Irbesartan + Hydrochlorothiazide: Brands, Price & Uses in Bangladesh

Irbesartan + Hydrochlorothiazide is a fixed-dose combination of an angiotensin II receptor blocker (ARB) and a thiazide diuretic, indicated for the following:

Established/FDA-approved use

• Hypertension: Treatment of high blood pressure in adults whose blood pressure is not adequately controlled on monotherapy with either irbesartan or hydrochlorothiazide alone, or in patients who are expected to require multiple drugs to reach their blood pressure goal. Irbesartan + Hydrochlorothiazide is not indicated for initial therapy of hypertension.

Irbesartan + Hydrochlorothiazide lowers blood pressure but has not been specifically studied for reduction of cardiovascular morbidity and mortality; such benefits are inferred from the individual components used in other trials.

Adult dosage for hypertension

The full antihypertensive effect is generally seen within 2-4 weeks of starting or adjusting the dose. Irbesartan + Hydrochlorothiazide may be taken with or without food, at approximately the same time each day.

Renal impairment

Irbesartan + Hydrochlorothiazide is not recommended in patients with severe renal impairment (creatinine clearance below approximately 30 mL/min); thiazide diuretics may be ineffective in this setting and loop diuretics are usually preferred.

Hepatic impairment

No dosage adjustment of Irbesartan + Hydrochlorothiazide is generally required in mild-to-moderate hepatic impairment; thiazides should be used with caution in hepatic impairment because minor fluid and electrolyte changes may precipitate hepatic coma.

Elderly

No initial dosage adjustment is generally required in elderly patients, though they may be more sensitive to blood-pressure-lowering and volume effects.

Most people tolerate Irbesartan + Hydrochlorothiazide well. Reported side effects include:

Common

• Dizziness, fatigue, headache
• Musculoskeletal pain
• Nausea, upset stomach, diarrhea
• Mild increase in blood urea nitrogen and serum creatinine

Less common but important

• Orthostatic hypotension, especially in volume-depleted patients
• Electrolyte disturbances (hypokalemia, hyponatremia, hyperkalemia, hypomagnesemia)
• Elevated uric acid, precipitation of gout attacks
• Hyperglycemia and altered glucose tolerance

Rare but serious

• Angioedema (swelling of face, lips, tongue, throat)
• Acute renal failure
• Acute myopia and acute angle-closure glaucoma (thiazide-associated, usually within hours to weeks of starting)
• Photosensitivity reactions and other skin reactions
• Blood dyscrasias (rare, thiazide-associated)
• Pancreatitis (rare)

Seek urgent medical attention for signs of angioedema, severe dizziness/fainting, or eye pain with vision changes.