Fudaiwen (valsartan hydrochlorothiazide tablets) should focus on the three major risks of electrolyte imbalance, hypotension, and renal function monitoring. The precautions involve pre medication evaluation, monitoring during treatment, and abnormal handling strategies. The following sub items detail the key management points.

1. Electrolyte disorder management

(1) Hypokalemia: Hydrochlorothiazide can increase potassium excretion, and regular monitoring of blood potassium is necessary during medication, especially when combined with digitalis or in the presence of vomiting/diarrhea.

(2) Hyperkalemia: Valsartan may increase blood potassium levels, and those with renal dysfunction or combined use of potassium sparing diuretics/potassium supplements are at higher risk and should be tested every 1-3 months.

(3) Hyponatremia/hypomagnesemia: Long term medication may cause it, manifested as fatigue or arrhythmia. Elderly patients and alcohol dependent individuals need to strengthen monitoring.

2. Prevention and treatment of hypotension

(1) Risk population: Dehydration, insufficient salt intake, heart failure, or combination use of other antihypertensive drugs are prone to occur, and supine blood pressure should be monitored 4-8 hours after the first dose.

(2) Intervention measures: If symptomatic hypotension occurs, one should lie flat and replenish fluids. If necessary, reduce or suspend medication to avoid sudden changes in position.

(3) Capacity management: Correct dehydration or low sodium status before treatment, and pay attention to supplementing electrolyte solution during summer or diarrhea.

3. Key points of renal function monitoring

(1) Baseline assessment: creatinine and estimated GFR should be tested before medication, and should not be used for patients with bilateral renal artery stenosis.

(2) Dynamic monitoring: After 2-4 weeks of treatment, renal function should be rechecked. If creatinine increases by more than 30%, the cause should be evaluated, and if it increases by more than 50%, medication should be discontinued.

(3) High risk individuals: those with chronic kidney disease, heart failure, or concomitant use of NSAIDs should be monitored every 1-2 months to avoid insufficient capacity.

4. Other important precautions

(1) Uric acid monitoring: Hydrochlorothiazide may induce gout. Regularly check uric acid levels and use with caution in individuals with a history of gout.

(2) Pregnancy contraindications: If pregnancy is detected, the medication should be stopped immediately. Valsartan can cause fetal damage or even death.

(3) Drug interactions: Avoid using drugs that affect electrolyte or ARB metabolism, such as lithium agents and colexamine, in combination.