Irbesartan Disease Interactions
There are 4 disease interactions with irbesartan:
Ar Antagonists (Includes Irbesartan) ↔ Hypotension
Severe Potential Hazard, High plausibility
Applies to: Dehydration, hemodialysis, Hyponatremia
Angiotensin II receptor (AR) antagonists can cause symptomatic hypotension in patients with an activated renin-angiotensin system, such as volume- and/or sodium-depleted patients. Therapy with AR antagonists should be administered cautiously in such patients and in those predisposed to hypovolemic or hyponatremic states (e.g., patients on diuretic therapy, especially if high doses were used or if recently instituted; those on dietary salt restriction; renal dialysis patients). Volume and/or sodium depletion should be corrected prior to initiating therapy with AR antagonists, and the patient should be hemodynamically stable. Ideally, patients at risk for excessive hypotension should initiate AR antagonist therapy under close medical supervision, preferably with a lower dose, and followed closely for the first 2 weeks of treatment and whenever the dosage of AR antagonist or diuretic is increased.
Ar Antagonists (Includes Irbesartan) ↔ Chf
Moderate Potential Hazard, Moderate plausibility
Applies to: Congestive Heart Failure
Angiotensin II receptor (AR) antagonists can cause renal impairment in patients whose renal function depends on the activity of the renin-angiotensin-aldosterone system. In addition, symptomatic hypotension can occur in susceptible individuals, which may compromise renal and myocardial perfusion. In patients with severe congestive heart failure (CHF), treatment with AR antagonists has been associated with oliguria and/or progressive azotemia and, rarely, renal failure, myocardial ischemia, and death. Therapy with AR antagonists should be initiated cautiously in patients with severe CHF, especially when accompanied by volume and/or sodium depletion. In patients who experience a decline in renal function, discontinuation of AR antagonist therapy is usually not required provided there is symptomatic improvement of the heart failure and renal deterioration is well-tolerated. Transient hypotension is also not a contraindication to further treatment with AR antagonists, since therapy can usually be reinstated without difficulty after blood pressure stabilizes.
Ar Antagonists (Includes Irbesartan) ↔ Renal Artery Stenosis
Moderate Potential Hazard, Moderate plausibility
Applies to: Renal Artery Atherosclerosis
In patients with bilateral renal artery stenosis or renal artery stenosis in a solitary kidney, angiotensin II receptor (AR) antagonists may reduce renal perfusion to a critically low level. Increases in serum creatinine or blood urea nitrogen have been reported with ACE inhibitors, a class of drugs that also block the renin-angiotensin-aldosterone system. Although there are no long-term data on the use of AR antagonists in patients with renal artery stenosis, a similar effect should be anticipated. Renal function should be monitored closely for the first few weeks of therapy.
Irbesartan (Includes Irbesartan) ↔ Renal/Liver Disease
Moderate Potential Hazard, Low plausibility
Applies to: Liver Disease, Biliary Obstruction, Renal Dysfunction
Irbesartan is metabolized by the liver, and both parent drug and metabolites are eliminated by the kidney (20%) as well as by biliary excretion (80%). Dosage adjustments are not necessary in patients with renal impairment unless they are also volume-depleted, in which case therapy should be initiated under medical supervision. Likewise, patients with hepatic impairment or biliary obstruction generally do not require a dosage adjustment. However, reduced dosages may be appropriate in patients with both renal and liver or biliary disease.
You should also know about...
irbesartan drug Interactions
There are 402 drug interactions with irbesartan
irbesartan alcohol/food Interactions
There is 1 alcohol/food interaction with irbesartan
See also...
Drug Interaction Classification
The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
| Major | Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. |
| Moderate | Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. |
| Minor | Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. |
Do not stop taking any medications without consulting your healthcare provider.
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