Market-share Percentages of patients receiving various irbesartan (± HCT) dosages at study entry (n = 72 479). HCT = hydrochlorothiazide
Pharmacological Mechanisms(Pharmacodynamic): Antagonizes the effect of angiotensin II (vasoconstriction and aldosterone secretion) by blocking the angiotensin II (AT1 receptor) in vascular smooth muscle and the adrenal gland, producing decreased BP
Combination with diuretic Irbesartan is also available in a combination formulation with a low dose thiazide diuretic, invariably hydrochlorothiazide, to achieve an additive antihypertensive effect. Hydrochlorothiazide Irbesartan/hydrochlorothiazide combination preparations are marketed under similar trade names to irbesartan preparations, including Irda, CoIrda, CoAprovel, Karvezide, Avalide and Avapro HCT.
Pharmacokinetics: Absorption:The mean absolute bioavailability is:60% to 80%.The T max is 1.5 to 2 h. Food does not affect the bioavailability of irbesartan.
Pharmacokinetics,(continue) Distribution:90% is protein bound.Weakly crosses blood-brain barrier andplacenta.
Pharmacokinetics,(continue) Metabolism:Less than 20% converted to metabolites, primarily via CYP2C9. Elimination:Renal clearances is 3 to 3.5 mL/min.The mean t ½ is 11 to 15 h.Approximately, 20% is eliminated in theurine and 80% in the feces.
Indications and Usage Treatment of hypertension. Maximum antihypertensive effects are attained within 2 to 4 weeks after a change in dose.
Drug-Drug interactions : No significant drug-drug pharmacokinetic (or pharmacodynamic) interactions have been found in interaction studies with : Hydrochlorothiazide, a diuretic and antihypertensive drug. Digoxin, cardiotonic steroid . Warfarin, anticoagulant. Nifedipine, a calcium channel blocker . Lithium : However, Plasma concentrations my be increased by irbesartan, resulting in an increase in the pharmacologic and adverse effects of lithium
Drug-Food interactions: The chances of an interaction with Avapro are low.Avalide may be administered with or without food.
Side Effects: Several potential side effects may develop with the use of Avapro. Side effects that were most commonly reported include : diarrhea, heartburn, dizziness, and fatigue.
OVERDOSE No data are available in regard to over dosage in humans. However, daily doses of 900 mg for 8 weeks were well-tolerated. The most likely manifestations of over dosage are expected to be : hypotension and tachycardia;bradycardia might also occur from overdose. Irbesartan is not removed by hemodialysis.
Contraindications: Avapro® (irbesartan) is contraindicated in patients who are hypersensitive to any component of this product. However,Because of the hydrochlorothiazide component,this product is contraindicated in patients with : Anuria , Hypersensitivity to other sulfonamide-derived drugs.
WARNING: USE IN PREGNANCYWhen pregnancy is detected, discontinue AVALIDE as soon aspossible.When used in pregnancy during the second and third trimesters,drugs that act directly on the renin-angiotensin system cancause injury and even death to the developing fetus.
Storage Store at 25°C (77°F); excursions permitted to 15°C - 30°C (59°F - 86°F)
http://www.medicineonline.com/drugs/A/2137/AVReferences APRO-irbesartan-Tablets.html^ Lewis EJ, Hunsicker LG, Clarke WR, Berl T, Pohl MA, Lewis JB, Ritz E, Atkins RC, Rohde R, Raz I; Collaborative Study Group. (2001)."Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes". N Engl J Med 345 (12): 851–60. doi:10.1056/NEJMoa011303. PMID 11565517.^ Rossi S, editor. Australian Medicines Handbook 2006. Adelaide: Australian Medicines Handbook; 2006. ISBN 0-9757919-2-3^ Massie BM, Carson PE, McMurray JJ, Komajda M, McKelvie R, Zile MR, Anderson S, Donovan M, Iverson E, Staiger C, Ptaszynska A (December 2008). "Irbesartan in patients with heart failure and preserved ejection fraction". N. Engl. J. Med. 359 (23): 2456–67. doi:10.1056/NEJMoa0805450. PMID 19001508.
Team, Students from No. 3011-3020 Ahmed Salah Mohamed 2011 Ahmed Adel Ibrahim 2012 Ahmed Abdel Aziz El-beltagi 2013 Ahmed Abdel Mohsen 2014 Ahmed Alaa El-dien Ahmed 2015 Ahmed Fathi Abdel Samee’a 2016 Ahmed Fawzy Selim 2017 Ahmed Karim El-dien Zaki 2018 Ahmed Kamal Abdel Aziz 2019 Ahmed Maher Ismael 2020