Child <6 yr. Unilateral or bilateral renal artery stenosis; vol or Na depletion; aortic or mitral valve stenosis, hypertrophic cardiomyopathy.
Lactation: Potential harm to nursing infant; discontinue drug, or do not nurse
Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks
Mode of Action
Irbesartan is an angiotensin II receptor antagonist. It blocks the vasoconstricting and aldosterone-secreting effects of angiotensin II by binding to AT1 receptors.
Interaction
May antagonise hypotensive effect and increase risk of nephrotoxicity w/ NSAIDs. May increase serum lithium levels and toxicity. Increased risk of hyperkalaemia w/ K-sparing diuretics (e.g. amiloride, triamterene, spironolactone), K supplements or K-containing salt substitutes.
Potentially Fatal: May increase nephrotoxic, hyperkalaemic and hypotensive effect w/ aliskiren in patients w/ diabetes and renal impairment (GFR <60 mL/min).
Pregnancy Category Note
Pregnancy category: 1st trimester, C; 2nd and 3rd trimesters, D
Adult Dose
Oral
Hypertension
Adult: 150 mg once daily, may increase to 300 mg once daily if needed. Patient w/ intravascular volume depletion: Initially, 75 mg once daily.
Elderly: >75 yr Initially, 75 mg once daily.
Diabetic nephropathy in Type 2 diabetes mellitus
Adult: Initially, 75-150 mg once daily, may increase to 300 mg once daily if needed.
Child Dose
Hypertension
<6 years: Safety and efficacy not established
6-12 years: 75 mg/day PO initially; not to exceed 150 mg/day
>12 years: 150 mg/day PO initially; may be increased to 300 mg/day PO
Renal Dose
Renal impairment:
Haemodialysis: Initially, 75 mg once daily.
Mild-to-severe renal impairment: Dosage adjustment not necessary unless patient is hypovolemic
Administration
May be taken with or without food.
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