#avapro

Brand Name: Avapro

Generic Available

Common Dosage Forms:

Tablets: 75 mg, 150 mg, 300 mg

FDA Indications/Dosages:

For the treatment of hypertension: Recommended initial dose is 150 mg once daily. Patients requiring further reduction in blood pressure should be titrated to 300 mg once daily. Irbesartan may be used alone or in combination with other antihypertensive agents. No dosage adjustment is necessary in elderly patients, or in patients with hepatic impairment or mild to severe renal impairment. Avapro may be administered with or without food.

For the treatment of diabetic nephropathy with an elevated serum creatinine and proteinuria (>300 mg/day) in patients with type 2 diabetes and hypertension: The recommended target dose is 300 mg once daily.

Pharmacology/Pharmacokinetics: Angiotensin II is a potent vasoconstrictor, the primary vasoactive hormone of the renin-angiotensin system and an important component in the pathophysiology of hypertension. It also stimulates aldosterone secretion by the adrenal cortex. Irbesartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor found in many tissues. Irbesartan does not inhibit ACE, bind to, or block other hormone receptors of ion channels known to be important in cardiovascular regulation. After an oral dose, irbesartan is rapidly absorbed with an average absolute bioavailability of 60-80%. Peak plasma levels are reached in 1.5-2 hours. Terminal elimination half-life averages 11-15 hours with steady state levels reached in 3 days. Metabolism occurs via glucuronide conjugation and oxidation (2C9). Irbesartan is 90% bound to serum proteins.

Drug Interactions: NSAIDs, including COX-2 inhibitors, may decrease effects and increase risk of renal function deterioration. Increased adverse effects may occur when used with other renin-angiotensin system blockers or aliskiren.

Contraindications/Precautions: Contraindicated with aliskiren. DO NOT USE DURING PREGNANCY. Do not use in nursing mothers. Use with caution in patients whose renal function may be dependent on the activity of the renin-angiotensin-aldosterone system, such as those with congestive heart failure. Rare cases of oliguria and/or progressive azotemia resulting in renal failure or death have occurred in patients receiving angiotensin converting enzyme inhibitors and angiotensin receptor antagonists. Patients should have intravascular sodium- and volume- depletion corrected prior to initiation of therapy or the initial dose should be lowered. Pregnancy Category D.

Adverse Effects: Mild adverse effects include upper respiratory tract infection (9%), fatigue (4%), diarrhea (3%), dyspepsia/heartburn (2%), and musculoskeletal trauma (2%).

Patient Consultation:

May be administered with or without food.

When pregnancy is detected, discontinue drug as soon as possible.

Store in a cool, dry place away from sunlight and children.

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