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irbesartan and diuretics

C09DA04

Forms & Strengths

Irbesartan/hydrochlorothiazide 150 mg/12.5 mg oral tablet
Irbesartan/hydrochlorothiazide 300 mg/12.5 mg oral tablet
Irbesartan/hydrochlorothiazide 300 mg/25 mg oral tablet

Adult Dosing

Hypertension: Initial 150/12.5 mg once daily; may titrate up to 300/25 mg once daily as needed for blood pressure control
Switching therapy: May be initiated when monotherapy (irbesartan or hydrochlorothiazide) fails to achieve adequate control
Maximum dose: 300 mg irbesartan / 25 mg hydrochlorothiazide once daily

Pediatric Dosing

Safety and efficacy in pediatric patients have not been established
Use in children and adolescents is not recommended

Indications

Treatment of hypertension, to lower blood pressure
Initial therapy not recommended for hypertension unless monotherapy has failed or is unlikely to achieve target BP

Mechanism of Action

Irbesartan is an angiotensin II receptor blocker (ARB) that selectively blocks the AT1 receptor, causing vasodilation and decreased aldosterone secretion
Hydrochlorothiazide is a thiazide diuretic that inhibits sodium chloride reabsorption in the distal convoluted tubules, increasing excretion of sodium, chloride, and water

Contraindications

Hypersensitivity to irbesartan, sulfonamide-derived drugs, or any component of the formulation
Anuria
Co-administration with aliskiren in patients with diabetes mellitus

Adverse Reactions

Dizziness
Fatigue
Nausea and vomiting
Hyperuricemia
Hypokalemia or hyperkalemia
Orthostatic hypotension

Drug Interactions

Lithium: Risk of decreased renal clearance and increased lithium toxicity
NSAIDs: May decrease antihypertensive efficacy and increase risk of renal impairment
Potassium-sparing diuretics, potassium supplements, or salt substitutes: Increased risk of hyperkalemia
Other antihypertensive agents: May produce additive hypotensive effects

Curated Content: Needs Vetting Before Put to Clinical Use