Avalide

Treatment is started separately with irbesartan and hydrochlorothiazide. Once the best dose of each component (irbesartan and hydrochlorothiazide) has been determined, the combination tablets can be started. Irbesartan - hydrochlorothiazide is generally not started until the best dose of each ingredient has been determined.

The dose ranges from 1 tablet containing 150 mg irbesartan and 12.5 mg hydrochlorothiazide once daily to 1 tablet containing 300 mg irbesartan and 25 mg hydrochlorothiazide once daily. Tablets should be taken at approximately the same time each day, with or without food, and taken in the same manner each day.

If you miss a dose, skip the missed dose and carry on as usual with your next dose. Do not take a double dose to make up for a missed dose. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

It is important to take Avalide regularly and to follow your doctor's instructions regarding monitoring blood pressure to ensure that you receive the maximum benefit from the medication.

Store Avalide at room temperature and keep it in a dry place (not in the bathroom). Keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause headaches; it may cause dizziness - use caution when getting up from a lying or sitting position and use caution if driving; it may cause unusual tiredness; it may cause nausea or, rarely, vomiting; it may make your skin more sensitive to UV rays (e.g., sunlight, tanning lamps) - avoid exposure to UV rays as much as possible and protect yourself when out in the sun; on occasion, it may cause a dry cough - contact your pharmacist or doctor if it becomes bothersome. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

150 mg/12.5 mg
Each peach, biconvex, oval tablet, with a heart shape debossed on one side and the digits "2775" on the other, contains 150 mg of irbesartan and 12.5 mg of hydrochlorothiazide. Nonmedicinal ingredients: croscarmellose sodium, ferric oxide red, ferric oxide yellow, lactose, magnesium stearate, microcrystalline cellulose, pregelatinized starch, and silicon dioxide.

300 mg/12.5 mg
Each peach, biconvex, oval tablet, with a heart shape debossed on one side and the digits "2776" on the other, contains 300 mg of irbesartan and 12.5 mg of hydrochlorothiazide. Nonmedicinal ingredients: croscarmellose sodium, ferric oxide red, ferric oxide yellow, lactose, magnesium stearate, microcrystalline cellulose, pregelatinized starch, and silicon dioxide.

Do not take Avalide if you:

• are allergic to irbesartan, hydrochlorothiazide, or any ingredients of the medication
• are allergic to sulfonamide-containing medications
• are breast-feeding
• are pregnant or plan to become pregnant
• have anuria (no urine flow)
• have Kidney Disease as a complication of Diabetes and are taking medications that belong to the family angiotensin-converting enzyme inhibitors (e.g., Ramipril, Enalapril)
• have diabetes and are taking the medication Aliskiren
• have moderate-to-severe kidney disease and are taking the medication aliskiren
• have galactose intolerance or glucose malabsorption (a rare hereditary disease)

There may be an interaction between irbesartan - hydrochlorothiazide and any of the following:

• aclidinium
• alcohol
• Aldesleukin
• aliskiren
• Allopurinol
• Amiodarone
• alpha-blockers (e.g., Alfuzosin, Doxazosin, Tamsulosin)
• alpha-agonists (e.g., Clonidine, methyldopa)
• amphetamines (e.g., Dextroamphetamine, Lisdexamfetamine)
• angiotensin-converting enzyme inhibitors (ACEIs; Captopril, enalapril, ramipril)
• antihistamines (e.g., cetirizine, doxylamine, Diphenhydramine, Hydroxyzine, Loratadine)
• antipsychotics (e.g., Chlorpromazine, Clozapine, Haloperidol, Olanzapine, Quetiapine, Risperidone)
• atropine
• azelastine
• barbiturates (e.g., butalbital, pentobarbital, Phenobarbital)
• belladonna
• Benztropine
• beta-adrenergic blockers (e.g., Atenolol, Propranolol, Sotalol)
• beta-2 agonists (e.g., salbutamol, formoterol, terbutaline)
• brimonidine
• calcium channel blockers (e.g., Amlodipine, Diltiazem, Nifedipine, Verapamil)
• calcium supplements (e.g., calcium carbonate, calcium citrate)
• Carbamazepine
• Celecoxib
• Cholestyramine
• Colesevelam
• Colestipol
• Cyclobenzaprine
• Cyclophosphamide
• Cyclosporine
• Dapsone
• Darifenacin
• dexmethylphenidate
• diabetes medications (e.g., chlorpropamide, Glyburide, insulin, Metformin, Nateglinide, Rosiglitazone)
• Digoxin
• Disopyramide
• diuretics (water pills; e.g., Furosemide, hydrochlorothiazide, triamterene)
• dofetilide
• Duloxetine
• Enzalutamide
• Eplerenone
• Flavoxate
• glycopyrrolate
• Guanfacine
• Heparin
• inhaled corticosteroids (e.g., budesonide, ciclesonide, fluticasone)
• ipratropium
• Ivabradine
• ketotifen
• levodopa
• lithium
• low-molecular-weight heparins (e.g., Dalteparin, Enoxaparin, Tinzaparin)
• Methylphenidate
• multivitamin supplements
• narcotic pain relievers (e.g., Codeine, Fentanyl, Morphine, Oxycodone)
• nitrates (e.g., Nitroglycerin, isosorbide dinitrate, isosorbide mononitrate)
• non-steroidal anti-inflammatory medications (NSAIDs; e.g., Diclofenac, Ibuprofen, Naproxen)
• Obinutuzumab
• oral corticosteroids (e.g., Dexamethasone, Hydrocortisone, Prednisone)
• orphenadrine
• other angiotensin receptor blockers (ARBs; e.g., Candesartan, Losartan)
• Oxcarbazepine
• Oxybutynin
• Paclitaxel
• Pentoxifylline
• Phenytoin
• phosphodiesterase-5 inhibitors (e.g., Sildenafil, Tadalafil, Vardenafil)
• Porfimer
• potassium supplements
• quinine
• Riociguat
• scopolamine
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Fluoxetine, Paroxetine, Sertraline)
• sodium phosphates
• Solifenacin
• sulfonamide antibiotics ("sulfas"; e.g., sulfadiazine, sulfisoxazole, sulfamethoxazole)
• tiotropium
• Tolterodine
• Tolvaptan
• Topiramate
• Tranylcypromine
• tretinoin
• tricyclic antidepressants (e.g., Amitriptyline, Clomipramine, Desipramine, Trimipramine)
• Trimethoprim
• umeclidinium
• vitamin D analogues (e.g., alfacalcidiol, Calcitriol, cholecalciferol)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. In many cases, interactions are intended or are managed by close monitoring. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Avalide. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, decongestants, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Avalide.

Allergic reaction: Some people who are allergic to sulfonamide medications also experience allergic reactions to hydrochlorothiazide. Before you take Avalide, inform your doctor about any previous adverse reactions you have had to medications, especially to sulfonamide antibiotics or diabetes medications. Contact your doctor at once if you experience signs of an allergic reaction, such as skin rash, itching, difficulty breathing, or swelling of the face and throat.

Cholesterol: An increase in cholesterol and triglycerides levels may occur when taking hydrochlorothiazide. Your doctor will monitor you for these changes while you are taking Avalide.

Diabetes: Hydrochlorothiazide may make it more difficult to control diabetes. If you have diabetes, your doctor may ask that you monitor your blood sugar carefully while taking Avalide.

An adjustment of your dose of antidiabetes medications, including insulin, may be needed.

Drowsiness/reduced alertness: Although irbesartan - hydrochlorothiazide is unlikely to affect alertness, occasionally dizziness or tiredness occurs when treating high blood pressure. Do not drive, operate machinery, or perform other potentially hazardous tasks until you have determined how Avalide affects you.

Fluid and electrolyte balance: As with other diuretics, levels of electrolytes such as potassium, sodium, magnesium, and chloride can be affected by the use of Avalide. Your doctor will periodically check to make sure your electrolytes are in balance.

Gout: Hydrochlorothiazide may increase the level of uric acid in the body, causing an attack of gout for people prone to this condition. If you have a history of gout or Kidney Stones, discuss with your doctor how Avalide may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Avalide, and whether any special monitoring is needed.

If you develop painful, warm, and swollen joints, contact your doctor as soon as possible.

Heart problems: Fluid and mineral changes in the body can affect several other medical conditions, including heart conditions. Irbesartan - hydrochlorothiazide can cause fluid to build up, increasing the work the heart must do to keep the blood circulating. If you have had a recent Heart Attack, or you have Congestive Heart Failure, taking irbesartan - hydrochlorothiazide can make symptoms of these heart conditions worse. If you have a history of heart problems, discuss with your doctor how Avalide may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Avalide, and whether any special monitoring is needed.

Low blood pressure: Occasionally, a larger-than-expected decrease in blood pressure occurs after taking Avalide. In some cases, this happens after the first dose. It is more likely to occur if you take diuretics (water pills) such as aliskiren, have a reduced salt intake, are on dialysis, or are experiencing diarrhea or vomiting. Blood pressure should be monitored more often in these situations. If you have low blood pressure or if you are just starting to take Avalide, move slowly from sitting or lying down to an upright position to reduce the risk of dizziness.

Kidney function: Irbesartan - hydrochlorothiazide can cause changes to kidney function that may result in decreased kidney function, kidney failure, or possibly death. Certain people have experienced changes in kidney function (e.g., people with narrowed blood vessels in their kidneys, or those with severe congestive heart failure). The use of diuretics (water pills), nonsteroidal anti-inflammatory drugs (NSAIDs), or aliskiren may further increase risk of kidney problems for people already at risk for this problem. If you have reduced kidney function, renal artery stenosis (narrowing of blood vessels in the kidneys), or congestive heart failure, discuss with your doctor how Avalide may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Avalide, and whether any special monitoring is needed. If you have reduced kidney function, you may require lower doses of Avalide.

Do not take Avalide if you have severely decreased kidney function.

Liver function: On rare occasions, irbesartan can cause liver problems. If you have liver disease or decreased liver function, discuss with your doctor how Avalide may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Avalide, and whether any special monitoring is needed.

If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Lupus: Hydrochlorothiazide may worsen the symptoms of systemic lupus erythematosus (SLE). If you have lupus, discuss with your doctor how Avalide may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Avalide, and whether any special monitoring is needed.

Sensitivity to sunlight: Avalide may increase the sensitivity of the skin to sunlight, increasing the risk of Sunburn. Avoid exposure to sunlight for long periods of time, particularly between the hours of 10 am and 2 pm, while you are taking Avalide and for 7 days after completing treatment. Wear a broad-spectrum sunscreen and lip balm with an SPF of 30 or higher. If you notice any unusual skin rash or peeling, contact your doctor immediately.

Skin Cancer: Recent studies of hydrochlorothiazide has connected long-term use of the medication with an increased risk of developing non-melanoma skin cancer. Talk to your doctor about any concerns you may have.

Vision changes: Hydrochlorothiazide occasionally causes vision changes, including increased eye pressure and myopia (nearsightedness). If you experience any eye symptoms, such as pain or change in vision, contact your doctor as soon as possible.

Pregnancy: Irbesartan may cause severe harm to an unborn fetus and should not be used during pregnancy. If you become pregnant while taking Avalide, contact your doctor immediately.

Women taking irbesartan - hydrochlorothiazide who are planning or trying to become pregnant should discuss other, more appropriate medications to control blood pressure with their doctor.

Breast-feeding: It is not known whether irbesartan passes into breast milk. Hydrochlorothiazide passes into breast milk. If you are a breast-feeding mother and are taking Avalide, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Avalide have not been established for children.

Seniors: Seniors may be more sensitive to the effects of Avalide and may experience more side effects, even at normal adult doses.

This medication is typically used only once a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. You should take this medication at approximately the same time each day. It must be used regularly and continuously to maintain its beneficial effects. Be sure to keep an adequate supply on hand. If you forget a dose, simply skip it and then take the next dose at the regularly scheduled time. This medication may be taken with or without food. Consuming alcohol may modify the effect of this product. Limit alcohol consumption during treatment.