Irbesartan

About Irbesartan

Irbesartan blocks the receptor angiotensin II uses to tighten blood vessels and retain salt, lowering blood pressure. It usually starts at 150 mg once a day, rising to 300 mg if needed, with or without food; people low on fluid or salt, such as those on strong diuretics or hemodialysis, start at 75 mg. In type 2 diabetes with high blood pressure, raised creatinine and protein in the urine, 300 mg a day is used to slow kidney damage.

The boxed warning is for fetal toxicity: it can injure or kill a developing baby, so it is stopped as soon as pregnancy is detected, and the label advises against it while breastfeeding. Low blood pressure, raised potassium and kidney changes can occur, especially with low fluid or kidney disease, so blood tests follow. Diarrhea, heartburn and tiredness are the most common side effects; swelling of the face, lips, tongue or throat needs emergency care. With diabetes it must not be taken with aliskiren.

The combination with hydrochlorothiazide (Avalide and generics) is not recommended as a first treatment in people low on fluid. It is not used if you cannot pass urine or are allergic to sulfonamide-derived drugs; eye pain or a sudden change in vision needs prompt care; and hydrochlorothiazide is linked to non-melanoma skin cancer, so the label advises sun protection and regular skin checks.

Taking Irbesartan

How to take it

Once a day at about the same time, with or without food. It may take two weeks to notice the full benefit; keep taking it even if you feel well, since it controls blood pressure but does not cure it.

If you miss a dose

Take it as soon as you remember, unless the next dose is almost due; then skip the missed dose and continue as usual. Do not take a double dose.

Storage

At room temperature in the original container, tightly closed, away from heat and moisture, out of reach of children.

Interactions to know about

Anti-inflammatory painkillers such as ibuprofen can weaken its effect and strain the kidneys. Potassium supplements, potassium salt substitutes and other drugs that raise potassium can push it too high, and it can raise lithium levels. ACE inhibitors, other ARBs and aliskiren are generally avoided with it. With the combination, protect your skin from the sun.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Irbesartan differs from pharmacy to pharmacy

Irbesartan and the combination have many generic makers, so a cash quote mostly reflects each pharmacy’s dispensing fee and markup. A pharmacy that seldom fills it may need to order it.

Avapro and Avalide are still sold, and a prescription naming one without allowing substitution is priced as a brand. The 300/25 mg combination comes only from some makers, so not every pharmacy may stock it.

Ways to pay less for Irbesartan without insurance

• Ask the prescriber to allow generic substitution.
• If you take the combination, ask for quotes on it and on the two separate generics; your prescriber decides which to write.
• Ask for a ninety-day supply once your dose is stable.
• For the 300/25 mg combination, confirm the pharmacy stocks it before the prescription is sent.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Irbesartan

1. 1.Is this plain irbesartan or the combination, and which strength?
2. 2.When will my potassium and kidney function be checked?
3. 3.Which painkillers, potassium supplements or salt substitutes should I avoid?
4. 4.What should I do if I feel faint or very dizzy?
5. 5.What should I do if I am planning a pregnancy?

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