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Cardiovascular complications are the major cause of diabetes mellitus-related morbidity and mortality. Increased renin–angiotensin–aldosterone system activity and decreased β-adrenergic receptor (β-AR) responsiveness contribute to diabetic cardiac dysfunction. We evaluated the effect of sacubitril/valsartan (neprilysin inhibitor plus angiotensin receptor antagonist combination) and valsartan treatments on the diabetic cardiac function through β-AR responsiveness and on protein expression of diastolic components. Six-week-old male Sprague Dawley rats were divided into control, diabetic, sacubitril/valsartan (68 mg/kg)-, and valsartan-treated (31 mg/kg) diabetic groups. Diabetes was induced by a high-fat diet plus low-dose streptozotocin (30 mg/kg, intraperitoneal). After 10 weeks of diabetes, rats were treated for 4 weeks. Systolic/diastolic function was assessed by in vivo echocardiography and pressure–volume loop analysis. β-AR-mediated responsiveness was assessed by in vitro papillary muscle and Langendorff heart experiments. Protein expression of sarcoplasmic reticulum calcium ATPase2a, phospholamban, and phosphorylated phospholamban was determined by Western blot. Sacubitril/valsartan improved ejection fraction and fractional shortening to a similar extent as valsartan alone. None of the treatments affected in vivo diastolic parameters or the expression of related proteins. β1-/β2-AR-mediated responsiveness was partially restored in treated animals. β3-AR-mediated cardiac relaxation (an indicator of diastolic function) responses were comparable among groups. The beneficial effect of sacubitril/valsartan on systolic function may be attributed to improved β1-/β2-AR responsiveness. [ABSTRACT FROM AUTHOR]

Background: Hypertension is a common complication in patients with osteoarthritis (OA). There is increasing interest in the relationship between hypertension and OA. However, hypertension has been reported to negatively affect symptoms and quality of life in patients with OA. Therefore, treating hypertension is crucial for patients with OA. However, there is a lack of realworld studies on the effects of medications for treating hypertension on OA. Methods: Data from the FAERS database from January 2004 to December 2023 were extracted for disproportionality analyses, and proportional reporting ratios (PRRs) were used to assess the association between medications for hypertension and all types of arthritis. Adverse event signals were identified and determined using reporting odds ratios (RORs) Adverse event signals were considered to have occurred if a drug-induced adverse event was recorded more than or equal to 3 and the lower limit of the ROR confidence interval was more than 1. We selected five classes of drugs including, calcium channel blockers (CCBs), angiotensin converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), thiazide diuretics and ß-blockers and representative drugs were analysed for osteoarthritis-related adverse reactions, and age and gender subgroups were analysed for drugs of significance. We also analysed the occurrence of AEs in relation to time using the Weibull distribution. Results: In terms of overall data, we found significant OA adverse reaction signals only for ARBs among the five drug classes.ARB AEs for spinal osteoarthritis (ROR 4.64, 95% CI 3.62-5.94), osteoarthritis (ROR 3.24 95% CI 2.82-3.72) and gouty arthritis (ROR 3.27 95% CI 1.22-8.75) were the three adverse reactions with the loudest signals. Next, we found that valsartan had strong osteoarthritis adverse reaction signals among the three ARBs, namely, irbesartan, cloxartan, and valsartan. We also analysed age and gender subgroups and found that osteoarthritis signals were strongest in the 18-65 and 65+ population, while females seem to be more prone to valsartan-related OA AEs. Conclusion: ARBs, especially valsartan, have significant positive signals for OA AEs. Therefore, ARB drugs, especially valsartan, should be used with caution when treating patients with OA combined with hypertension. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the association between sacubitril/valsartan and dementia-related adverse events (AEs) in geographical subpopulations using subgroup disproportionality analysis. Cases from the FDA adverse event reporting system involving patients aged 60 or older with sacubitril/valsartan or angiotensin receptor blockers (ARBs) were analyzed. The adjusted reporting odds ratios (RORs) for dementia-related AEs were calculated for each continent. A total of 61,518 AEs associated with sacubitril/valsartan or ARBs were identified. Among these, 1441 were dementia-related AEs. In Asia, Europe, and Africa, the reporting risk of dementia-related AEs associated with sacubitril/valsartan was lower compared to ARBs (adjusted ROR, 0.57 [95% CI 0.31–1.01]; adjusted ROR, 0.89 [95% CI 0.69–1.14]; adjusted ROR, 0.40 [95% CI 0.27–0.61], respectively). In Latin America and Oceania, the reporting risk of dementia-related AEs associated with sacubitril/valsartan was similar to that associated with ARBs (adjusted ROR, 1.04 [95% CI 0.75–1.44]; adjusted ROR, 1.02 [95% CI 0.31–3.37], respectively). On the contrary, in North America, the reporting risk associated with sacubitril/valsartan was higher compared to ARBs (adjusted ROR, 1.29 [95% CI 1.10–1.53]). Although the ROR value did not meet the criteria for signal detection, the significantly greater than 1 ROR observed in North America suggests that caution may be warranted regarding potential dementia-related adverse events associated with sacubitril/valsartan. [ABSTRACT FROM AUTHOR]

The aim of the study was to propose pharmacy-compounded oral gels as a new and alternative dosage form that is attractive to children as having a better masking taste than syrups and reducing the risk of spilling. The application and physical properties of the gels prepared with cellulose derivatives (hydroxyethylcellulose and carmellose sodium) or carbomers were evaluated. The results of the study showed the most suitable consistency, viscosity, and organoleptic properties for gels prepared with carbomer and cellulose derivatives at concentrations of 0.75% and 2.0%, respectively. The microbial stability of the gels was guaranteed by the use of methylparaben and potassium sorbate. VAL (valsartan) and CC (candesartan cilexetil) tablets, often used off-label in children, were pulverized and suspended in the hydrogel bases, resulting in final drug concentrations of 4 mg/g and 1 mg/g, respectively. There was no significant change in viscosity and consistency parameters when the pulverized tablets were added, and only small changes in viscosity and consistency were observed during 35 days of storage, especially in the gels with sodium carmellose and candesartan. On the basis of the drug assay, an expiry date of 25 °C was recommended: 35 days for valsartan and 14 days for candesartan preparations. [ABSTRACT FROM AUTHOR]

Background: Following the mass recall of valsartan products with nitrosamine impurities in July 2018, the number of patients exposed to these products, the duration of exposure, and the potential for cancer remains unknown. Therefore, we assessed the extent and duration of use of valsartan products with a nitrosamine impurity in the United States, Canada, and Denmark. Methods: We conducted a retrospective cohort study using administrative healthcare data from the US FDA Sentinel System, four Canadian provinces that contribute to the Canadian Network for Observational Drug Effect Studies (CNODES), and the Danish National Prescription Registry. Patients, 18 years and older between May 2012 and December 2020 with a valsartan dispensing were identified in each database. Patients were followed from the date of valsartan dispensing until discontinuation. We defined four valsartan exposure categories based on nitrosamine impurity status; recalled generic products with confirmed NDMA/NDEA levels (recalled‐tested); recalled generic products that were not tested (recalled); non‐recalled generic and non‐recalled branded products. In Denmark, the recalled‐tested category was not included due to absence of testing data. The proportion and duration of use of valsartan episodes stratified by nitrosamine‐impurity status was calculated. Results: We identified 3.3 and 2.8 million (United States) and 51.3 and 229 thousand (Canada) recalled‐tested and recalled valsartan exposures. In Denmark, where valsartan exposure was generally low, there were 10 747 recalled exposures. Immediately after the recall notices were issued, there was increased rates of switching to a non‐valsartan ARB. The mean duration of use of the recalled‐tested products was 167 (±223.1) and 146 (±255.8) days in the United States and Canada respectively. For the recalled products, mean cumulative duration of use was 178 (±249.6), 269 (±397.3) and 166 (±251.0) days in the United States, Canada, and Denmark, respectively. Conclusion: In this cohort study, despite widespread use of recalled generic valsartan between 2012 and 2018, the duration of use was relatively short and probably did not pose an elevated risk of nitrosamine‐induced cancer. However, since products with nitrosamine impurity could have been on the market over a 6‐year period, patients exposed to these products for longer durations could have a potentially different risk of cancer. [ABSTRACT FROM AUTHOR]

The main goal of this study is the examination of polypropylene (PP) microplastics (MPs) as possible carriers of daily use pharmaceutical compounds. The selected compounds can be separated into three groups: (i) antibiotics (Trimethoprim, Metronidazole, Indomethacin, Isoniazid), (ii) anti-inflammatories (Ketoprofen, Diclofenac), and (iii) anti-hypertensive (Valsartan). Two types of PP MPs (virgin and UV-aged) were used in the experimental procedure, and the effect of time and the effect of the initial concentrations of the drugs were examined. The impact of various environmental factors such as pH, salinity, and natural organic matter were also explored. The last two factors were studied using real aqueous matrices such as wastewater and seawater. According to the obtained results, the highest uptake was observed in indomethacin (9.3 mg/g) and diclofenac (7.3 mg/g), owing to their physiochemical properties. Aged particles showed enhanced adsorption ability in accordance with the existing literature, as their adsorption capacity was between 0.5–1.5 times greater than that of the virgin ones. Regarding the desorption of compounds from the virgin and aged PP MPs at three different pH values, diclofenac and indomethacin exhibited the highest desorption capacity, while alkaline conditions favored the desorption ability of PP MPs for most of the target compounds. [ABSTRACT FROM AUTHOR]

Valsartan and rosuvastatin together in a binary form have been utilized to reduce hypertension and hyperlipidemia to control cardiovascular complications. This study depicts the simple three mathematically manipulated UV spectroscopic techniques for the estimation of rosuvastatin and valsartan in the formulation. The first method is simple UV absorption at 310 nm by RST and the first derivatization method for VTN. Determining the magnitude difference of a ratio spectrum at two identified wavelengths is the second approach, and determination of the magnitude of the first derivatives of the ratio spectra of RST and VTN constitute the third technique. The selection of wavelengths, divisor concentrations, and peak amplitudes were optimized and validated. The straight line was constructed in the range of 1–30 and 2–25 µg/ml for RST and VST by the normal and first derivatization method. By using the magnitude difference and magnitude of first derivative ratio spectra approaches, the concentrations of 1–12 and 2–25 µg/ml for RST and VTN, respectively, displayed a straight line. The limit of quantification was less than 1 µg/ml for RST and less than 2 µg/ml for VTN. It was eventually found that the accuracy, expressed as a percentage recovery, ranged between 98.94 and 99.55% for RST and 100.36 and 101.08% for VTN. The % RSD did not exceed 1.82 and 1.91 for RST and VTN, respectively. The three techniques were used to accurately measure RST and VTN in their binary formulations and physically mixed solutions, and the results were statistically compared to the previously published HPLC technique. The outstanding recovery achieved by using the authentic standard addition approach validated the methods’ supplemental accurateness. The Analytical Greenness and Red Green Blue procedures verified the eco-friendliness of the suggested UV spectroscopic approaches, which were also found to be superior to the documented HPLC methods.

Objective: To investigate whether angiotensin II type 1 receptor (AGTR1 A1166C) gene polymorphism was associated with the effectiveness of valsartan monotherapy in Chinese patients with essential hypertension. Methods: This retrospective analysis included 198 patients (⩾18 years of age) who received valsartan monotherapy (80 mg/day) for newly developed essential hypertension at the authors’ center between January 1, 2020 and December 31, 2023. Genotyping for AGTR1 A1166C gene polymorphism was done by polymerase chain reaction (PCR)-melting curve analysis of genomic DNA from peripheral blood samples. A dominant genetic model for AGTR1 A1166C (AA genotype versus AC + CC genotype) was used. Multivariate regression analysis of baseline variables and AGTR1 polymorphism was conducted to identify predictors of target blood pressure attainment (