irbesartan

Irbesartan is an oral medication in the angiotensin II receptor blocker (ARB) class. It is approved for the treatment of essential hypertension and for the management of diabetic nephropathy in people with type 2 diabetes. It may be used as part of combination therapy in certain cardiovascular conditions when appropriate. Brand names include Avapro.

Irbesartan works by selectively blocking the AT1 receptor for angiotensin II. This prevents the normal vasoconstrictive and aldosterone-secreting effects of angiotensin II, leading to vasodilation, reduced aldosterone-mediated sodium retention, and lower blood pressure.

In clinical use, irbesartan is primarily prescribed for hypertension and to slow progression of kidney disease in type 2 diabetes. Its efficacy in lowering blood pressure is established, and its kidney-protective effect in diabetic nephropathy is a key aspect of its use in diabetes management.

Administration and pharmacokinetics: irbesartan is taken by mouth, typically once daily, with or without food. Dosing commonly starts at 150 mg daily and may be increased to 300 mg daily depending on response. It is absorbed after oral administration, has substantial protein binding, and is metabolized in the liver with elimination mainly via the bile. The elimination half-life is approximately 11–15 hours.

Safety and precautions: common adverse effects include dizziness, fatigue, and upper respiratory infections. Hyperkalemia and hypotension can occur, particularly when used with other antihypertensives or potassium supplements. Angioedema is rare but serious. It is contraindicated in pregnancy due to risk of fetal harm and should be avoided during lactation unless benefits outweigh risks. Interactions include caution with potassium-sparing diuretics, NSAIDs, and other agents that lower blood pressure; concomitant use with aliskiren is not recommended in patients with diabetes or kidney impairment.