Irbesartan (Avapro) is a prescription angiotensin II receptor blocker (ARB) used to treat high blood pressure and to help protect kidney function in patients with type 2 diabetes and diabetic kidney disease.
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Dr. Steve Malen, PharmD
Dr. Steven Blikstein, PharmD
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Irbesartan (Avapro) is an angiotensin II receptor blocker (ARB) that works by blocking the binding of angiotensin II to receptors in blood vessels, allowing vessels to relax and blood pressure to fall. It is FDA-approved to treat hypertension, either alone or with other antihypertensive agents, and to treat diabetic nephropathy in patients with type 2 diabetes, hypertension, and elevated serum creatinine or proteinuria, where it helps slow the progression of kidney disease. The usual starting dose for hypertension is 150 mg once daily, which may be increased to 300 mg once daily for additional blood pressure control; for diabetic nephropathy, the target dose is typically 300 mg once daily. Irbesartan may be taken with or without food. Common side effects include dizziness, fatigue, and upset stomach. Irbesartan should not be used during pregnancy, as ARBs can cause injury or death to a developing fetus; patients should stop the medication and contact their physician as soon as pregnancy is known. Patients should notify their physician about swelling of the face, lips, tongue, or throat, or difficulty breathing (signs of angioedema), as well as significant dizziness or fainting, which can indicate low blood pressure. Periodic monitoring of kidney function and potassium levels is recommended, particularly when irbesartan is combined with other medications that raise potassium.
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Irbesartan is used both to lower blood pressure and, in patients with type 2 diabetes, to help protect the kidneys from further damage. For hypertension, the usual starting dose is 150 mg once daily, which can be increased to 300 mg once daily if additional blood pressure lowering is needed; some patients may be started at a lower dose if volume-depleted. For diabetic nephropathy, the target maintenance dose is 300 mg once daily. Irbesartan can be taken with or without food, at approximately the same time each day.
Common side effects include dizziness, fatigue, diarrhea, heartburn, and musculoskeletal pain. Blood pressure may drop significantly in patients who are volume- or salt-depleted (for example, from diuretics, low-salt diets, vomiting, or diarrhea); correcting volume depletion before starting therapy can reduce this risk.
Kidney and potassium monitoring: Because irbesartan affects the renin-angiotensin system, it can raise potassium levels and affect kidney function, especially in patients with kidney impairment, diabetes, or those taking potassium supplements, potassium-sparing diuretics, or NSAIDs. Periodic monitoring of renal function and serum potassium is recommended.
Pregnancy: Irbesartan can cause fetal harm and should be discontinued as soon as possible once pregnancy is detected.
Patients should seek immediate medical attention for swelling of the face, lips, tongue, or throat, or difficulty breathing or swallowing (angioedema).