Irbesartan 150mg Domesco treat hypertension, kidney disease (2 blisters x 14 tablets)

When Aldosteron is released, sodium and water will be reabsorbed, finally hypertension. Irbesartan clasped the circuit and aldosteron excretion of Angiotensin II thanks to selective attachment to the AT1 receptor of Angiotensin II with 8500 times stronger than attaching to the AT2 receptor. AT2 receptor is also present in many tissues, but does not play a role in the cardiovascular air conditioner.

Irbesartan does not inhibit ACE, so it does not inhibit the breakdown of Bradykinin, so it does not cause persistent dry cough still common in enzyme inhibitors. When using Irbesartan with recommended dose, blood potassium does not change significantly.

In hypertension, Irbesartan reduces blood pressure but the heart frequency changes very little. Hypotension effect depends on the dose and tends to not lower when taken at a dose higher than 300 mg/1 time per day. Maximum lowering blood pressure for about 3 - 6 hours after drinking.

Anti -hypertension effect maintained at least 24 hours. Anti -hypertension effect is shown within 1-2 weeks, maximum efficiency achieved within 4-6 weeks from the beginning of treatment and maintenance when long -term treatment. If the treatment stops, the blood pressure gradually returns to the original state, but there is no sudden disease back when stopping the drug. Irbesartan anti -hypertension effects and thiazid diuretics are combined.

Kidney pathology in people with diabetes: Irbesartan is used to care for kidney disease in diabetes with manifestation of increased plasma creatinine and protein (> 300 mg/day) in people with type 2 diabetes with hypertension.

Both Angiotensin II receptor antagonists and enzyme inhibitors (ACE) slow down the progression of kidney disease in patients with hypertension with diabetes and microalbuminuria or have significant kidney disease. Some evidence shows that these drugs slow down the progression of kidney disease with an independent mechanism with their anti -hypertension effect.

Combining treatment with ACE inhibitors and Angiotensin II receptor antagonists shows a combination effect in lowering blood pressure and microalbuminurin. However, more research is needed to determine the effect of this combination on kidney function. If you do not tolerate this group of drugs, you can use one of the other drug group.

pharmacokinetics

absorption:

Irbesartan quickly absorbed through the gastrointestinal tract with bioavailability of 60 - 80 %. Food does not change much to the bioavailability of the drug.

Distribution:

The drug is about 96 % with plasma proteins. The distribution of the drug is about 53 - 93 liters. The peak concentration in plasma is about 1-2 hours after a dose of oral. The concentration of medication in the blood reaches a stable equilibrium after 3 days of taking medicine.

Metabolism:

Metabolic drugs in the liver thanks to the glucuronic and oxidation process. Irbesartan is oxidized mainly through the catalyst of CYP2C9 enzyme of Cytochrome P450.

Era:

Medicines and metabolic products are eliminated through bile and urine. After drinking, about 20 % of the drug excreted through the urine, the rest (about 80 %) in the feces. A small amount of less than 2 % of the dose eliminated through urine in the form of unchanged. The sale time of the drug is 11 - 15 hours.

Be cautious when used

In patients with blood volume reduced such as salt loss and water due to strong diuretics, diarrhea or prolonged vomiting, symptomic hypotension may occur, especially after taking the first dose. It is necessary to treat these abnormalities before taking Irbesartan.

For patients with kidney stenosis on one side or both sides, when using Irbesartan is at risk of strong hypotension and impaired renal function.

Careful with people with kidney failure and kidney transplant. Potassium and blood creatinine periodic must be checked.

Irbesartan acts on the renin-angiotensin-aldosteron system, the hyperkalemia may be seen during treatment with Irbesartan, especially when kidney failure, proteinuria related to diabetes due to diabetes and heart failure. Need to check potassium blood in these patients.

Using Irbesartan must be particularly cautious in diseases: aortic valve stenosis, mitral stenosis, or obstructive hypertrophy.

Patients with primary Aldosteron intense often do not respond to anti-hypertension drugs, the type of effect through inhibition of the renin-angiotensin system. Therefore, Irbesartan should not be used for these patients.

Patients with vascular energy and renal function depend mainly on the activity of the renin-angiotensin-aldosteron system (for example, patients with severe congestive heart failure or kidney disease such as renal artery stenosis), treatment with transferred enzyme inhibitors or Angiotensin II receptor antagonists on the system have seen acute hypotension, nitrogen hyperket level.

As with any anti -hypertension drugs, sudden hypoglycemia in people with ischemic heart disease can lead to myocardial infarction or stroke.

Patients with galactose tolerance problems, patients with lapp lactase enzyme deficiency or glucose-galactose abutment should not be taken.

The ability to drive and operate machinery

The effect of drugs on the job (operators, train car driving, higher people working and other cases): The drug can cause dizziness, headache (common), patients should not drive and operate machinery, work on high and other cases.

Pregnancy

Contraindicated drugs for pregnant women. In the first 3 months of pregnancy, contraindicated due to caution. In the middle 3 months and the last 3 months, the drug is toxic to the fetus (reducing the kidney function, less amniotic fluid, slow chemical bone) and toxic to babies (kidney failure, hypotension, hyperkalemia).

When detected pregnancy, Irbesartan should be stopped immediately and replaced with other drugs. If Irbesartan has been used for a long time, it is necessary to check the skull and kidney function, ultrasound for the fetus.

breastfeeding period

contraindicated use for women who are breastfeeding.

Interactive drug

Diuretics and other anti -hypertension drugs: Other anti -hypertension drugs may increase the hypotension effect of Irbesartan. However, Irbesartan has also been coordinated with other anti -hypertension drugs such as beta blockers, prolonged calcium blockers or thiazide diuretics. Pre -dose dosage treatment may cause blood volume and the risk of hypotension when starting with Irbesartan.

Medications containing Aliskiren and enzyme inhibitors: Clinical data shows the double-renin-angiotensin-aldosteron (RAAS) system inhibitors through the combination of enzyme inhibitors, Angiotensin II or Aliskiren receptor blockers related to the frequency of unwanted effects such as hypotension, hypertension and hypertension (acute impairment) Use a single-renotensin-aldosterone inhibitor.

Potassium supplements or potassium diuretics: concurrent with Irbesartan can cause hyperboly.

Lithi: Increasing blood concentration and increasing toxicity of lithium has been informed when coordinated with transferred enzyme inhibitors. The same effects have happened with Irbesartan, although very rare, so this combination should be avoided. If it is necessary to coordinate, closely monitor the concentration of blood lithium.

Non-steroid anti-inflammatory drugs: simultaneous use of Irbesartan with nonsteroidal anti-inflammatory drugs (for example, selective inhibitors of cycloxygenase type 2 (COX-2), acetylsalicylic acid (> 3 g/day) and non-selective nonsteroidal anti-inflammatory drugs, anti-hypertension effects of Irbesartan can be reduced.

As well as with angiotensin transfer enzyme inhibitors, simultaneous use of Angiotensin II antagonists and non -selective nonsteroidal anti -inflammatory substances can increase the risk of kidney function damage, which can lead to acute renal failure and hyperboly, especially in patients who have had kidney function before. The coordination must be cautious, especially in the elderly. Patients must be fully drinking and monitoring the kidney function after starting to coordinate and periodically.