Irbesartan is excreted in the milk of lactating rats. Irbesartan: 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. Hydrochlorothiazide: Thiazide diuretics have been reported to cause exacerbation or activation of systemic lupus erythematosus. The mean baseline seated systolic and diastolic blood pressures were 159 mmHg and 87 mmHg, respectively.
Irbesartan and its metabolites are excreted by both biliary and renal routes. Following either oral or intravenous administration of 14C-labeled irbesartan, about 20% of radioactivity is recovered in the urine and the remainder in the feces, as irbesartan or irbesartan glucuronide. Irbesartan tablets USP may be used alone or in combination with other antihypertensive agents. The mechanism of the antihypertensive effect of thiazides is not fully understood.
Irbesartan and Hydrochlorothiazide may be administered with or without food. Cleve Clin J Med. 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. Mitka M. Groups spar over new hypertension guidelines. JAMA.
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. Irbesartan and Hydrochlorothiazide was not mutagenic in standard in vitro tests Ames microbial test and Chinese hamster mammalian-cell forward gene-mutation assay. The choice of Irbesartan and Hydrochlorothiazide as initial therapy for hypertension should be based on an assessment of potential benefits and risks. The likelihood of achieving these goals on Irbesartan and Hydrochlorothiazide rises to about 40% systolic or 70% diastolic.
Tetrahydrocannabinol: CYP2C9 Inhibitors Moderate may increase the serum concentration of Tetrahydrocannabinol. Anon. Drugs for hypertension. Med Lett Drugs Ther. Irbesartan and Hydrochlorothiazide. Although the high dose combination appeared to be more toxic to the dams than either drug alone, there did not appear to be an increase in toxicity to the developing embryos. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall. Volpe M, Morganti A. 2010 Position Paper of the Italian Society of Hypertension SIIA: Angiotensin Receptor Blockers and Risk of Cancer. High Blood Press Cardiovasc Prev. Tolvaptan: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Refer to adult dosing. FDA pregnancy category D. Do not use hydrochlorothiazide and irbesartan if you are pregnant. Stop using this medication and tell your doctor right away if you become pregnant. Irbesartan can cause injury or death to the unborn baby if you take the medicine during your second or third trimester. Use effective birth control while taking hydrochlorothiazide and irbesartan. 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 high blood pressure do not feel sick. Monitor lithium levels in patients receiving irbesartan and lithium. Irbesartan and Hydrochlorothiazide is indicated for the treatment of hypertension. Molsidomine: May enhance the hypotensive effect of Blood Pressure Lowering Agents.
Keep all and herbal products away from children and pets. Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs. Irbesartan is an angiotensin II receptor antagonist. Irbesartan keeps blood vessels from narrowing, which lowers blood pressure and improves blood flow. Impaired renal function, including cases of renal failure in patients at risk, has been reported with irbesartan and Irbesartan and Hydrochlorothiazide. Hydrochlorothiazide: The most common signs and symptoms of overdose observed in humans are those caused by electrolyte depletion hypokalemia, hypochloremia, hyponatremia and dehydration resulting from excessive diuresis. If digitalis has also been administered, hypokalemia may accentuate cardiac arrhythmias. The degree to which hydrochlorothiazide is removed by hemodialysis has not been established. 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. It is unknown if this product passes into milk. Consult your doctor before breast-feeding. Irbesartan and Hydrochlorothiazide approximately 1%. 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. See USP Controlled Room Temperature. Our Irbesartan Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication. avelox
Every effort has been made to ensure that the information provided by Cerner Multum, Inc. 'Multum' is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Hydrochlorothiazide: After oral administration of hydrochlorothiazide, diuresis begins within 2 hours, peaks in about 4 hours and lasts about 6 to 12 hours. Skeletal Muscle Relaxants: Possible increased responsiveness to muscle relaxants such as curare derivatives. Where can I get more information? Angiotensin II receptor antagonists may be used as an alternative for those patients in whom an ACE inhibitor or ARNI is inappropriate. Irbesartan and Hydrochlorothiazide may be substituted for the titrated components. ranolazine dry cough syrup ranolazine
CYP2C8 Substrates: CYP2C8 Inhibitors Moderate may decrease the metabolism of CYP2C8 Substrates. Quinagolide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Use of drugs that act on the renin-angiotensin system during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death. Resulting oligohydramnios can be associated with fetal lung hypoplasia and skeletal deformations. Potential neonatal adverse effects include skull hypoplasia, anuria, hypotension, renal failure, and death. When pregnancy is detected, discontinue irbesartan as soon as possible. These adverse outcomes are usually associated with use of these drugs in the second and third trimesters of pregnancy. Most epidemiologic studies examining fetal abnormalities after exposure to antihypertensive use in the first trimester have not distinguished drugs affecting the renin-angiotensin system from other antihypertensive agents. Appropriate management of maternal hypertension during pregnancy is important to optimize outcomes for both mother and fetus. HCTZ at 8 weeks, respectively. HCTZ 25 mg, respectively.
Norepinephrine: possible decreased response to pressor amines but not sufficient to preclude their use. Irbesartan: Irbesartan is 90% bound to serum proteins primarily albumin and α 1-acid glycoprotein with negligible binding to cellular components of blood. The average volume of distribution is 53 to 93 liters. 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. Lewis EJ, Hunsicker LG, Clarke WR et al. Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med. Food and Drug Administration. FDA drug safety communication: ongoing safety review of the angiotensin receptor blockers and cancer. Anon. Valsartan for hypertension. Med Lett Drugs Ther. Food and Drug Administration. FDA drug safety communication: No increase in risk of cancer with certain blood pressure drugs-angiotensin receptor blockers ARBs. Rockville, MD; 2011 Jun 2. Available from FDA website. 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, unless it is considered life saving 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. The pharmacokinetics of irbesartan were not altered in patients with renal impairment or in patients on hemodialysis. Irbesartan is not removed by hemodialysis. Blankfield RP. Angiotensin-receptor blockers, type 2 diabetes, and renoprotection. N Engl J Med. Manufactured by: Macleods Pharmaceuticals Ltd. The following adverse reactions have been identified during post-approval use of irbesartan tablets. itan.info abilify
Methylphenidate: May diminish the antihypertensive effect of Antihypertensive Agents. Monitor serum potassium in such patients. Hg may still be considered. Patients not adequately treated by the maximum dose of 300 mg once daily are unlikely to derive additional benefit from a higher dose or twice-daily dosing. Mild to severe impairment: No dosage adjustment necessary unless the patient is also volume depleted. Pfeffer MA, Swedberg K, Granger CB et al. Effects of candesartan on mortality and morbidity in patients with chronic heart failure: the CHARM-Overall programme. Lancet. Does not share the ACE inhibitor common adverse effect of dry cough. 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. Irbesartan is metabolized via glucuronide conjugation and oxidation. Following oral or intravenous administration of 14C-labeled irbesartan, more than 80% of the circulating plasma radioactivity is attributable to unchanged irbesartan. The primary circulating metabolite is the inactive irbesartan glucuronide conjugate approximately 6%. Brenner BM, Cooper ME, de Zeeuw D et al. Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med. Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. What happens if I overdose? Adverse events occurred at about the same rates in men and women, older and younger patients, and black and non-black patients. cafergot italia
Blocks the physiologic actions of angiotensin II, including vasoconstrictor and aldosterone-secreting effects. 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. Patient may experience nausea, diarrhea, or loss of strength and energy. Have patient report immediately to prescriber signs of kidney problems urinary retention, blood in urine, change in amount of urine passed, weight gain signs of high potassium abnormal heartbeat, confusion, dizziness, passing out, weak, shortness of breath, numbness or tingling feeling severe dizziness, passing out, angina, tachycardia, or edema HCAHPS. 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. 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. Fixed-combination tablets containing irbesartan and hydrochlorothiazide are not recommended as initial therapy in patients with intravascular volume depletion. AHA guidelines for the evaluation and management of chronic heart failure in the adult. 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. In controlled clinical trials, clinically important differences in laboratory tests were rarely associated with administration of irbesartan.
In healthy black subjects, irbesartan AUC values were approximately 25% greater than whites; there were no differences in C max values. Tell your doctor if your condition does not improve or if it worsens for example, your increase. Of 1694 patients receiving Irbesartan and Hydrochlorothiazide in controlled clinical studies of hypertension, 264 15. Food and Drug Administration. FDA public health advisory: angiotensin-converting enzyme inhibitor ACE inhibitor drugs and pregnancy. 2006 June 7. From FDA website. 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. In Studies I to VI, there was no difference in response for men and women or in patients over or under 65 years of age. Black patients had a larger response to hydrochlorothiazide than non-black patients and a smaller response to irbesartan. The overall response to the combination was similar for black and non-black patients. The effect of irbesartan is apparent after the first dose, and it is close to its full observed effect at 2 weeks. Anon. Irbesartan for hypertension. Med Lett Drugs Ther. 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. Dronabinol: CYP2C9 Inhibitors Moderate may increase the serum concentration of Dronabinol. Irbesartan is slightly soluble in alcohol and methylene chloride and practically insoluble in water. As a consequence of inhibiting the renin-angiotensin-aldosterone system, changes in renal function may be anticipated in susceptible individuals. 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 the pharmacokinetics of digoxin. The pharmacokinetics of irbesartan were not affected by coadministration of nifedipine or hydrochlorothiazide. Hydrochlorothiazide is a thiazide diuretic water pill that helps prevent your body from absorbing too much salt, which can cause fluid retention. To obtain up-to-date information about the treatment of overdosage, a good resource is a certified regional Poison Control Center. In the moderate hypertension Study V mean SeDBP between 90 and 110 mmHg the types and incidences of adverse events reported for patients treated with Irbesartan and Hydrochlorothiazide was similar to the adverse event profile in patients on initial irbesartan or HCTZ monotherapy. There were no reported events of syncope in the Irbesartan and Hydrochlorothiazide treatment group and there was one reported event in the HCTZ treatment group. generic varenicline purchase now shopping
Crosses the placenta and is distributed in the fetus in animals. An American Heart Association Scientific Statement from the Council on Clinical Cardiology Subcommittee on Exercise, Cardiac rehabilitation, and Prevention. Circulation. Angiotensin II is a potent vasoconstrictor formed from angiotensin I in a reaction catalyzed by angiotensin-converting enzyme ACE, kininase II. Angiotensin II is the principal pressor agent of the renin-angiotensin system RAS and also stimulates aldosterone synthesis and secretion by adrenal cortex, cardiac contraction, renal resorption of sodium, activity of the sympathetic nervous system, and smooth muscle cell growth. Irbesartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively binding to the AT 1 angiotensin II receptor. There is also an AT 2 receptor in many tissues, but it is not involved in cardiovascular homeostasis. Food and Drug Administration. 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. Irbesartan and Hydrochlorothiazide Tablets USP are a combination of an angiotensin II receptor antagonist AT 1 subtype irbesartan, and a thiazide diuretic, hydrochlorothiazide HCTZ. It is unknown if irbesartan passes into milk. The terminal elimination half-life of irbesartan averaged 11 to 15 hours. Steady-state concentrations are achieved within 3 days. Hydrochlorothiazide: Thiazides should be used with caution in patients with impaired hepatic function or progressive liver disease, since minor alterations of fluid and electrolyte balance may precipitate hepatic coma. The combination of Irbesartan and Hydrochlorothiazide has not been evaluated in definitive studies of fertility. Irbesartan and Hydrochlorothiazide is contraindicated in patients who are hypersensitive to any component of this product. Importance of women informing their clinician if they are or plan to become pregnant or plan to breast-feed. Tell your doctor if your condition does not improve or if it worsens for example, your blood pressure readings increase. 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. order dostinex online shop europe
The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs. 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. 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. Yohimbine: May diminish the antihypertensive effect of Antihypertensive Agents. ACCF, AHA, and the Heart Failure Society of America HFSA recommend that patients with chronic symptomatic heart failure and reduced LVEF NYHA class II or III who are able to tolerate an ACE inhibitor or angiotensin II receptor antagonist be switched to therapy containing an ARNI to further reduce morbidity and mortality. The antihypertensive effects of the drug may be enhanced in the post-sympathectomy patient. This product is not recommended for use in children. Drinking alcohol can further lower your blood pressure and may increase certain side effects of irbesartan. 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. Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Food and Drug Administration. WebMD does not endorse any specific product, service, or treatment. Do not consider WebMD User-generated content as medical advice. Never delay or disregard seeking professional medical advice from your doctor or other qualified healthcare provider because of something you have read on WebMD. You should always speak with your doctor before you start, stop, or change any prescribed part of your care plan or treatment. WebMD understands that reading individual, real-life experiences can be a helpful resource, but it is never a substitute for professional medical advice, diagnosis, or treatment from a qualified health care provider. If you think you may have a medical emergency, call your doctor or dial 911 immediately. Irbesartan: Irbesartan is an orally active agent that does not require biotransformation into an active form. The oral absorption of irbesartan is rapid and complete with an average absolute bioavailability of 60% to 80%. If any of these effects persist or worsen, tell your doctor or promptly.
What should I avoid while taking hydrochlorothiazide and irbesartan Avalide? The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist. Lowering blood pressure reduces the risk of fatal and nonfatal events, primarily strokes and myocardial infarctions. 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. Analysis of age, gender, and race subgroups of patients showed that men and women, and patients over and under 65 years of age, had generally similar responses. Irbesartan was effective in reducing blood pressure regardless of race, although the effect was somewhat less in blacks usually a low-renin population. In elderly subjects age 65 to 80 years irbesartan elimination half-life was not significantly altered, but AUC and C max values were about 20% to 50% greater than those of young subjects age 18 to 40 years. No dosage adjustment is necessary in the elderly. Irbesartan does not inhibit ACE or renin or affect other hormone receptors or ion channels known to be involved in the cardiovascular regulation of blood pressure and sodium homeostasis. Because irbesartan does not inhibit ACE, it does not affect the response to bradykinin; whether this has clinical relevance is not known. Pasternak B, Svanström H, Callréus T et al. Use of angiotensin receptor blockers and the risk of cancer. Circulation. This product may make you dizzy or drowsy. not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit beverages. DOQI Clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease 2002. From National Kidney Foundation website. Renal impairment: Use with caution with preexisting renal insufficiency. Studies in animals indicate that radiolabeled irbesartan weakly crosses the blood-brain barrier and placenta. Irbesartan is excreted in the milk of lactating rats. buy genuine protopic-ointment online
Diazoxide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets. Irbesartan is an orally active agent that does not require biotransformation into an active form. The oral absorption of irbesartan is rapid and complete with an average absolute bioavailability of 60 to 80%. 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. What happens if I overdose Avalide? Older adults may be more sensitive to the side effects of this drug, especially dizziness and change in the amount of urine kidney problems. No gender-related differences in pharmacokinetics were observed in healthy elderly age 65 to 80 years or in healthy young age 18 to 40 years subjects. In studies of hypertensive patients, there was no gender difference in half-life or accumulation, but somewhat higher plasma concentrations of irbesartan were observed in females 11% to 44%. No gender-related dosage adjustment is necessary. Salt-depleted Patients under Dosage and Administration. Siragy HM. A current evaluation of the safety of angiotensin receptor blockers and direct renin inhibitors. Vasc Health Risk Manag. Your pharmacist can provide more information about hydrochlorothiazide and irbesartan. Check the labels on all your medicines such as -and-cold products, because they may contain ingredients that could increase the side effects of ginseng. Amifostine: Blood Pressure Lowering Agents may enhance the hypotensive effect of Amifostine. Management: When amifostine is used at chemotherapy doses, blood pressure lowering medications should be withheld for 24 hours prior to amifostine administration. If blood pressure lowering therapy cannot be withheld, amifostine should not be administered. NSAIDs including selective COX-2 inhibitors. Irbesartan and Hydrochlorothiazide than in the group treated with irbesartan. 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. Monitor renal function periodically in patients receiving irbesartan and NSAID therapy. epogen
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Crosses the blood-brain barrier poorly, if at all, in animals. Ginseng has been used for improving overall health. It has also been used to strengthen the and help fight off stress and disease. There are different types of ginseng. Safety and efficacy of the fixed-combination preparation containing irbesartan and hydrochlorothiazide not established. Hypotension-Associated Agents: Blood Pressure Lowering Agents may enhance the hypotensive effect of Hypotension-Associated Agents. Qaseem A, Hopkins RH, Sweet DE et al. Screening, monitoring, and treatment of stage 1 to 3 chronic kidney disease: A clinical practice guideline from the American College of Physicians. Ann Intern Med.
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. Do not share this medication with others. Take this product by as directed. Follow all directions on the product package. Dosage is based on the condition the product is used for and the type of ginseng. When pregnancy is detected, discontinue irbesartan tablets as soon as possible. When pregnancy is detected, discontinue irbesartan as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and even death to the developing fetus.
HCTZ also had an approximately additive effect. 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. 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. 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.
If hypotension occurs, the patient should be placed in the supine position and, if necessary, given an intravenous infusion of normal saline. A transient hypotensive response is not a contraindication to further treatment, which usually can be continued without difficulty once the blood pressure has stabilized. 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. Irbesartan and Hydrochlorothiazide may be used in patients whose blood pressure is not adequately controlled on monotherapy.