Ponikowski P, Voors AA, Anker SD et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology ESC. Developed with the special contribution of the Heart Failure Association HFA of the ESC. Aliskiren: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Aliskiren may enhance the hypotensive effect of Angiotensin II Receptor Blockers. Aliskiren may enhance the nephrotoxic effect of Angiotensin II Receptor Blockers. Management: Aliskiren use with ACEIs or ARBs in patients with diabetes is contraindicated.
If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip themissed dose and resume your usual dosing schedule. Also, not can reduce the risk of complications. Having other health problems can increase the risk for complications from diabetes. Parving HH, Lehnert H, Bröchner-Mortensen J et al. The effect of irbesartan on the development of diabetic nephropathy in patients with type 2 diabetes. N Engl J Med. Angiotensin II receptor antagonists may be used as an alternative for those patients in whom an ACE inhibitor or ARNI is inappropriate. HCTZ at 8 weeks, respectively.
Do not coadminister aliskiren with Irbesartan and Hydrochlorothiazide in patients with diabetes. Frohlich ED. Recognition of systolic hypertension for hypertension. Hypertension. Irbesartan is a specific competitive antagonist of AT 1 receptors with a much greater affinity more than 8500-fold for the AT 1 receptor than for the AT 2 receptor, and no agonist activity. Unless otherwise indicated, percentage of incidence is reported for patients with hypertension.
This product may affect your potassium levels. Before using potassium supplements or salt substitutes that contain potassium, consult your doctor or pharmacist. This product is not recommended for use in children. Table 2 presents results for demographic subgroups.
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Drospirenone: Angiotensin II Receptor Blockers may enhance the hyperkalemic effect of Drospirenone. Pitt B, Segal R, Martinez FA et al. Randomised trial of losartan versus captopril in patients over 65 with heart failure Evaluation of Losartan in the Elderly Study, ELITE. Lancet. Irbesartan is available in generic form. Irbesartan was not mutagenic in a battery of in vitro tests Ames microbial test, rat hepatocyte DNA repair test, V79 mammalian-cell forward gene-mutation assay. Irbesartan was negative in several tests for induction of chromosomal aberrations in vitro-human lymphocyte assay; in vivo-mouse micronucleus study. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial ALLHAT. JAMA. Bristol-Myers Squibb Company. Avalide irbesartan-hydrochlorothiazide tablets prescribing information. Princeton, NJ; 2008 Nov. Taler SJ, Agarwal R, Bakris GL et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for management of blood pressure in CKD. Am J Kidney Dis. The effect of irbesartan is apparent after the first dose and is close to the full observed effect at 2 weeks.
Two of the 7 placebo-controlled trials identified above and 2 additional placebo-controlled studies examined the antihypertensive effects of Irbesartan and Hydrochlorothiazide in combination. No data are available in regard to overdosage in humans. However, daily doses of 900 mg for 8 weeks were well-tolerated. The most likely manifestations of overdosage are expected to be hypotension and tachycardia; bradycardia might also occur from overdose. Irbesartan is not removed by hemodialysis. For these reasons, FAERS case reports cannot be used to calculate incidence or estimates of risk for a particular product or compare risks between products. MRHD on a body surface area basis. Kirk JK. Therapy with angiotensin II receptor antagonists. Clin Geriatrics. Sanofi-Aventis. Avapro irbesartan tablets prescribing information. Bridgewater, NJ; 2016 Feb. The likelihood of achieving these goals on Irbesartan and Hydrochlorothiazide rises to about 40% systolic or 70% diastolic. Hydrochlorothiazide: Hypersensitivity reactions to hydrochlorothiazide may occur in patients with or without a history of allergy or bronchial asthma, but are more likely in patients with such a history. Skeletal Muscle Relaxants: Possible increased responsiveness to muscle relaxants such as curare derivatives. No additional therapeutic benefit when angiotensin II receptor antagonist used in combination with an ACE inhibitor. In hypertensive patients, chronic oral doses of irbesartan up to 300 mg had no effect on glomerular filtration rate, renal plasma flow or filtration fraction. In multiple dose studies in hypertensive patients, there were no clinically important effects on fasting triglycerides, total cholesterol, HDL-cholesterol, or fasting glucose concentrations. There was no effect on serum uric acid during chronic oral administration and no uricosuric effect. Irbesartan tablets USP may be used alone or in combination with other antihypertensive agents. Kasiske VL, Kalil RSN, Ma JZ et al. Effect of antihypertensive therapy on the kidney in patients with diabetes: a meta-regression analysis. Ann Intern Med. Irbesartan and its metabolites are excreted by both and renal routes. nifedipine
Concomitant use of irbesartan and aliskiren in patients with diabetes mellitus. a b 550 See Specific Drugs under Interactions. Larochelle P, Flack JM, Hannah S et al et al. Irbesartan versus enalapril in severe hypertension. Am J Hypertens. Wright JT, Fine LJ, Lackland DT et al. Evidence supporting a systolic blood pressure goal of less than 150 mm Hg in patients aged 60 years or older: the minority view. Ann Intern Med. Bauer JH, Reams GP. The angiotensin II type 1 receptor antagonists: a new class of antihypertensive drugs. Arch Intern Med. In studies of ACE inhibitors in patients with unilateral or bilateral renal artery stenosis, increases in serum creatinine or BUN have been reported. There has been no known use of irbesartan in patients with unilateral or bilateral renal artery stenosis, but a similar effect should be anticipated. In healthy black patients, AUC values were approximately 25% greater than white patients. Björck S, Mulec H, Johnsen SA et al. Renal protective effect of enalapril in diabetic nephropathy. BMJ. When unstented bilateral renal artery stenosis is present, use is generally avoided due to the elevated risk of deterioration in renal function unless possible benefits outweigh risks. II receptor antagonists, angiotensin-converting-enzyme inhibitors and calcium channel blockers were not allowed oral hypoglycemic agents, and lipid-lowering agents. National Kidney Foundation Kidney Disease Outcomes Quality Initiative. HCTZ also had an approximately additive effect. ACCF Secondary Prevention and Risk Reduction Therapy for Patients with Coronary and other Atherosclerotic Vascular Disease: 2011 update: a guideline from the American Heart Association and American College of Cardiology Foundation. Circulation. Irbesartan and Hydrochlorothiazide may be used in patients whose blood pressure is not adequately controlled on monotherapy. buy rosuvastatin fast delivery rosuvastatin
This medication may interfere with certain laboratory tests including parathyroid function possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug. The information on this page is not a substitute for the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that a drug or drug combination is safe, effective or appropriate for any given patient. Drugs. Go AS, Bauman MA, Coleman King SM et al. An effective approach to high blood pressure control: a science advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. Hypertension. CYP2C8 Substrates: CYP2C8 Inhibitors Moderate may decrease the metabolism of CYP2C8 Substrates. Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. Blankfield RP. Angiotensin-receptor blockers, type 2 diabetes, and renoprotection. N Engl J Med. Cooper WO, Hernandez-Diaz S, Arbogast PG et al. Major congenital malformations after first-trimester exposure to ACE inhibitors. N Engl J Med. Velasquez MT. Angiotensin II receptor blockers: a new class of hypertensive drugs. Arch Fam Med. Blockade of the AT 1 receptor removes the negative feedback of angiotensin II on renin secretion, but the resulting increased plasma renin activity and circulating angiotensin II do not overcome the effects of irbesartan on blood pressure. Laboratory determinations of serum levels of irbesartan are not widely available, and such determinations have, in any event, no known established role in the management of irbesartan overdose. Important: The opinions expressed in WebMD User-generated content areas like communities, reviews, ratings, blogs, or WebMD Answers are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. User-generated content areas are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. In most patients no benefit has been associated with using two RAS inhibitors concomitantly. In general, avoid combined use of RAS inhibitors. Tell patients using Irbesartan and Hydrochlorothiazide that getting dehydrated can lower their blood pressure too much and lead to lightheadedness and possible fainting. Dehydration may occur with excessive sweating, diarrhea, or vomiting and with not drinking enough liquids. Renal impairment: Use with caution with preexisting renal insufficiency.
Get a every year. Goal is to achieve and maintain optimal control of BP; individualize specific target BP based on consideration of multiple factors, including patient age and comorbidities, and currently available evidence from clinical studies. 500 501 See Hypertension under Uses. Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day. It is important to continue taking this medication even if you feel well. Most people with not feel sick. Management of hypertension alone or in combination with other classes of antihypertensive agents. Usually you replace the lost liquid by drinking fluids and eating foods that contain water. zibra.info epivir
An increase or decrease in may also occur. Siberian ginseng may also cause drowsiness, nervousness, or mood changes. If any of these effects persist or worsen, contact your doctor or promptly. Kossler-Taub K, Littlejohn T, Elliott W et al. Comparative efficacy of two angiotensin II receptor antagonists, irbesartan and losartan, in mild-to-moderate hypertension. Am J Hypertens. Undergoes hepatic metabolism by glucuronide conjugation and oxidation principally by CYP2C9 to inactive metabolites. AvPAK SPL PATIENT PACKAGE INSERT PACKAGE LABEL. Before using this medication, tell your doctor or pharmacist your medical history, especially of: gout, kidney disease, liver disease, lupus, severe loss of body water and minerals dehydration. Surgical patients: In patients on chronic angiotensin receptor blocker ARB therapy, intraoperative hypotension may occur with induction and maintenance of general anesthesia; however, discontinuation of therapy prior to surgery is controversial. If continued preoperatively, avoidance of hypotensive agents during surgery is prudent Hillis 2011. Deterioration of renal function may occur. 1 26 See Renal Effects under Cautions. Thiazides appear in human milk. Because of the potential for adverse effects on the nursing infant, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother. Irbesartan and Hydrochlorothiazide is indicated for the treatment of hypertension. In rare cases, irbesartan can cause a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, and dark colored urine. Concomitant use of carbamazepine and hydrochlorothiazide has been associated with the risk of symptomatic hyponatremia. Monitor electrolytes during concomitant use. Burnier M, Buclin T, Biollaz J et al. Pharmacokinetic-pharmacodynamic relationships of three angiotensin II receptor antagonists in normal volunteers. Kidney Int. price atorvastatin in canada
Irbesartan is not removed by hemodialysis. Levodopa: Blood Pressure Lowering Agents may enhance the hypotensive effect of Levodopa. Hyperkalemia has been rarely reported. Category D. a b 26 See Boxed Warning. Do not co-administer aliskiren with irbesartan in patients with diabetes. Exclusivity is the sole marketing rights granted by the FDA to a manufacturer upon the approval of a drug and may run simultaneously with a patent. Exclusivity periods can run from 180 days to seven years depending upon the circumstance of the exclusivity grant. When pregnancy is detected, discontinue irbesartan tablets as soon as possible. Cohn JN, Tognoni G, for the Valsartan Heart Failure Trial Investigators. A randomized trial of the angiotensin-receptor blocker valsartan in chronic heart failure. N Engl J Med. Manufacturer states fixed-combination preparation can be used for initial treatment of hypertension in patients who are likely to need multiple drugs to achieve their BP goals. 26 Consider potential benefits and risks of initiating therapy with the fixed combination. Older adults may be more sensitive to the side effects of this drug, especially dizziness and change in the amount of urine kidney problems. Severe sweating, diarrhea, or vomiting can increase the risk for lightheadedness or a serious loss of body water dehydration. Report prolonged diarrhea or vomiting to your doctor. To prevent dehydration, drink plenty of fluids unless your doctor directs you otherwise. Prostacyclin Analogues: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Bosentan: CYP2C9 Inhibitors Moderate may increase the serum concentration of Bosentan. Management: Concomitant use of both a CYP2C9 inhibitor and a CYP3A inhibitor or a single agent that inhibits both enzymes with bosentan is likely to cause a large increase in serum concentrations of bosentan and is not recommended. See monograph for details. Dual blockade of the RAS with angiotensin-receptor blockers, ACE inhibitors, or aliskiren is associated with increased risks of hypotension, hyperkalemia, and changes in renal function including acute renal failure compared to monotherapy. Closely monitor blood pressure, renal function, and electrolytes in patients on Irbesartan and Hydrochlorothiazide and other agents that affect the RAS. Hg is reasonable for the secondary prevention of cardiovascular events.
This drug may make you dizzy. not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit beverages. Irbesartan and Hydrochlorothiazide Tablets USP are a combination of an angiotensin II receptor antagonist AT 1 subtype irbesartan, and a thiazide diuretic, hydrochlorothiazide HCTZ. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Always consult your doctor or healthcare specialist for medical advice. Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients. Amodiaquine: CYP2C8 Inhibitors may increase the serum concentration of Amodiaquine. Hypotension-Associated Agents: Blood Pressure Lowering Agents may enhance the hypotensive effect of Hypotension-Associated Agents. Williams CL, Hayman LL, Daniels SR et al. Cardiovascular health in childhood: a statement for health professional from the Committee on Atherosclerosis, Hypertension, and Obesity in the Young AHOY of the Council on Cardiovascular Disease in the Young, American Heart Association. Circulation. Crosses the blood-brain barrier poorly, if at all, in animals. Documentation of allergenic cross-reactivity for angiotensin receptor blockers is limited. If any of these effects persist or worsen, tell your doctor or promptly. buy now probenecid pharmacy uk
Canagliflozin: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Canagliflozin may enhance the hypotensive effect of Angiotensin II Receptor Blockers. Your pharmacist can provide more information about hydrochlorothiazide and irbesartan. Study VI, the overall pattern of adverse events reported through 7 weeks of follow-up was similar in patients treated with Irbesartan and Hydrochlorothiazide as initial therapy and in patients treated with irbesartan as initial therapy. Eplerenone: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Tolvaptan: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Phosphodiesterase 5 Inhibitors: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Store at room temperature away from moisture and heat. What happens if I miss a dose? Where can I get more information? Manufacturer recommends initial dosage of 150 mg once daily in adults without intravascular volume depletion. 1 In adults with depletion of intravascular volume, the usual initial dosage is 75 mg once daily. Irbesartan is an angiotensin receptor antagonist. Angiotensin II acts as a vasoconstrictor. In addition to causing direct vasoconstriction, angiotensin II also stimulates the release of aldosterone. Once aldosterone is released, sodium as well as water are reabsorbed. The end result is an elevation in blood pressure. Irbesartan binds to the AT1 angiotensin II receptor. Irbesartan tablets may be administered with other antihypertensive agents and with or without food. Irbesartan and Hydrochlorothiazide combination than on placebo, regardless of drug relationship. How should I take irbesartan? In the unusual case that there is no appropriate alternative to therapy with drugs affecting the renin-angiotensin system for a particular patient, apprise the mother of the potential risk to the fetus. Perform serial ultrasound examinations to assess the intra-amniotic environment. If oligohydramnios is observed, discontinue Irbesartan and Hydrochlorothiazide, unless it is considered lifesaving for the mother. Fetal testing may be appropriate, based on the week of pregnancy. Patients and physicians should be aware, however, that oligohydramnios may not appear until after the fetus has sustained irreversible injury. Study IV investigated the effects of the addition of irbesartan 75 or 150 mg in patients not controlled SeDBP 93-120 mmHg on hydrochlorothiazide 25 mg alone. Cannabis: CYP2C9 Inhibitors Moderate may increase the serum concentration of Cannabis. More specifically, tetrahydrocannabinol serum concentrations may be increased. cheapest vidalta purchase payment canada
Wright JT, Dunn JK, Cutler JA et al. Outcomes in hypertensive black and nonblack patients treated with chlorthalidone, amlodipine, and lisinopril. JAMA. Molsidomine: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Does not share the ACE inhibitor common adverse effect of dry cough. Dronabinol: CYP2C9 Inhibitors Moderate may increase the serum concentration of Dronabinol. Keep all regular medical and laboratory appointments. Dizziness, syncope, and vertigo were reported with equal or less frequency in patients receiving irbesartan compared with placebo.
The optimum BP threshold for initiating antihypertensive drug therapy is controversial. Nicorandil: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Irbesartan is a specific competitive antagonist of AT 1 receptors with a much greater affinity more than 8500-fold for the AT 1 receptor than for the AT 2 receptor and no agonist activity. Initial dosage of 75 mg once daily used in clinical trial. 1 Increase dosage to target maintenance dosage of 300 mg once daily. 1 No data available on effects of lower dosages. Cleve Clin J Med. Irbesartan and Hydrochlorothiazide may be administered with or without food. FDA product labels and may differ in countries outside the USA. Every effort has been made to ensure that the information provided on this page is accurate, up-to-date and complete, but no guarantee is made to that effect. Drugs. Irbesartan and Hydrochlorothiazide was not mutagenic in standard in vitro tests Ames microbial test and Chinese hamster mammalian-cell forward gene-mutation assay. These effects are usually reversible. When used in fixed combination with hydrochlorothiazide, consider the cautions, precautions, and contraindications associated with hydrochlorothiazide. Hydrochlorothiazide: After oral administration of hydrochlorothiazide, diuresis begins within 2 hours, peaks in about 4 hours and lasts about 6 to 12 hours. Pitt B, Segal R, Martinez FA et al for the ELITE study investigators. Randomized trial of losartan versus captopril in patients over 65 with heart failure Evaluation of Losartan in the Elderly Study, ELITE. Lancet. The curve of each treatment group in each study was estimated by logistic regression modeling from all available data of that treatment group. The estimated likelihood at the right tail of each curve is less reliable due to small numbers of subjects with high baseline blood pressures. Barbiturates: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Hydrochlorothiazide may alter glucose tolerance and raise serum levels of cholesterol and triglycerides. coversyl canada review
Hydrochlorothiazide: Hydrochlorothiazide is a thiazide diuretic. Thiazides affect the renal tubular mechanisms of electrolyte reabsorption, directly increasing excretion of sodium and chloride in approximately equivalent amounts. Indirectly, the diuretic action of hydrochlorothiazide reduces plasma volume, with consequent increases in plasma renin activity, increases in aldosterone secretion, increases in urinary potassium loss, and decreases in serum potassium. The renin-aldosterone link is mediated by angiotensin II, so coadministration of an angiotensin II receptor antagonist tends to reverse the potassium loss associated with these diuretics. No substantial differences in safety or efficacy of irbesartan monotherapy or fixed-combination containing irbesartan and hydrochlorothiazide relative to younger adults, but increased sensitivity cannot be ruled out. In separate studies of patients receiving maintenance doses of warfarin, hydrochlorothiazide, or digoxin, irbesartan administration for 7 days had no effect on the pharmacodynamics of warfarin prothrombin time or pharmacokinetics of digoxin. The pharmacokinetics of irbesartan were not affected by coadministration of nifedipine or hydrochlorothiazide. The mean baseline seated systolic and diastolic blood pressures were 159 mmHg and 87 mmHg, respectively. If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. You may need or want additional if certain situations raise your chance for exposure to disease. Of 4925 subjects receiving irbesartan tablets in controlled clinical studies of hypertension, 911 18. Irbesartan is slightly soluble in alcohol and methylene chloride and practically insoluble in water. You may also be given an electromyogram EMG and nerve conduction velocity NCV tests, which is used to assess nerve and muscle function and measure the electrical properties of the nerves. Using these tests, doctors can often pinpoint the abnormal nerves and determine which part of their structure is damaged. Irbesartan crosses the placenta in rats and rabbits. It is not known whether irbesartan is excreted in human milk, but irbesartan or some metabolite of irbesartan is secreted at low concentration in the milk of lactating rats. Patent and Trademark Office and assigns exclusive legal right to the patent holder to protect the proprietary chemical formulation. The patent assigns exclusive legal right to the inventor or patent holder, and may include entities such as the drug brand name, trademark, product dosage form, ingredient formulation, or manufacturing process A patent usually expires 20 years from the date of filing, but can be variable based on many factors, including development of new formulations of the original chemical, and patent infringement litigation. Diazoxide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Sanofi-Aventis. Avalide irbesartan-hydrochlorothiazide tablets prescribing information. Bridgewater, NJ; 2016 Feb. Studies in animals indicate that radiolabeled irbesartan weakly crosses the blood-brain barrier and placenta. Irbesartan is excreted in the milk of lactating rats. It is unknown if irbesartan passes into breast milk. Hydrochlorothiazide passes into breast milk, but is unlikely to harm a nursing infant. Consult your doctor before breast-feeding. losartan
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In healthy subjects, single oral irbesartan doses of up to 300 mg produced dose-dependent inhibition of the pressor effect of angiotensin II infusions. Inhibition was complete 100% 4 hours following oral doses of 150 mg or 300 mg and partial inhibition was sustained for 24 hours 60% and 40% at 300 mg and 150 mg, respectively. No patient discontinued due to increases or decreases in serum potassium. On average, the combination of Irbesartan and Hydrochlorothiazide had no effect on serum potassium. Higher doses of irbesartan ameliorated the hypokalemic response to hydrochlorothiazide. Coadministration of Irbesartan and Hydrochlorothiazide with other drugs that raise serum potassium levels may result in hyperkalemia, sometimes severe. Monitor serum potassium in such patients.
Hypertension: Management of hypertension alone or in combination with other antihypertensives. Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough. Pool JL, Guthrie RM, Littlejohn T et al. The antihypertensive effects of irbesartan in patients with mild-to-moderate hypertension. Am J Hypertens. This medication may make you more sensitive to the sun. Avoid prolonged sun exposure, tanning booths, and sunlamps. Use a sunscreen and wear protective clothing when outdoors.
Co, Inc. Results of second heart-failure study with Cozaar presented at American Heart Association scientific sessions. West Point, PA; 1999 Nov 10. Press release from Yahoo web site. In patients who are elderly, volume-depleted including those on diuretic therapy or with compromised renal function, coadministration of NSAIDs, including selective COX-2 inhibitors, with angiotensin II receptor antagonists, including irbesartan, may result in deterioration of renal function, including possible acute renal failure. These effects are usually reversible. The antihypertensive effect of ARBs may be attenuated by NSAIDs. Therefore, monitor renal function and blood pressure periodically in patients receiving irbesartan and NSAID therapy.
Adolescents off-label use: Initial: 150 mg once daily; may be titrated to a maximum dose of 300 mg once daily NHBPEP, 2004. Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. The adverse reaction information from clinical trials does, however, provide a basis for identifying the adverse events that appear to be related to drug use and for approximating rates. Pentoxifylline: May enhance the hypotensive effect of Blood Pressure Lowering Agents.