Avalide Side Effects

Generic Name: hydrochlorothiazide / irbesartan

Note: This page contains information about the side effects of hydrochlorothiazide / irbesartan. Some of the dosage forms included on this document may not apply to the brand name Avalide.

Not all side effects for Avalide may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to hydrochlorothiazide / irbesartan: oral tablet

In addition to its needed effects, some unwanted effects may be caused by hydrochlorothiazide / irbesartan. In the event that any of these side effects do occur, they may require medical attention.

You should check with your doctor immediately if any of these side effects occur when taking hydrochlorothiazide / irbesartan:

Less common
  • Abdominal or stomach pain
  • bloody or cloudy urine
  • chest pain
  • confusion
  • difficult with breathing
  • difficult, burning, or painful urination
  • fast, pounding, or irregular heartbeat or pulse
  • frequent urge to urinate
  • lower back or side pain
  • nausea or vomiting
  • numbness or tingling in the hands, feet, or lips
  • swelling
  • weakness or heaviness of the legs
Rare
  • Blurred vision
  • convulsions
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • loss of appetite
  • muscle pain or cramps
  • sweating
  • unusual tiredness or weakness
Incidence not known
  • Dark-colored urine
  • fever
  • hives or welts, itching, or skin rash
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • muscle spasms or stiffness
  • upper right abdominal or stomach pain
  • yellow eyes and skin

Some of the side effects that can occur with hydrochlorothiazide / irbesartan may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common
  • Headache
  • sunburn
Less common
  • Acid or sour stomach
  • chills
  • congestion
  • cough
  • diarrhea
  • dryness or soreness of the throat
  • joint pain
  • sneezing
  • stomach discomfort or upset
  • tender, swollen glands in the neck
  • trouble sleeping
  • trouble swallowing

For Healthcare Professionals

Applies to hydrochlorothiazide / irbesartan: oral tablet

General

In general, the safety and efficacy of hydrochlorothiazide-irbesartan has been tested in over 700 patients. Side effects associated with the use of hydrochlorothiazide-irbesartan have generally been mild and transient.[Ref]

Cardiovascular

Cardiovascular side effects associated with hydrochlorothiazide-irbesartan have been reported rarely and have occurred at a rate less than or equal to placebo. These have included chest pain, edema, dizziness, sinus arrhythmia, tachycardia, and cardiac arrhythmias (including ventricular ectopy and complete AV heart block). Arrhythmias in the absence of HCTZ-induced electrolyte disturbances have been reported rarely. Orthostatic hypotension has been reported rarely.

Cardiovascular side effects associated with irbesartan including flushing, hypertension, cardiac murmur, myocardial infarction, angina pectoris, arrhythmias, cardiorespiratory arrest, and hypertensive crisis have been reported in less than 1% of patients in controlled trials. Bradycardia has been reported in less than 1% of patients in postmarketing experience.[Ref]

Gastrointestinal

Gastrointestinal side effects associated with HCTZ have rarely included pancreatitis and acute cholecystitis. Bowel strictures have been reported.

Gastrointestinal side effects associated with irbesartan have been reported the most frequently. Diarrhea (3% vs. 2% in placebo) and dyspepsia (2% vs. 1% in placebo) have been reported. Abdominal pain, nausea, and vomiting have been reported in 1% or greater among patients and at least as frequent or more frequent in patients receiving placebo. Constipation, gastroenteritis, flatulence, and abdominal distension have been reported in less than 1% of patients in controlled trials. Dry mouth, pyrosis, and epigastralgia have been reported in less than 1% of patients in postmarketing experience.[Ref]

Reports of bowel strictures associated with thiazide ingestion have been reported, although these patients were on a combination hydrochlorothiazide-potassium product.[Ref]

Hypersensitivity

Hypersensitivity side effects associated with thiazide-type diuretics have been reported rarely. Anaphylaxis and approximately 30 cases of acute pulmonary edema have been reported.

Hypersensitivity side effects associated with irbesartan including allergic reactions have been reported in less than 1% of patients in postmarketing experience.[Ref]

There have been approximately 34 known cases of thiazide-induced pulmonary edema, encompassing 52 episodes of pulmonary edema. In some cases, doses as small as 12.5 mg were associated with the development of pulmonary edema. The average time to onset of this adverse reaction is 44 minutes, women carry a relative risk of 9:1, and the average age is 56 years. The mortality rate is 6%. Some experts consider this side effect grossly underreported.[Ref]

Nervous system

Nervous system side effects including headache have been reported in patients receiving hydrochlorothiazide-irbesartan (11.9%) compared to HCTZ-placebo (7.5%). Extremely rare cases of stroke have been associated with HCTZ-induced plasma volume contraction.

Nervous system side effects associated with irbesartan have been reported rarely. These have included dizziness, numbness, somnolence, paresthesias, tremor, transient ischemic attack, and stroke at a frequency less than or similar to placebo. Fatigue has been reported in 4% of patients compared to 3% in placebo. Lethargy and paresis has been reported in less than 1% of patients in postmarketing experience.[Ref]

Metabolic

Metabolic side effects associated with the use of thiazide-type diuretics have included glucose intolerance (3%), hyperuricemia, hypophosphatemia, hypomagnesemia, and reduced insulin secretion. Metabolic side effects associated with HCTZ have included metabolic alkalosis, hyponatremia, hypercalcemia, hyperglycemia, and hypokalemia. Increased (by 11%) total serum cholesterol, increased (by 12%) LDL lipoprotein cholesterol, and increased (by 50%) VLDL lipoprotein cholesterol have been reported.

Metabolic side effects associated with some A-II inhibitors have included greater than 20% increases in baseline serum potassium (4.4% vs. 2.9% in placebo). Gouty arthritis associated with irbesartan has been reported in less than 1% of patients in controlled trials.[Ref]

Hyperuricemia may be an important consideration in patients with a history of gout. Hypophosphatemia and low serum magnesium concentrations may occur, but are usually clinically insignificant except in malnourished patients.

Hypokalemia, which is typically associated with the use of HCTZ, is much less likely with the addition of irbesartan because A-II inhibitors decrease serum aldosterone levels. (The risk of hypokalemia associated with HCTZ monotherapy is significantly increased when daily HCTZ doses exceed 50 mg.) In addition, the mild hyperkalemia, although usually clinically insignificant, that may accompany the use of irbesartan is much less likely due to HCTZ-induced kaliuresis.

A prospective study of 34 patients who received oral thiazide diuretics for 14 years without interruption revealed significantly increased average fasting blood glucose levels. Withdrawal of thiazide therapy for 7 months in 10 of the patients resulted in average reductions of 10% in fasting blood glucose and 25% in 2-hour glucose tolerance test values. A control group was not reported.

True glucose intolerance is typically reversible within six months after discontinuation of therapy.[Ref]

Dermatologic

Dermatologic side effects associated with thiazide-type diuretics have been reported rarely. These have included erythema annular centrifugum, acute eczematous dermatitis, morbilliform and leukocytoclastic vasculitis. Phototoxic dermatitis has been reported. Rarely, distinct entity with clinical and laboratory features indistinguishable from those of subacute cutaneous lupus erythematosus has been reported with the use of HCTZ.

Dermatologic side effects associated with irbesartan have included pruritus, dermatitis, ecchymosis, facial erythema, and urticaria in less than 1% of patients in controlled trials. Rash has been reported in less than 1% of patients and at a rate similar to placebo. Facial edema and sweating have been reported in less than 1% of patients in postmarketing experience.[Ref]

Respiratory

Respiratory side effects associated with irbesartan that have occurred in treated patients at rates less than or similar to placebo have included pharyngitis, rhinitis, tracheobronchitis, pulmonary congestion, dyspnea, and wheezing. A causal association has not been proven. Cough is a relatively common and obnoxious side effect associated with the use of angiotensin converting enzyme inhibitors. However, the use of irbesartan has not been associated with an increased incidence of dry cough.[Ref]

Renal

Preexisting hypovolemia could predispose a patient to the risk of developing azotemia associated with the use of this combination drug.[Ref]

Renal side effects associated with hydrochlorothiazide-irbesartan have included azotemia. Renal side effects associated with HCTZ have frequently included new or worsened renal insufficiency. Rarely, interstitial nephritis has been reported.

Renal side effects associated with irbesartan have rarely included new or worsened renal insufficiency.[Ref]

Musculoskeletal

Musculoskeletal side effects associated with hydrochlorothiazide-irbesartan have included aches and pains, chills, and cramps. Joint stiffness, bursitis, and weakness have been reported rarely.

Musculoskeletal side effects associated with irbesartan have included myalgia in less than 1% of patients in postmarketing experience. Rhabdomyolysis has been reported during postmarketing experience in patients receiving angiotensin II receptor blockers.[Ref]

Immunologic

Immunologic side effects associated with the use of HCTZ have rarely included allergic vasculitis and hemolytic anemia. There have been numerous case reports of patients developing a rash histologically identical to subacute cutaneous lupus following HCTZ administration.[Ref]

Genitourinary

Genitourinary side effects have been reported extremely rarely in controlled trials. Sexual dysfunction, abnormal urination and prostate problems have been reported with the use of irbesartan in less than 1% of patients in controlled trials. Rarely, interstitial cystitis has been reported. Urinary retention and oliguria have been reported in less than 1% of patients in postmarketing experience. Most genitourinary side effects during therapy probably reflect underlying disease. At least one case of penile angioedema has also been reported with the use of irbesartan.[Ref]

Hematologic

Hematologic side effects associated with HCTZ have rarely included immune-complex hemolytic anemia.

Hematologic side effects associated with the use of irbesartan have not been reported. Decreases (greater than 20%) in hematocrit (0.8%) and hemoglobin (0.4%) have been reported in the use of a similar product, valsartan. Neutropenia (1.9% vs. 0.8% in placebo) associated with valsartan has been reported in controlled trials.[Ref]

Hepatic

Hepatic side effects associated with irbesartan have rarely included cholestatic jaundice. Hepatitis has been reported during postmarketing experience.[Ref]

Psychiatric

Psychiatric side effects rarely associated with the use of irbesartan and at a frequency less than or similar to placebo have included anxiety, nervousness, sleep disturbances, emotional problems, and depression. Alterations in libido have been reported in less than 1% of patients in controlled trials. Nightmares and hallucinations have been reported in less than 1% of patients in postmarketing experience.[Ref]

Other

Other side effects associated with irbesartan including general discomfort have been reported in less than 1% of patients in postmarketing experience.[Ref]

Ocular

Ocular side effects have included idiosyncratic reactions to hydrochlorothiazide resulting in acute transient myopia and acute angle-closure glaucoma.

References

1. "Product Information. Avapro (irbesartan)." Bristol-Myers Squibb, Princeton, NJ.

2. Noormohamed FH, McNabb WR, Lant AF "Pharmacokinetic and pharmacodynamic actions of enalapril in humans: effect of probenecid pretreatment." J Pharmacol Exp Ther 253 (1990): 362-8

3. Hoss DM, Nierenberg DW "Severe shaking chills and fever following hydrochlorothiazide administration." Am J Med 85 (1988): 747

4. Grunwald MH, Halevy S, Livni E "Allergic vasculitis induced by hydrochlorothiazide: confirmation by mast cell degranulation test." Isr J Med Sci 25 (1989): 572-4

5. Freis ED "The efficacy and safety of diuretics in treating hypertension." Ann Intern Med 122 (1995): 223-6

6. Kreisberg RA "Low high-density lipoprotein cholesterol: what does it mean, what can we do about it, and what should we do about it?" Am J Med 94 (1993): 1-6

7. Weir MR, Wright JT, Jr Ferdinand KC, Cook CA, Champion D, Wong S, Jenkins PA, Kong BW "Comparison of the efficacy and metabolic effects of nicardipine and hydrochlorothiazide in hypertensive black men and women." J Hum Hypertens 7 (1993): 141-7

8. Holland OB, Kuhnert L, Pollard J, Padia M, Anderson RJ, Blomqvist G "Ventricular ectopic activity with diuretic therapy." Am J Hypertens 1 (1988): 380-5

9. Peters RW, Hamilton J, Hamilton BP "Incidence of cardiac arrhythmias associated with mild hypokalemia induced by low-dose diuretic therapy for hypertension." South Med J 82 (1989): 966-9,

10. Miller M, Bachorik PS, McCrindle BW, Kwiterovich PO, Jr "Effect of gemfibrozil in men with primary isolated low high-density lipoprotein cholesterol: a randomized, double-blind, placebo- controlled, crossover study." Am J Med 94 (1993): 7-12

11. Mouallem M, Friedman E, Shemesh Y, Mayan H, Pauzner R, Farfel Z "Cardiac conduction defects associated with hyponatremia." Clin Cardiol 14 (1991): 165-8

12. Morales-Olivas FJ, Aristegui I, Estan L, et al. "The KARTAN study: a postmarketing assessment of Irbesartan in patients with hypertension." Clin Ther 26 (2004): 232-44

13. Krishna GG, Narins RG "Hemodynamic consequences of diuretic-induced hypokalemia." Am J Kidney Dis 12 (1988): 329-31

14. Pollare T, Lithell H, Berne C "A comparison of the effects of hydrochlorothiazide and captopril on glucose and lipid metabolism in patients with hypertension." N Engl J Med 321 (1989): 868-73

15. Pollare T, Lithell H, Berne C "A comparison of the effects of hydrochlorothiazide and captopril on glucose and lipid metabolism in patients with hypertension." N Engl J Med 321 (1989): 868-73

16. Rosenstock J, Rossi L, Lin CS, MacNeil D, Osbakken M "The effects of irbesartan added to hydrochlorothiazide for the treatment of hypertension in patients nonresponsive to hydrochlorothiazide alone." J Clin Pharm Ther 23 (1998): 433-40

17. Mahabir RN, Laufer ST "Clinical evaluation of diuretics in congestive heart failure. A detailed study in four patients." Arch Intern Med 124 (1969): 1-7

18. Papademetriou V, Fletcher R, Khatri IM, Freis ED "Diuretic-induced hypokalemia in uncomplicated systemic hypertension: effect of plasma potassium correction on cardiac arrhythmias." Am J Cardiol 52 (1983): 1017-22

19. Campbell JR, Knapp RW "Small bowel ulceration associated with thiazide and potassium therapy: review of 13 cases." Ann Surg 163 (1966): 291-6

20. Dietz MW "Iatrogenic jejunal ulcer." Am J Roentgenol Radium Ther Nucl Med 99 (1967): 136-8

21. Diamond MT "Hyperglycemic hyperosmolar coma associated with hydrochlorothiazide and pancreatitis." N Y State J Med 72 (1972): 1741-2

22. Wagner W, Longerbeam JK, Smith LL, Feikes HL "Drug-induced ulcers of the small bowel causing intestinal obstruction or perforation." Am Surg 33 (1967): 7-11

23. Smith BL, Tedeschi A, Lane CD "Pancreatitis with a twist." Hosp Pract (Off Ed) 23 (1988): 150,

24. Reinus FZ, Weinberger HA, Fischer WW "Medication-induced ulceration of the small bowel." Am J Surg 112 (1966): 97-101

25. Rosenberg L, Shapiro S, Slone D, Kaufman DW, Miettinen OS, Stolley PD "Thiazides and acute cholecystitis." N Engl J Med 303 (1980): 546-8

26. Gould L, Reddy CV, Zen B, Singh BK "Life-threatening reaction to thiazides." N Y State J Med 80 (1980): 1975-6

27. Holland GW "Stenosing ulcers of the small bowel associated with thiazide and potassium therapy." N Z Med J 64 (1965): 383-5

28. Prupas HM, Brown D "Acute idiosyncratic reaction to hydrochlorothiazide ingestion." West J Med 138 (1983): 101-2

29. Biron P, Dessureault J, Napke E "Acute allergic interstitial pneumonitis induced by hydrochlorothiazide [published erratum appears in Can Med Assoc J 1991 Sep 1;145(5):391]." Can Med Assoc J 145 (1991): 28-34

30. Grace AA, Morgan AD, Strickland NH "Hydrochlorothiazide causing unexplained pulmonary oedema." Br J Clin Pract 43 (1989): 79-81

31. Magil AB, Ballon HS, Cameron EC, Rae A "Acute interstitial nephritis associated with thiazide diuretics. Clinical and pathologic observations in three cases." Am J Med 69 (1980): 939-43

32. Diffey BL, Langtry J "Phototoxic potential of thiazide diuretics in normal subjects." Arch Dermatol 125 (1989): 1355-8

33. Goette DK, Beatrice E "Erythema annulare centrifugum caused by hydrochlorothiazide-induced interstitial nephritis." Int J Dermatol 27 (1988): 129-30

34. Fine SR, Lodha A, Zoneraich S, Mollura JL "Thiazide-induced pulmonary edema." Ann Pharmacother 30 (1996): 416

35. Fine SR, Lodha A, Zoneraich S, Mollura JL "Hydrochlorothiazide-induced acute pulmonary edema." Ann Pharmacother 29 (1995): 701-3

36. Levay ID "Hydrochlorothiazide-induced pulmonary edema." Drug Intell Clin Pharm 18 (1984): 238-9

37. Biron P "Thiazide-induced pulmonary edema." Ann Pharmacother 30 (1996): 415-6

38. Hoegholm A, Rasmussen SW, Kristensen KS "Pulmonary oedema with shock induced by hydrochlorothiazide: a rare side effect mimicking myocardial infarction." Br Heart J 63 (1990): 186

39. Alted E, Navarro M, Cantalapiedra JA, Alvarez JA, Blasco MA, Nunez A "Non-cardiogenic pulmonary edema after oral ingestion of hydrochlorothiazide ." Intensive Care Med 13 (1987): 364-5

40. Brown CW, Deng JS "Thiazide diuretics induce cutaneous lupus-like adverse reaction." J Toxicol Clin Toxicol 33 (1995): 729-33

41. Klein MD "Noncardiogenic pulmonary edema following hydrochlorothiazide ingestion." Ann Emerg Med 16 (1987): 901-3

42. Magil AB "Drug-induced acute interstitial nephritis with granulomas." Hum Pathol 14 (1983): 36-41

43. Beaudry C, Laplante L "Severe allergic pneumonitis from hydrochlorothiazide." Ann Intern Med 78 (1973): 251-3

44. Frierson JH, Marvel SL, Thomas GM "Hydrochlorothiazide-induced pulmonary edema with severe acute myocardial dysfunction." Clin Cardiol 18 (1995): 112-4

45. Dorn MR, Walker BK "Noncardiogenic pulmonary edema associated with hydrochlorothiazide therapy." Chest 79 (1981): 482-3

46. Geanon JD, Perkins TW "Bilateral acute angle-closure glaucoma associated with drug sensitivity to hydrochlorothiazide." Arch Ophthalmol 113 (1995): 1231-2

47. Jones IG, Pickens PT "Diabetes mellitus following oral diuretics." Practitioner 199 (1967): 209-10

48. Papademetriou V, Price M, Notargiacomo A, Gottdiener J, Fletcher RD, Freis ED "Effect of diuretic therapy on ventricular arrhythmias in hypertensive patients with or without left ventricular hypertrophy." Am Heart J 110 (1985): 595-9

49. Kone B, Gimenez L, Watson AJ "Thiazide-induced hyponatremia." South Med J 79 (1986): 1456-7

50. Itescu S, Haskell LP, Tannenberg AM "Thiazide-induced clinically significant hypophosphatemia ." Clin Nephrol 27 (1987): 161-2

51. Hakim R, Tolis G, Goltzman D, Meltzer S, Friedman R "Severe hypercalcemia associated with hydrochlorothiazide and calcium carbonate therapy." Can Med Assoc J 121 (1979): 591-4

52. Benfield GF, Haffner C, Harris P, Stableforth DE "Dilutional hyponatraemia masquerading as subarachnoid haemorrhage in patient on hydrochlorothiazide/amiloride/timolol combined drug ." Lancet 2 (1986): 341

53. Pickkers P, Schachter M, Hughes AD, Feher MD, Sever PS "Thiazide-induced hyperglycaemia: a role for calcium-activated potassium channels?" Diabetologia 39 (1996): 861-4

54. Kasiske BL, Ma JZ, Kalil RS, Louis TA "Effects of antihypertensive therapy on serum lipids." Ann Intern Med 122 (1995): 133-41

55. Berlin I "Prazosin, diuretics, and glucose intolerance." Ann Intern Med 119 (1993): 860

56. Fager G, Berglund G, Bondjers G, Elmfeldt D, Lager I, Olofsson SO, Smith U, Wiklund O "Effects of anti-hypertensive therapy on serum lipoproteins. Treatment with metoprolol, propranolol and hydrochlorothiazide." Artery 11 (1983): 283-96

57. Murphy MB, Kohner E, Lewis PJ, Schumer B, Dollery CT "Glucose intolerance in hypertensive patients treated with diuretics: a fourteen-year follow-up." Lancet 2 (1982): 1293-5

58. Byatt CM, Millard PH, Levin GE "Diuretics and electrolyte disturbances in 1000 consecutive geriatric admissions." J R Soc Med 83 (1990): 704-8

59. Bain PG, Egner W, Walker PR "Thiazide-induced dilutional hyponatraemia masquerading as subarachnoid haemorrhage ." Lancet 2 (1986): 634

60. Polanska AI, Baron DN "Hyponatraemia associated with hydrochlorothiazide treatment ." Br Med J 1 (1978): 175-6

61. Bell DS "Insulin resistance. An often unrecognized problem accompanying chronic medical disorders." Postgrad Med 93 (1993): 99-103,

62. Pinnock CA "Hyponatraemia associated with hydrochlorothiazide treatment ." Br Med J 1 (1978): 48

63. Harper R, Ennis CN, Heaney AP, Sheridan B, Gormley M, Atkinson AB, Johnston GD, Bell PM "A comparison of the effects of low- and conventional-dose thiazide diuretic on insulin action in hypertensive patients with NIDDM." Diabetologia 38 (1995): 853-9

64. Fichman MP, Vorherr H, Kleeman CR, Telfer N "Diuretic-induced hyponatremia." Ann Intern Med 75 (1971): 853-63

65. Klimiuk PS, Davies M, Adams PH "Primary hyperparathyroidism and thiazide diuretics." Postgrad Med J 57 (1981): 80-3

66. Duarte CG, Winnacker JL, Becker KL, Pace A "Thiazide-induced hypercalcemia." N Engl J Med 284 (1971): 828-30

67. Kuller L, Farrier N, Caggiula A, Borhani N, Dunkle S "Relationship of diuretic therapy and serum magnesium levels among participants in the Multiple Risk Factor Intervention Trial." Am J Epidemiol 122 (1985): 1045-59

68. Seelig CB "Magnesium deficiency in two hypertensive patient groups." South Med J 83 (1990): 739-42

69. Reed BR, Huff JC, Jones SK, Orton PW, Lee LA, Norris DA "Subacute cutaneous lupus erythematosus associated with hydrochlorothiazide therapy." Ann Intern Med 103 (1985): 49-51

70. Goodrich AL, Kohn SR "Hydrochlorothiazide-induced lupus erythematosus: a new variant?" J Am Acad Dermatol 28 (1993): 1001-2

71. Parodi A, Romagnoli M, Rebora A "Subacute cutaneous lupus erythematosus-like eruption caused by hydrochlorothiazide." Photodermatol 6 (1989): 100-2

72. Bjornberg A, Gisslen H "Thiazides: A cause of necrotising vasculitis?" Lancet 2 (1965): 982-3

73. Rich MW, Eckman JM "Can hydrochlorothiazide cause lupus?" J Rheumatol 22 (1995): 1001

74. Robinson HN, Morison WL, Hood AF "Thiazide diuretic therapy and chronic photosensitivity." Arch Dermatol 121 (1985): 522-4

75. Delevett AF, Recalde M "Diuretic-induced renal colic." JAMA 225 (1973): 992

76. Burnier M, Roch-Ramel F, Brunner HR "Renal effects of angiotensin II receptor blockade in normotensive subjects." Kidney Int 49 (1996): 1787-90

77. van den Meiracker AH, Admiraal PJ, Janssen JA, Kroodsma JM, de Ronde WA, Boomsma F, Sissmann J, Blankestijn PJ, Mulder PG, Man In 't Veld AJ "Hemodynamic and biochemical effects of the AT1 receptor antagonist irbesartan in hypertension." Hypertension 25 (1995): 22-9

78. Ziai F, Ots M, Provoost AP, Troy JL, Rennke HG, Brenner BM, Mackenzie HS "The angiotensin receptor antagonist, irbesartan, reduces renal injury in experimental chronic renal failure." Kidney Int Suppl 57 (1996): s132-6

79. McIntyre M, MacFadyen RJ, Meredith PA, Brouard R, Reid JL "Dose-ranging study of the angiotensin II receptor antagonist irbesartan (SR 47436/BMS-186295) on blood pressure and neurohormona effects in salt-deplete men." J Cardiovasc Pharmacol 28 (1996): 101-6

80. Burnier M, Hagman M, Nussberger J, Biollaz J, Armagnac C, Brouard R, Weber B, Brunner HR "Short-term and sustained renal effects of angiotensin II receptor blockade in healthy subjects." Hypertension 25 (1995): 602-9

81. Garratty G, Houston M, Petz LD, Webb M "Acute immune intravascular hemolysis due to hydrochlorothiazide." Am J Clin Pathol 76 (1981): 73-8

82. Eisner EV, Crowell EB "Hydrochlorothiazide-dependent thrombocytopenia due to IgM antibody." JAMA 215 (1971): 480-2

83. Shirey RS, Bartholomew J, Bell W, Pollack B, Kickler TS, Ness PM "Characterization of antibody and selection of alternative drug therapy in hydrochlorothiazide-induced immune hemolytic anemia." Transfusion 28 (1988): 70-2

84. Beck ML, Cline JF, Hardman JT, Racela LS, Davis JW "Fatal intravascular immune hemolysis induced by hydrochlorothiazide." Am J Clin Pathol 81 (1984): 791-4

85. McCabe J, Stork C, Mailloux D, Su M "Penile angioedema associated with the use of angiotensin-converting-enzyme inhibitors and angiotensin II receptor blockers." Am J Health Syst Pharm 65 (2008): 420-421

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.

Hide
(web4)