Names and pronunciation
(er-be-sar′tan) Avapro
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Individual generic drug information
Extracted information for irbesartan only.
(er-be-sar′tan) Avapro
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Func. class.: Antihypertensive
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Chem. class.: Angiotensin II receptor blocker (Type AT1)
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Do not confuse: Avapro/Anaprox
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ACTION: Blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II; selectively blocks the binding of angioten- sin II to the AT1 receptor found in tissues
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USES: Hypertension, alone or in com- bination; nephropathy in type 2 diabetic patients; proteinuria
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Extracted information for irbesartan only.
CONTRAINDICATIONS: Hypersensitivity
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Black Box Warning: Do not use in preg- nancy Precautions: Breastfeeding, children <6 yr, geriatric patients, hypersensitivity to ACE inhibitors; hepatic/renal disease; renal artery stenosis, African descent, angioedema DOSAGES AND ROUTES Hypertension • Adult: PO 150 mg/day; may be in- creased to 300 mg/day, volume-depleted patients: start with 75 mg/day Nephropathy in type 2 diabetic patients • Adult: PO maintenance dose 300 mg/ day, start 75 mg/day Black Box Warning: To notify prescriber if pregnancy is suspected; discontinue if pregnant
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SIDE EFFECTS CNS: Dizziness, anxiety, headache, fatigue, syncope CV: Hypotension GI: Diarrhea, dyspepsia, hepatitis, cholestasis HEMA: Thrombocytopenia MISC: Edema, chest pain, rash, tachy- cardia, UTI, angioedema, hyperkalemia RESP: Cough, upper respiratory tract infection, sinus disorder, pharyngitis, rhinitis
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INTERACTIONS Increase: hyperkalemia—potassium- sparing diuretics, potassium salt substi- tutes, ACE inhibitors Increase: irbesartan level—CYP2C9 inhibitors (amiodarone, delavirdine, fluconazole, FLUoxetine, fluvastatin, flu- voxaMINE, imatinib, sulfonamides, sul- finpyrazone, voriconazole, zafirlukast) Decrease: antihypertensive effect— NSAIDs Drug/Herb Increase: antihypertensive effect—black cohosh, garlic, goldenseal, hawthorn, kelp Increase or decrease: antihypertensive effect—astragalus, cola tree Decrease: antihypertensive effect— guarana, khat, licorice, yohimbe I
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Extracted information for irbesartan only.
Available forms: Tabs 75, 150, 300 mg
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Administer: • Without regard to meals • May be used with other antihyperten- sives, diuretic • Volume depletion should be corrected before use
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Extracted information for irbesartan only.
Assess: • Hypotension: for severe hypotension, place in supine position and give IV infu- sion of NS, drug may be continued after B/P is restored • B/P, pulse q4hr; note rate, rhythm, quality • Baselines of renal/hepatic studies be- fore therapy begins; periodically monitor LFTs, total/direct bilirubin • Skin turgor, dryness of mucous mem- branes for hydration status; edema in feet, legs daily
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Evaluate: • Therapeutic response: decreased B/P
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • To comply with dosage schedule, even if feeling better; that max therapeutic ef- fects may take 2-3 mo, to take without regard to food • That product may cause dizziness, fainting, light-headedness • To rise slowly to sitting or standing position to minimize orthostatic hypotension • Not to stop product abruptly
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Extracted information for irbesartan only.
PHARMACOKINETICS Peak 1.5-2 hr, extensively metabolized by CYP2C9, half-life 11-15 hr, highly bound to plasma proteins, excreted in urine and feces, protein binding 90%
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Filter the extracted dose blocks for this individual drug.