Arbitan tablet is indicated for the treatment of essential hypertension. Treatment of renal disease in patients with hypertension and type 2 diabetes mellitus as part of an antihypertensive drug regimen.
Irbesartan is an angiotensin II receptor antagonist. It blocks the vasoconstricting and aldosterone-secreting effects of angiotensin II by binding to AT1 receptors.
Adult: The usual recommended initial and maintenance dose is Irbesartan 150 mg once daily, with or without food. Irbesartan at a dose of 150 mg once daily generally provides a better 24 hour blood pressure control than 75 mg. However, initiation of therapy with Irbesartan 75 mg could be considered, particularly in haemodialysed patients and in the elderly over 75 years. In patients insufficiently controlled with Irbesartan 150 mg once daily, the dose of Irbesartan can be increased to Irbesartan 300 mg, or other anti-hypertensive agents can be added. In particular, the addition of a diuretic such as hydrochlorothiazide has been shown to have an additive effect with Irbesartan. In hypertensive type 2 diabetic patients, therapy should be initiated at Irbesartan 150 mg once daily and titrated up to Irbesartan 300 mg once daily as the preferred maintenance dose for treatment of renal disease. The demonstration of renal benefit of Irbesartan in hypertensive type 2 diabetic patients is based on studies where Irbesartan was used in addition to other antihypertensive agents, as needed, to reach target blood pressure. Elderly: although consideration should be given to initiating therapy with Irbesartan 75 mg in patients over 75 years of age, dosage adjustment is not usually necessary for the elderly Paediatric: Irbesartan is not recommended for use in children and adolescents due to insufficient data on safety and efficacy.
Always consult a registered doctor before taking any medicine. This information is for general knowledge only.
One of the main advantages of Arbitan is the low incidence of adverse effects, especially cough, a common effect of ACE inhibitors which work on the same reninangiotensin system. Common side effects: Headache, dizziness or light-headedness, fatigue, nausea, and vomiting. Less common: Anxiety, Nervousness, Belching, Heartburn, Stomach discomfort, Diarrhoea, Headache, Muscle or bone pain, Unusual tiredness.
Concomitant use with aliskiren in patients with diabetes and renal impairment (GFR <60 ml/min). Pregnancy.
Diuretics and other antihypertensive agents : prior treatment with high dose diuretics may result in volume depletion and a risk of hypotension when initiating therapy with Arbitan. Potassium supplements and potassium-sparing diuretics : based on experience with the use of other drugs that affect the renin-angiotensin system, concomitant use of potassiumsparing diuretics, potassium supplements, salt substitutes containing potassium or other drugs that may increase serum potassium levels (e.g. heparin) may lead to increases in serum potassium and is, therefore, not recommended. Lithium : reversible increases in serum lithium concentrations and toxicity have been reported during concomitant administration of lithium with angiotensin converting enzyme inhibitors. Similar effects have been very rarely reported with Arbitan so far. Therefore, Arbitan is not recommended. If the combination proves necessary, careful monitoring of serum lithium levels is recommended. Non-steroidal anti-inflammatory drugs : When angiotensin II antagonists are administered simultaneously with non-steroidal anti- inflammatory drugs (i.e. selective COX-2 inhibitors, acetylsalicylic acid > 3 g/day and non-selective NSAIDs), attenuation of the antihypertensive effect may occur. Additional information on Arbitan interactions: In clinical studies, the pharmacokinetic of Arbitan is not affected by hydrochlorothiazide. Arbitan is mainly metabolised by CYP2C9 and to a lesser extent by glucuronidation. No significant pharmacokinetic or pharmacodynamic interactions were observed when Arbitan was coadministered with warfarin, a drug metabolised by CYP2C9. The effects of CYP2C9 inducers such as rifampicin on the pharmacokinetic of Arbitan have not been evaluated. The pharmacokinetic of digoxin was not altered by coadministration of Arbitan.
Patients with unilateral or bilateral renal artery stenosis, depletion of intravascular volume, aortic or mitral stenosis, or obstructive hypertrophic cardiomyopathy. Renal impairment. Lactation.