Can valsartan cause gout? A look at risk factors, alternatives, and management

October 8, 2025 •

3 min read

An estimated 74% of patients with gout also have hypertension, and the medications used to treat high blood pressure can impact uric acid levels. This raises a critical question for many: can valsartan cause gout or worsen existing symptoms?

Quick Summary

Studies suggest valsartan can increase serum uric acid levels, potentially raising the risk of gout attacks, unlike some other ARBs. The risk is notably higher with valsartan/hydrochlorothiazide combinations. Discussing medication options with a doctor is crucial for management.

Key Points

Valsartan and Hyperuricemia: Valsartan may increase or have a neutral effect on serum uric acid levels, which can potentially increase the risk of a gout attack.
Losartan as an Alternative: Unlike valsartan, losartan is an ARB with a known uricosuric effect, making it a preferred option for hypertensive patients with gout or hyperuricemia.
Combined Diuretics Increase Risk: If valsartan is taken in a combination pill with a diuretic like hydrochlorothiazide, the risk of gout is significantly higher due to the diuretic's effect on uric acid clearance.
Talk to Your Doctor: Never stop taking valsartan without consulting your doctor. A healthcare provider can help you weigh the risks and benefits and determine if an alternative medication is appropriate.
Lifestyle Management is Key: For gout prevention, lifestyle changes such as a low-purine diet, adequate hydration, and moderate alcohol consumption are essential, regardless of medication choice.
Monitor for Symptoms: Watch for signs of a gout flare, such as sudden and severe joint pain, swelling, and redness, and contact your doctor immediately if symptoms appear.

Understanding Gout and Uric Acid

Gout is an inflammatory arthritis caused by urate crystal accumulation in joints, often the big toe, leading to pain and swelling. These crystals form from high blood uric acid (hyperuricemia). Uric acid is a purine breakdown product, and gout occurs when the kidneys don't excr ete enough or the body makes too much.

The Valsartan Connection to Gout

Valsartan is an Angiotensin II Receptor Blocker (ARB) that lowers blood pressure by relaxing blood vessels. While ARBs are generally safe, their effect on uric acid varies. Valsartan can have a neutral or negative impact on serum uric acid, potentially increasing levels. One study showed valsartan significantly increased uric acid compared to losartan. Elevated uric acid increases the risk of acute gout attacks.

Combination Medications and Increased Risk

Valsartan is often combined with diuretics like hydrochlorothiazide (HCTZ). HCTZ is known to increase uric acid by reducing kidney excretion. Combining valsartan and HCTZ significantly increases the risk of developing or worsening gout.

Comparing Valsartan and Other ARBs

Losartan, another ARB, differs from valsartan. It is a weak uricosuric agent, meaning it helps the kidneys exc rete uric acid. This makes losartan a preferred option for hypertensive patients with hyperuricemia or gout. Details comparing Valsartan, Losartan and Valsartan + Hydrochlorothiazide can be found on {Link: DrOracle website https://www.droracle.ai/articles/43269/is-valsartan-hard-on-renal-function}.

Managing Gout While on Valsartan

Managing gout risk on valsartan involves medical supervision and lifestyle adjustments.

Discuss Medication Alternatives

Consult your doctor to review your treatment. If you have a history of gout, alternatives like losartan or some calcium channel blockers may be considered. Do not stop valsartan without medical advice.

Lifestyle and Dietary Changes

Lifestyle modifications are crucial for controlling gout:

Diet: Eat vegetables, fruits, whole grains, and low-fat dairy. Limit high-purine foods (red meat, organ meats, certain seafood) and high-fructose corn syrup.
Hydration: Drink plenty of water to help kidneys exc rete uric acid.
Alcohol: Reduce or avoid alcohol, especially beer and hard liquor.
Weight: Achieve a healthy weight; avoid crash dieting.
Exercise: Engage in regular, moderate exercise.

Conclusion

Valsartan can increase serum uric acid levels and potentially lead to gout attacks, particularly in combination with HCTZ. Losartan is an alternative ARB that may be preferable for patients with gout or hyperuricemia due to its uric acid-lowering effect. Managing gout risk while on or switching from valsartan requires working with a healthcare provider and implementing lifestyle changes. For dietary guidance, resources like Healthline's gout-friendly diet guide are available.

What to Do If You Suspect Gout on Valsartan

If you experience symptoms of a gout attack (pain, swelling, redness), contact your doctor immediately. Do not stop valsartan without medical approval. Your doctor can measure uric acid and recommend treatment or medication adjustments.

Additional Considerations for Patients

Patient factors like kidney disease or diabetes can increase gout risk with valsartan. Regular monitoring of kidney function and electrolytes is important. The medication's specific formulation, such as a combination with amlodipine, may also affect uric acid levels. Personalized medical advice based on your health history is essential.

Frequently Asked Questions

Compared to losartan, another common ARB, valsartan is associated with a higher risk of increasing uric acid levels. In contrast, losartan actually helps lower uric acid, making it a better option for patients with gout.

Hydrochlorothiazide is a diuretic that reduces the kidneys' ability to clear uric acid from the body, leading to higher levels in the blood. When combined with valsartan, which can also increase uric acid, the risk of a gout attack is significantly higher than with valsartan alone.

If you experience gout symptoms, contact your doctor immediately. They can confirm the diagnosis, prescribe short-term medication for the flare-up, and discuss long-term strategies, which may include switching to an alternative blood pressure medication.

Gout attacks often occur suddenly and involve severe joint pain, swelling, and redness. The affected joint may feel hot to the touch, and even light pressure, such as from a bedsheet, can be intolerable.

Yes, dietary changes are crucial. A diet low in high-purine foods (red meat, certain seafood), sugary drinks, and alcohol, combined with proper hydration and weight management, can help lower uric acid levels and reduce gout risk.

Common side effects of valsartan include dizziness, lightheadedness, fatigue, headache, and diarrhea. Some serious but rare side effects include kidney problems or allergic reactions with swelling.

No, you should never stop taking valsartan or any prescribed medication without consulting your doctor. Abruptly stopping blood pressure medication can lead to dangerous health complications. Your doctor can guide you on the safest course of action.