Indications:
Treatment of essential hypertension.
Treatment of type 2 diabetic nephropathy with hypertension.
Usage And Dosage:
The recommended initial and maintenance dose is 150 mg per day, with no effect on diet. In general, irbesartan 150 mg once daily provides better blood pressure control for 24 hours than irbesartan 75 mg once daily. However, for some special patients, especially those undergoing hemodialysis and over 75 years of age, 75 mg may be considered as an initial dose.
Patients whose blood pressure is not effectively controlled on irbesartan 150 mg once daily may increase the dose to 300 mg or add another antihypertensive agent. In particular, the addition of diuretics such as hydrochlorothiazide has been shown to have an additive effect.
In hypertensive patients with type 2 diabetes, the initial dose should be 150 mg once daily and increased to 300 mg once daily as a good maintenance dose for nephropathy. Clinical studies have shown that Ambovir benefits the kidneys of patients with hypertensive type 2 diabetes. In the study, irbesartan was added to other antihypertensive drugs when necessary to lower blood pressure and achieve the target value.
Renal impairment: Dose adjustment is not required in patients with renal impairment, but a lower initial dose (75 mg) may be considered in patients undergoing hemodialysis.
Hypovolemic: Patients with hypovolemic and/or sodium deficiencies should be corrected before use of this product.
Liver damage: Patients with mild to moderate liver damage need not adjust the dose of this product. There is no clinical experience in patients with severe liver damage.
Elderly patients: Although 75 mg may be considered as a starting dose for those over 75 years of age, there is usually no need to adjust the dose for elderly patients.
Children: The safety and efficacy of Ambovir in children have not been established.
Interactions:
Diuretics and other antihypertensive medications: the hypotensive effect of this product may be enhanced when used in combination with other hypotensive medications. However, it can be safely combined with other hypotensive agents such as long-acting calcium channel blockers, beta-blockers, and thiazide diuretics. Excessive doses of diuretics before first use may result in volume depletion and hypotension risk.
Potassium supplements and potassium-conserving diuretics: Based on clinical experience with other drugs that affect the renin-angiotensin system, the combination of potassium-conserving diuretics, potassium supplements, potassium-containing salt substitutes, or other drugs that increase serum potassium levels (e.g., heparin sodium) can lead to an increase in serum potassium and is therefore not recommended.
Lithium: Increased serum lithium reversibility and toxicity have been reported when lithium is used in combination with angiotensin converting enzyme inhibitors. Moreover, thiazide diuretics can reduce renal clearance of lithium, and similar effects have rarely been reported in the use of this product. Therefore, combined use is not recommended. Careful monitoring of serum lithium concentration is recommended if this product is to be used in conjunction with lithium.
Nsaids: Like other antihypertensive drugs, the antihypertensive effects of irbesartan are attenuated by NSaids.
Additional information on drug interactions: In healthy male subjects, the pharmacokinetics of digoxin did not change when used in combination with irbesartan 150 mg. Irbesartan pharmacokinetics were not affected when used in combination with hydrochlorothiazide. Irbesartan is mainly metabolized by CYP 2C9, and a small part of irbesartan is metabolized by gluconaldehyde acidification. Inhibition of the glucuronic transferase pathway does not result in clinically significant interactions. In vitro experiments, interactions between irbesartan and warfarin, toluensulfonylurea (CYP 2C9 substrate) and nifedipine (CYP 2C9 inhibitor) were observed. In healthy men, however.
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