What are other names for this medicine?

Type of medicine: angiotensin II receptor antagonist; diuretic; antihypertensive

Generic and brand names: irbesartan/hydrochlorothiazide, oral; Avalide

What is this medicine used for?

This medicine is a combination of 2 drugs: an angiotensin receptor II blocker and a diuretic (water pill). This medicine is taken by mouth to treat and control high blood pressure.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before you take this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• Asthma
• Diabetes
• Glaucoma
• Gout
• Heart failure or other heart disease
• High cholesterol or high triglyceride levels
• Imbalances of sodium, potassium, magnesium, or calcium in the blood
• Kidney problems
• Liver problems
• Lupus
• Trouble urinating

Tell your healthcare provider if you have been on a low-salt diet.

Females of childbearing age: This medicine is not usually given to pregnant women because it can harm the baby. If you are pregnant, tell your healthcare provider. Do not become pregnant during treatment with this medicine. If you become pregnant while taking this medicine, contact your healthcare provider right away. Do not breast-feed while you are taking this medicine.

How do I take it?

Check the label on the medicine for directions about your specific dose. Take this medicine every day exactly as your healthcare provider prescribes, even if you start to feel better. Take the medicine at the same time each day to help you remember to take it. Do not stop taking this medicine without your healthcare provider’s approval.

Check with your healthcare provider before using this medicine in children under age 18.

You may take this medicine with or without food. Taking it with meals may lessen the chance the drug will upset your stomach.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: dizziness; weakness; fainting; dry mouth; increased urination; lightheadedness; fast, slow, or irregular heartbeat.

What should I watch out for?

Talk with your healthcare provider about potassium in your diet. Do not use potassium supplements or salt substitutes containing potassium without your healthcare provider’s approval. Follow the diet and exercise program your health provider recommends.

Your blood pressure needs to be checked regularly while you are taking this medicine. You will need to have lab tests regularly to see how this medicine affects you. Keep all appointments for these tests.

This medicine may cause eye problems that could lead to vision loss. Contact your healthcare provider right away if you have eye pain or a decrease in vision.

If you are dehydrated (due to diarrhea, vomiting, or sweating heavily) or you have lost salt from your system, this medicine may cause low blood pressure (lightheadedness, dizziness, fainting). Be careful when exercising, especially in hot weather. If you feel faint, lie down until the reaction passes. Talk with your healthcare provider if this happens often. Do not drive or operate machinery unless you are fully alert.

You may also feel dizzy or faint when you get up quickly after sitting or lying down. Getting up slowly may help. Also, drinking alcohol may make it worse. Do not drink alcohol unless your healthcare provider approves.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

This medicine may make your skin more sensitive to the sun, which may lead to painful sunburns. While you are taking this medicine, avoid long exposure to the sun. Wear protective clothing, a hat, and sunscreen lotion when you need to be outdoors. Do not use a sunlamp. If you get a severe sunburn, contact your healthcare provider right away.

If you have diabetes: This medicine may affect your blood sugar level and change the amount of insulin or other diabetes medicines you may need. Talk to your healthcare provider about this.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your healthcare provider right away): Chest pain; trouble breathing; severe dizziness or fainting; severe drowsiness; irregular, fast, or slow heartbeat; unexplained tiredness or weakness; fainting; trouble urinating or producing little urine; severe nausea, vomiting, or diarrhea; seizures; eye pain; decrease in vision; unexplained swelling; yellow eyes or skin; dark urine; pale stools; very dry mouth; extreme thirst; muscle cramps or pain; unusual restlessness or confusion; severe skin rash.

Other: Dizziness, blurred vision, upset stomach, muscle aches, back or leg pain, headache, dry cough, runny or stuffy nose, diarrhea.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• ACE inhibitors such as benazepril (Lotensin), captopril, enalapril (Vasotec), fosinopril, lisinopril (Prinivil, Zestril), quinapril (Accupril), and ramipril (Altace)
• Aliskiren (Tekturna)
• Alpha-1 blockers such as alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress), silodosin (Rapaflo), and terazosin (Hytrin)
• Allopurinol (Zyloprim)
• Amifostine (Ethyol)
• Angiotensin receptor II blockers such as candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), olmesartan (Benicar), telmisartan (Micardis), and valsartan (Diovan)
• Aspirin or other salicylates
• Heart medicines such as amiodarone (Cordarone, Pacerone), digoxin (Lanoxin), dronedarone (Multaq), and dofetilide (Tikosyn)
• Barbiturates such as butabarbital (Butisol), pentobarbital (Nembutal), and phenobarbital
• Calcium supplements
• Carbamazepine (Tegretol)
• Cholesterol-lowering medicines such as cholestyramine (Questran), colesevelam (WelChol), and colestipol (Colestid)
• Corticosteroids such as betamethasone (Celestone), cortisone, dexamethasone, fludrocortisone (Florinef), hydrocortisone (Cortef), methylprednisolone (Medrol), prednisolone (Orapred), prednisone, and triamcinolone (Aristospan, Kenalog)
• Cyclosporine (Gengraf, Sandimmune, Neoral)
• Diabetes medicines such as canagliflozin (Invokana), glipizide (Glucotrol, Glucotrol XL), glyburide (DiaBeta, Glynase PresTab), insulin, metformin (Glucophage), pioglitazone (Actos), repaglinide (Prandin), and rosiglitazone (Avandia)
• Diuretics (water pills) such as amiloride, bumetanide, chlorothiazide (Diuril), eplerenone (Inspra), furosemide (Lasix), hydrochlorothiazide (Microzide), spironolactone (Aldactone), torsemide (Demadex), and triamterene (Dyrenium)
• Fluconazole (Diflucan)
• Lithium (Lithobid)
• MAO inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam), and tranylcypromine (Parnate) (Do not take this medicine and an MAO inhibitor within 14 days of each other.)
• Medicines to treat erectile dysfunction such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra)
• Narcotic pain medicines such as codeine, fentanyl (Duragesic, Actiq), hydrocodone/acetaminophen (Vicodin, Lortab), hydromorphone (Dilaudid), meperidine (Demerol), methadone (Dolophine), morphine (Kadian, MS Contin), oxycodone (OxyContin, Roxicodone), oxycodone/acetaminophen (Percocet), and pentazocine (Talwin)
• Natural remedies such as alfalfa, American ginseng, aminocaproic acid, arginine, bayberry, bitter orange, black cohosh, blue cohosh, cayenne, California poppy, goldenseal, dandelion, ephedra, ginger, gotu kola, hawthorn, horsetail, licorice, lily of the valley, lysine, milkweed, nettle, noni juice, and Siberian ginseng
• Nitrates such as isosorbide dinitrate or mononitrate (Imdur, Ismo, Isordil, Monoket, Dilatrate-SR), or nitroglycerin (Minitran, Nitro-Bid, Nitrostat, Nitrolingual, NitroMist, Nitro-Dur, Transderm Nitro)
• Nonsteroidal anti-inflammatory medicines (NSAIDs) such as celecoxib (Celebrex), diclofenac (Voltaren, Cataflam), ibuprofen (Motrin, Motrin IB, Advil), indomethacin (Indocin), ketoprofen, ketorolac, nabumetone (Relafen), naproxen (Naprosyn, Anaprox, Aleve, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)
• Other medicines for high blood pressure
• Pimozide (Orap)
• Potassium supplements or salt substitutes containing potassium
• Rifampin (Rifadin, Rimactane)
• Sodium phosphates (OsmoPrep, Fleet Enema)
• Tolvaptan (Samsca)
• Topiramate (Topamax)
• Trimethoprim (Primsol) or sulfamethoxazole-trimethoprim (Bactrim, Septra, Sulfatrim)

Do not drink alcohol while you are taking this medicine, unless your healthcare provider approves.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.