte Dodatek I) 160 mg filmsko obložene tablete Diovan in sorodna imena (glejte Dodatek I) 320 mg filmsko obložene tablete [Glejte Dodatek I - Izpolni država lanica] valsartan
He may also combine Diovan with an additional medicine (e.g. a diuretic). 
Zdravilu Diovan lahko doda tudi druga zdravila (npr. diuretike).
• muscle spasms, abnormal heart rhythm (signs of hyperkalaemia) 
• mišini kri, nenormalen srni ritem (znaki hiperkaliemije)
Other conditions with stimulation of the renin-angiotensin system In patients whose renal function may depend on the activity of the renin-angiotensin system (e.g patients with severe congestive heart failure), treatment with angiotensin converting enzyme inhibitors has been associated with oliguria and/or progressive azotaemia and in rare cases with acute renal failure and/or death. 
Druge bolezni, pri katerih je stimuliran renin-angiotenzinski sistem Pri bolnikih, pri katerih je delovanje ledvic lahko odvisno od aktivnosti renin-angiotenzinskega sistema, (npr. pri bolnikih s hudim kongestivnim sr nim popuš anjem), je bilo zdravljenje z zaviralcem angiotenzinske konvertaze povezano z oligurijo in/ali s progresivno azotemijo, v redkih primerih tudi z akutno odpovedjo ledvic in/ali s smrtjo.
5.2 Pharmacokinetic properties 
5.2 Farmakokineti ne lastnosti
Patients were randomised within 12 hours to 10 days after the onset of myocardial infarction symptoms to valsartan, captopril, or the combination of both. 
Po nastopu simptomov miokardnega infarkta so bili bolniki v roku 12 ur do 10 dni randomizirani v skupino z valsartanom, s kaptoprilom ali s kombinacijo obeh.
These include potassium supplements or salt substitutes containing potassium, potassium-sparing medicines and heparin. 
To vklju uje kalijeve nadomestke ali nadomestke soli, ki vsebujejo kalij, zdravila, ki var ujejo s kalijem in heparin.
Caution required with concomitant use 
Pri so asni uporabi je potrebna previdnost
Clinical experience in children less than 6 years of age Two clinical studies were conducted in patients aged 1 to 6 years with 90 and 75 patients, respectively. 
Pri bolnikih v starosti od 1 leta do 6 let so izvedli dve klini ni študiji: v eno je bilo vklju enih 90 bolnikov, v drugo pa 75.
Regarding renal function, doubling of serum creatinine was observed in 4.2% of valsartan-treated patients, 4.8% of valsartan+captopril-treated patients, and 3.4% of captopril-treated patients. 
Glede delovanja ledvic so opazili podvojitev koncentracije kreatinina v serumu pri 4,2 % bolnikov, ki so se zdravili z valsartanom, pri 4,8 % bolnikov, ki so se zdravili s kombinacijo valsartana in kaptoprila, in pri 3,4 % bolnikov, ki so se zdravili s kaptoprilom.
In the overall Val-HeFT population, valsartan treated patients showed significant improvement in NYHA class, and heart failure signs and symptoms, including dyspnoea, fatigue, oedema and rales compared to placebo. 
V celotni populaciji študije Val-HeFT se je pri bolnikih, zdravljenih z valsartanom, pokazalo zna ilno izboljšanje po razvrstitvi NYHA in v znakih ter simptomih sr nega popuš anja, vklju no z dispnejo, utrujenostjo, edemom in s piskanjem pri dihanju v primerjavi s placebom.
In patients whose renal function may depend on the activity of the renin-angiotensin system (e.g patients with severe congestive heart failure), treatment with angiotensin converting enzyme inhibitors has been associated with oliguria and/or progressive azotaemia and in rare cases with acute renal failure and/or death. 
Pri bolnikih, pri katerih je delovanje ledvic lahko odvisno od aktivnosti renin-angiotenzinskega sistema, (npr. pri bolnikih s hudim kongestivnim sr nim popuš anjem), je bilo zdravljenje z zaviralcem angiotenzinske konvertaze povezano z oligurijo in/ali s progresivno azotemijo, v redkih primerih tudi z akutno odpovedjo ledvic in/ali s smrtjo.
The VALsartan In Acute myocardial iNfarcTion trial (VALIANT) was a randomised, controlled, multinational, double-blind study in 14,703 patients with acute myocardial infarction and signs, symptoms or radiological evidence of congestive heart failure and/or evidence of left ventricular systolic dysfunction (manifested as an ejection fraction 40% by radionuclide ventriculography or 35% by echocardiography or ventricular contrast angiography). 
VALIANT (VALsartan In Acute myocardial iNfarcTion) je bilo randomizirano, kontrolirano, multinacionalno, dvojno slepo preskušanje, v katerem je sodelovalo 14.703 bolnikov z akutnim miokardnim infarktom, ki so imeli znake, simptome ali radiološke dokaze kongestivnega sr nega popuš anja in/ali znake sistoli ne disfunkcije levega prekata (kar se kaže kot iztisna frakcija 40 % pri radionuklidni ventrikulografiji ali 35 % pri ehokardiografiji ali kontrastni angiografiji prekata).
The recommended starting dose of Diovan is 40 mg twice daily. 
Priporo en za etni odmerek zdravila Diovan je 40 mg dvakrat na dan.
Valsartan is unlikely to be removed by haemodialysis. 
Ni verjetno, da bi se valsartan lahko izloil s hemodializo.
Concomitant use not recommended 
So asna uporaba ni priporo ena
Therefore, the combination of valsartan with an ACE inhibitor is not recommended. 
Zato uporaba kombinacije valsartana z zaviralcem ACE ni priporo ena.
At 30 weeks, the percentage change in UAE was significantly reduced by 36% from baseline with valsartan 160 mg (95%CI: 22 to 47%), and by 44% with valsartan 320 mg (95%CI: 31 to 54%). 
Po 30 tednih je bila z valsartanom 160 mg sprememba izlo anja albumina z urinom v odstotkih zna ilno manjša za 36 % od izhodiš ne vrednosti (95 % IZ: 22 do 47 %), z valsartanom 320 mg pa za 44 % (95 % IZ: 31 do 54 %).
• increase of level of blood urea nitrogen and increase of level of serum creatinine (which can indicate abnormal kidney function) 
• zvišana koncentracija dušika se nine v krvi in zvišana koncentracija kreatinina v serumu (kar lahko kaže na nenormalno delovanje ledvic)
Children weighing between 18 kg and <35 kg received valsartan 80 mg or enalapril 10 mg; those between 35 kg and <80 kg received valsartan 160 mg or enalapril 20 mg; those 80 kg received valsartan 320 mg or enalapril 40 mg. 
Otroci s telesno maso med 18 in < 35 kg so prejemali valsartan v odmerku 80 mg ali enalapril v odmerku 10 mg; tisti s telesno maso med 35 kg in < 80 kg so prejemali valsartan v odmerku 160 mg ali enalapril v odmerku 20 mg; tisti s telesno maso 80 kg pa so prejemali valsartan v odmerku 320 mg ali enalapril v odmerku 40 mg.
Patients treated with valsartan had a better quality of life as demonstrated by change in the Minnesota Living with Heart Failure Quality of Life score from baseline at endpoint than placebo. 
Bolniki z valsartanom so imeli ob zaklju ku študije boljšo kakovost življenja v primerjavi s tistimi, ki so prejemali placebo, kot je pokazala sprememba rezultata Minnesotske lestvice kakovosti življenja za bolnike s sr nim popuš anjem od izhodiš a do konca študije (Minnesota Living with Heart Failure Quality of Life).
Uptitration to 80 mg and 160 mg twice daily should be done at intervals of at least two weeks to the highest dose, as tolerated by the patient. 
Ve anje odmerka na 80 mg in 160 mg dvakrat na dan mora potekati v vsaj dvotedenskim intervalih do najve jega odmerka, glede na to, kako bolnik odmerjanje prenaša.
18 kg to <35 kg 
18 kg do < 35 kg 80 mg
However, the triple combination of an ACE inhibitor, a beta blocker and valsartan is not recommended (see sections 4.4 and 5.1). 
Vendar trojna kombinacija zaviralca ACE, antagonista adrenergi nih receptorjev beta in valsartana ni priporo ena (glejte poglavji 4.4 in 5.1).
Use in paediatric patients aged 6 to 18 years with hepatic impairment As in adults, Diovan is contraindicated in paediatric patients with severe hepatic impairment, biliary cirrhosis and in patients with cholestasis (see sections 4.3, 4.4 and 5.2). 
Uporaba pri pediatri nih bolnikih, ki so stari od 6 do 18 let in imajo okvaro jeter Kot pri odraslih je zdravilo Diovan kontraindicirano pri pediatri nih bolnikih s hudo okvaro jeter, z biliarno cirozo in pri bolnikih s holestazo (glejte poglavja 4.3, 4.4 in 5.2).
Valsartan was as effective as captopril in reducing all-cause mortality after myocardial infarction. 
Valsartan je bil pri zmanjševanju umrljivosti iz vseh vzrokov po miokardnem infarktu enako u inkovit kot kaptopril.
There is currently no experience on the safe use in patients with a creatinine clearance <10 ml/min and patients undergoing dialysis, therefore valsartan should be used with caution in these patients. 
Trenutno ni izkušenj z varno uporabo pri bolnikih z o istkom kreatinina < 10 ml/min in pri bolnikih, ki se zdravijo z dializo, zato je treba valsartan pri teh bolnikih uporabljati previdno.
There is currently no experience on the safe use in patients with a creatinine clearance <10 ml/min and patients undergoing dialysis, therefore valsartan should be used with caution in these patients (see sections 4.2 and 
Trenutno ni izkušenj o varni uporabi pri bolnikih z o istkom kreatinina < 10 ml/min in pri bolnikih, ki se zdravijo z dializo, zato je treba pri teh bolnikih valsartan uporabljati previdno (glejte poglavji 4.2 in 4.4).
Concomitant use with potassium supplements, potassium-sparing diuretics, salt substitutes containing potassium, or other agents that may increase potassium levels (heparin, etc.) is not recommended. 
So asna uporaba kalijevih nadomestkov, diuretikov, ki var ujejo kalij, nadomestkov soli, ki vsebujejo kalij, ali drugih zdravil, ki lahko povzro ijo zve anje koncentracije kalija (heparin, itd.), ni priporo ena.
In some patients whose blood pressure is not adequately controlled, the dose can be increased to 160 mg and to a maximum of 320 mg. Diovan may also be administered with other antihypertensive agents. 
Bolnikom, pri katerih krvni tlak ni ustrezno urejen, je mogo e odmerek zve ati na 160 mg in na najve 320 mg.