Avalide is a prescription medication combining two antihypertensive agents—irbesartan and hydrochlorothiazide—to deliver synergistic blood pressure management. This fixed-dose combination therapy is designed for patients whose hypertension is not adequately controlled by monotherapy, offering the convenience of two medications in a single tablet. By targeting multiple pathways of blood pressure regulation, Avalide provides a comprehensive approach to reducing cardiovascular risk, improving medication adherence, and simplifying treatment regimens under physician supervision.

Features

• Contains irbesartan (an angiotensin II receptor blocker) and hydrochlorothiazide (a thiazide diuretic)
• Available in multiple strength combinations: 150 mg/12.5 mg, 300 mg/12.5 mg, and 300 mg/25 mg
• Once-daily oral administration
• FDA-approved for hypertension treatment
• Not indicated for initial therapy

Benefits

• Provides superior blood pressure reduction compared to monotherapy components
• Lowers risk of stroke, myocardial infarction, and other cardiovascular events
• Reduces pill burden through fixed-dose combination therapy
• Maintains 24-hour blood pressure control with once-daily dosing
• May preserve potassium balance better than some other diuretic therapies
• Offers flexible dosing options to accommodate individual patient needs

Common use

Avalide is primarily prescribed for the treatment of hypertension in patients whose blood pressure is not adequately controlled on irbesartan or hydrochlorothiazide alone. It may also be used as substitute therapy in patients receiving both components as separate tablets. The medication is typically incorporated into a comprehensive hypertension management plan that includes lifestyle modifications such as sodium restriction, weight management, and regular physical activity. Healthcare providers may consider Avalide for patients who would benefit from simplified dosing to improve adherence to antihypertensive therapy.

Dosage and direction

The recommended starting dose of Avalide is individualized based on the patient’s previous antihypertensive therapy. For patients not adequately controlled on hydrochlorothiazide 25 mg once daily, the recommended initial dose is Avalide 150 mg/12.5 mg once daily. For patients inadequately controlled on irbesartan 300 mg once daily, the recommended dose is Avalide 300 mg/12.5 mg once daily. The dosage may be titrated after two to four weeks of therapy, with a maximum recommended daily dose of irbesartan 300 mg/hydrochlorothiazide 25 mg. Avalide should be taken consistently, with or without food, at approximately the same time each day. Dose adjustment may be necessary for elderly patients or those with renal impairment.

Precautions

Patients taking Avalide should be monitored for hypotension, especially during initial dose titration or volume depletion. Regular assessment of renal function is recommended, particularly in patients with pre-existing renal impairment, as the hydrochlorothiazide component may cause azotemia. Electrolyte imbalances, including hypokalemia, hyponatremia, and hypomagnesemia, should be monitored periodically. Caution is advised in patients with impaired hepatic function or history of liver disease. Avalide may exacerbate or activate systemic lupus erythematosus. Patients should be advised to avoid excessive perspiration, dehydration, and prolonged sun exposure due to potential photosensitivity reactions. Regular eye examinations are recommended as hydrochlorothiazide may cause acute transient myopia and acute angle-closure glaucoma.

Contraindications

Avalide is contraindicated in patients with known hypersensitivity to any component of this product or other sulfonamide-derived drugs. It is contraindicated in patients with anuria or severe renal impairment (creatinine clearance <30 mL/min). The medication is contraindicated in pregnancy, particularly during the second and third trimesters, due to the risk of fetal injury and death. Concomitant use with aliskiren in patients with diabetes is contraindicated. Avalide should not be used in patients with refractory hypokalemia, hypercalcemia, or clinically significant hyperuricemia.

Possible side effects

Common adverse reactions (≥2%) include dizziness, fatigue, musculoskeletal pain, nausea, vomiting, hyperkalemia, orthostatic hypotension, flushing, and diarrhea. Less frequent but serious side effects may include renal impairment, acute renal failure, hepatic impairment, pancreatitis, electrolyte imbalances, and hypersensitivity reactions including anaphylaxis and angioedema. Hematologic effects such as leukopenia, agranulocytosis, and thrombocytopenia have been reported. Metabolic effects may include hyperglycemia, glycosuria, hyperuricemia, and lipid abnormalities. Dermatological reactions including photosensitivity, rash, and urticaria may occur. Patients should report any signs of infection, unusual bleeding, or persistent cough to their healthcare provider.

Drug interaction

Avalide may interact with lithium, increasing lithium serum levels and toxicity risk. Concomitant use with other antihypertensive agents may result in additive hypotensive effects. Nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce the antihypertensive effect and increase risk of renal impairment. Potassium-sparing diuretics, potassium supplements, or salt substitutes containing potassium may increase the risk of hyperkalemia. Alcohol, barbiturates, or narcotics may potentiate orthostatic hypotension. Corticosteroids and ACTH may enhance electrolyte depletion. Cholestyramine and colestipol may reduce hydrochlorothiazide absorption. The antihypertensive effect may be reduced by sympathomimetics. Insulin requirements may be altered in diabetic patients. Avalide may increase the toxicity of non-depolarizing skeletal muscle relaxants.

Missed dose

If a dose of Avalide is missed, it should be taken as soon as remembered on the same day. However, if it is almost time for the next scheduled dose, the missed dose should be skipped and the regular dosing schedule resumed. Patients should not take a double dose to make up for a missed dose. Consistent daily administration is important for maintaining blood pressure control. Patients should establish a routine for medication administration and consider using pill organizers or reminder systems if missed doses occur frequently.

Overdose

Symptoms of Avalide overdose may include hypotension, tachycardia, bradycardia, dizziness, decreased urinary output, electrolyte imbalances, and renal failure. The most likely manifestation of overdose would be hypotension and dehydration due to the hydrochlorothiazide component. Treatment should be supportive and symptomatic, with close monitoring of vital signs, electrolyte levels, and renal function. Gastric lavage may be considered if ingestion was recent. Intravenous normal saline may be administered for volume depletion, with careful monitoring to avoid fluid overload. Irbesartan is not dialyzable, while hydrochlorothiazide is eliminated by hemodialysis. Specific treatment should be directed toward correcting electrolyte imbalances and supporting cardiovascular function.

Storage

Avalide tablets should be stored at controlled room temperature between 20°C to 25°C (68°F to 77°F), with excursions permitted between 15°C to 30°C (59°F to 86°F). The medication should be kept in its original container with the lid tightly closed to protect from moisture and light. Tablets should not be stored in bathroom cabinets or other humid locations. Keep out of reach of children and pets. Properly discard any expired or unused medication according to local regulations, preferably through medication take-back programs. Do not flush medications down the toilet unless specifically instructed to do so.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Avalide is a prescription medication that should be used only under the supervision of a qualified healthcare professional. Individual patient responses may vary, and treatment decisions should be based on the healthcare provider’s assessment of the patient’s specific medical condition, history, and needs. Patients should not adjust their dosage or discontinue treatment without consulting their physician. The complete prescribing information should be consulted before initiating therapy.

Reviews

Clinical studies have demonstrated that Avalide provides effective blood pressure reduction in diverse patient populations. In randomized controlled trials, the combination therapy showed significantly greater blood pressure lowering effects compared to either component alone. Many healthcare providers report improved patient adherence with the fixed-dose combination compared to separate tablets. Some patients note the convenience of once-daily dosing and reduced pill burden. However, individual experiences may vary, and some patients may experience side effects that require dosage adjustment or alternative therapy. Long-term observational studies suggest maintained efficacy in blood pressure control with appropriate monitoring and dose titration.