Hydrochlorothiazide + Irbesartan

Indications

Hydrochlorothiazide + Irbesartan is used for: Diabetic nephropathy, Hypertension

Adult Dose

Hypertension 150 mg/12.5 mg PO qDay intially; if needed, after 1-2 weeks may titrate up to 300 mg/25 mg PO qDay

Child Dose

Renal Dose

Administration

Contra Indications

Hypersensitivity; pregnancy and lactation.

Precautions

Child <6 yr. Unilateral or bilateral renal artery stenosis; vol or Na depletion; aortic or mitral valve stenosis, hypertrophic cardiomyopathy. Lactation: discontinue drug or do not nurse

Pregnancy-Lactation

Pregnancy Category: C (1st trimester); D (2nd & 3rd trimesters) Lactation: discontinue drug or do not nurse

Interactions

Other antihypertensives, lithium, K-sparing diuretics, K supplements, salt substitutes containing K. CNS depressants, antidiabetics, cholestyramine & colestipol resins, corticosteroids, ACTH, digitalis glycosides, antiarrhythmics, NSAIDs, tubocurarine, antigout medications, Ca salts. Alcohol; ?-blockers, diazoxide, atropine, beperiden, amantadine, cyclophosphamide, methotrexate.

Adverse Effects

Side effects of Hydrochlorothiazide + Irbesartan : >10% Irbesartan Hyperkalemia (19%) 1-10% Chest pain (2%), Tachycardia (1%), Abnormal urination (2%), Musculoskeletal pain (6%), Flu-like syndrome (3%), Edema (3%), Tachycardia (1%), Chest pain (2%), Creatinine increased (1%), Increased BUN (2%) Irbesartan Dizziness (10%), URI (9%), Orthostatic hypotension (5%), Fatigue (4%), Diarrhea (3%), Dyspepsia (2%) Frequency Not Defined Hydrochlorothiazide Anorexia, Epigastric distress, Hypotension, Orthostatic hypotension, Photosensitivity, Anaphylaxis, Anemia, Confusion, Erythema multiforme, Stevens-Johnson syndrome, Exfoliative dermatitis including toxic epidermal necrolysis, Dizziness, Hypokalemia and/or hypomagnesemia, Hyperuricemia, Headache

Mechanism of Action

Hydrochlorothiazide inhibits the reabsorption of Na and chloride in the distal tubules causing increased excretion of Na and water K and hydrogen ions. Irbesartan is an angiotensin II receptor antagonist. It blocks the vasoconstricting and aldosterone-secreting effects of angiotensin II by binding to AT1 receptors.