Irbesartan

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Mar 11, 2024

Warnings

Irbesartan (Avapro) Risks, Warnings, and Complications

Irbesartan can cause adverse reactions and serious health problems in certain people. Talk to your doctor or pharmacist about other options for lowering blood pressure if you are at a high risk of complications from irbesartan use. Some of the risks of taking irbesartan include:

RISK DURING PREGNANCY: Irbesartan should not be used during pregnancy. This medication can cause harm to the developing fetus (unborn baby) if it is taken in the second or third trimesters (last 6 months) of pregnancy. Irbesartan is linked to an increased risk of developing acute renal failure, low blood pressure, serious birth defects, and death. Before starting irbesartan, tell your doctor if you are pregnant, could be pregnant, or planning a pregnancy in the near future. Stop taking irbesartan immediately and call your doctor if you become pregnant while on this medicine.
HYPOTENSION: Irbesartan can cause hypotension (low blood pressure) in people with an activated renin-angiotensin system, for example, in volume-depleted (dehydrated) or salt-depleted patients. Signs and symptoms of orthostatic dizziness can include lightheadedness and fainting. This particular risk is higher if you are also taking diuretics (water pills) to lower blood pressure. Your doctor will correct volume or salt depletion and use a lower starting dose if needed.
HYPERKALEMIA: Taking irbesartan with other drugs that can raise serum potassium levels can result in hyperkalemia (high blood potassium levels). Your doctor may order blood tests to monitor serum potassium.
COMPROMISED RENAL FUNCTION: In people with volume depletion, severe congestive heart failure, kidney dysfunction, or renal artery stenosis, kidney function depends on the renin-angiotensin system. In these individuals, taking irbesartan (which inhibits the renin-angiotensin system) can lead to kidney problems, including renal impairment (reduced kidney function) and acute kidney failure. Your doctor will monitor renal function periodically. If you develop signs of reduced renal function, for example, elevated serum creatinine, they may consider discontinuing therapy.

Precautions Before Starting Irbesartan (Avapro)

Tell your doctor if you have ever had allergic reactions to irbesartan, any of the active or inactive ingredients in irbesartan tablets, or any other drugs. Your pharmacy can give you a list of ingredients.

Give your doctor and pharmacist a complete list of your medications, including prescription drugs, over-the-counter medicines, vitamins, dietary supplements, and herbal products. This can help avoid possible drug interactions.

Be sure to tell your doctor if you are taking a medication called aliskiren (trade names Tekturna, Tekturna HCT, Tekamlo, Amturnide), which is prescribed for diabetes management. You should not take irbesartan and aliskiren together.

Give your doctor a complete medical history. Irbesartan may not be safe for people with certain medical conditions, such as severe heart failure or kidney disease.

Tell your doctor if you are pregnant, could be pregnant, are planning a pregnancy, or are breast-feeding. Talk to your doctor about appropriate birth control while on irbesartan.

Precautions During Use of Irbesartan (Avapro)

Keep all your medical and laboratory appointments during treatment with irbesartan. Your doctor may want to adjust your dose and monitor you for side effects.

Irbesartan can cause drowsiness, dizziness, and lightheadedness. Do not drive or operate heavy machinery until you know how this medicine affects you.

Irbesartan can cause orthostatic hypotension or symptomatic hypotension (low blood pressure) when going from a sitting or lying position to standing. The risk is highest when you first start treatment and after dose adjustments. Get out of bed slowly and place your feet on the ground for a few minutes before standing up to lower your risk of lightheadedness and fainting.

Call your healthcare provider if you develop diarrhea, vomiting, excessive sweating, or dehydration during treatment with irbesartan. This can lead to low blood pressure, which can cause lightheadedness and fainting.

If your doctor has recommended limited sodium intake (a low-salt diet), follow it carefully. Do not take potassium supplements, potassium-sparing diuretics, or potassium-containing salt substitutes without talking to your healthcare provider first.

Stop taking irbesartan and tell your doctor immediately if you become pregnant while on irbesartan. Do not nurse an infant on breast milk while on this medicine.

Tell all your doctors you are on irbesartan before any surgery, including dental procedures.

Irbesartan (Avapro) Drug Interactions

Certain medicines can affect how irbesartan works. Possible interactions between irbesartan and other medicines can increase the risk of severe adverse effects. Your doctor may prescribe lower doses, switch you to a different blood pressure medication, and/or monitor you carefully for side effects if there are known interactions between irbesartan and your other medications.

Diabetic patients who are on a medication called aliskiren (Tekturna, Tekturna HCT, Tekamlo, Amturnide) should not take irbesartan.

The following medications can also have interactions with irbesartan:

Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn)
Selective COX-2 inhibitors such as celecoxib (Celebrex)
Angiotensin-converting enzyme (ACE) inhibitors such as enalapril (Vasotec), benazepril (Lotensin, in Lotrel), fosinopril, captopril (Capoten, in Capozide), lisinopril (in Prinzide, in Zestoretic), perindopril (Aceon), moexipril (Univasc, in Uniretic), ramipril (Altace), quinapril (Accupril, in Accuretic, in Quinaretic), and trandolapril (Mavik, in Tarka)
Diuretics or water pills
Potassium supplements, potassium-sparing diuretics, potassium-containing salt substitutes

The above list may not include all the possible interactions of irbesartan. Give your doctor or pharmacist a complete list of your medications, including prescription drugs, over-the-counter medicines, dietary supplements, and herbal remedies. Also, tell your healthcare professional if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription and over-the-counter medicines.

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