irbesartan, Avapro

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Pharmacy Author:

Omudhome Ogbru, PharmD

Omudhome Ogbru, PharmD

Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

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Medical and Pharmacy Editor:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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GENERIC NAME: irbesartan

BRAND NAME: Avapro

DRUG CLASS AND MECHANISM: Irbesartan is an oral medication that is used to treat high blood pressure (hypertension) and diabetic nephropathy or kidney disease. It belongs to a class of drugs called angiotensin receptor blockers (ARBs) which also includes valsartan (Diovan), losartan (Cozaar), and candesartan (Atacand). Angiotensin, formed in the blood by the action of angiotensin converting enzyme (ACE), is a powerful chemical that attaches to angiotensin receptors found in many tissues but primarily on smooth muscle cells of blood vessels. Angiotensin's attachment to the receptors causes the blood vessels to narrow (vasoconstrict), which leads to an increase in blood pressure (hypertension ). Irbesartan blocks the angiotensin receptor. By blocking the action of angiotensin, irbesartan dilates blood vessels and reduces blood pressure. The FDA approved irbesartan in September 1997.

GENERIC AVAILABLE: No

PRESCRIPTION: Yes

PREPARATIONS: Tablets: 75 mg, 150 mg and 300 mg.

STORAGE: Tablets should be stored at room temperature, 15-30 C (59-86 F).

PRESCRIBED FOR: Irbesartan is used to treat high blood pressure. It may be used alone or in combination with other drugs. Irbesartan also is used for treating nephropathy (kidney failure) in patients with type 2 diabetes.

DOSING: The recommended dose of irbesartan for treating hypertension is 75 to 300 mg once daily. Most hypertensive patients are started on 150 mg daily. Diabetic nephropathy is treated with 300 mg daily.

DRUG INTERACTIONS: Combining irbesartan with potassium-sparing diuretics (for example., spironolactone [Aldactone], triamterene, amiloride), potassium supplements, or salt substitutes containing potassium may lead to hyperkalemia (elevated potassium in the blood) and toxicity from potassium.

Combining irbesartan or other ARBs with nonsteroidal anti-inflammatory drugs (NSAIDs) in patients who are elderly, fluid-depleted (including those on diuretic therapy), or with poor kidney function may result in reduced kidney function, including kidney failure. These effects usually are reversible. There have been reports that aspirin and other NSAIDs such as ibuprofen (Advil, Children's Advil/Motrin, Medipren, Motrin, Nuprin, PediaCare Fever, etc.), indomethacin (Indocin, Indocin-SR), and naproxen (Anaprox, Naprelan, Naprosyn, Aleve) may reduce the effects of ARBs.

PREGNANCY: All ARBs should not be used during pregnancy. When used in the second or third trimester of pregnancy, irbesartan and similar drugs may cause injury and even death to the fetus. Irbesartan should not be used during pregnancy. When pregnancy is detected, irbesartan should be stopped as soon as possible.

NURSING MOTHERS: It is not known whether irbesartan is secreted into human milk. Irbesartan is secreted into the milk of rats.

SIDE EFFECTS: The most common side effects are dizziness, hyperkalemia, diarrhea, abdominal pain or heartburn, fatigue, and reduced blood pressure when rising from a sitting or standing position (orthostatic hypotension). Patients also may experience impotence, reduced renal function, and allergic reactions. Rhabdomyolysis (inflammation and destruction of muscle) and angioedema (swelling of soft tissues including those of the throat and larynx) are rare but serious side effects of irbesartan.

Reference: FDA Prescribing Information

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