Hydrochlorothiazide (hye-droe-klor-oh-THYE-a-zide), Irbesartan (ir-be-SAR-tan)

Used alone or together with other medicines to treat high blood pressure. Lowering blood pressure reduces the risk of strokes and heart attacks. This medicine is a combination of an angiotensin receptor blocker (ARB) and a diuretic "water pill".

Brand Name(s):

Avalide

When This Medicine Should Not Be Used:

How to Use This Medicine:

Tablet

• Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
• You may take this medicine with or without food.
• Be sure to drink plenty of fluids if you exercise, sweat more than usual, or have diarrhea or vomiting while you are using this medicine.

If a dose is missed:

• If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine:

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any leftover medicine after you have finished your treatment. You will also need to throw away old medicine after the expiration date has passed.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are using digoxin (Lanoxin®), lithium (Eskalith®, Lithobid®), norepinephrine, a diuretic or "water pill" (such as amiloride, furosemide, triamterene, Dyazide®, Lasix®, or Maxzide®), other blood pressure medicine (such as atenolol, lisinopril, metoprolol, quinapril, Accupril®, Cozaar®, Diovan®, Lotrel®, Norvasc®, Toprol®, or Zestril®), or a pain or arthritis medicine (such as aspirin, celecoxib, diclofenac, ibuprofen, naproxen, rofecoxib, valdecoxib, Advil®, Aleve®, Bextra®, Celebrex®, Ecotrin®, Motrin®, or Vioxx®).
• Tell your doctor if you are using muscle relaxers, a medicine to lower cholesterol (cholestyramine, colestipol, Colestid®, or Questran®), a steroid medicine (such as dexamethasone, prednisolone, prednisone, or Medrol®), insulin or diabetes medicine that you take by mouth (such as glyburide, glipizide, metformin, Actos®, Amaryl®, Avandia®, Glucophage®, Glucotrol®, or Glucovance®).
• Drinking alcohol or taking narcotic pain relievers or sleeping pills with this medicine may intensify feeling lightheaded, dizzy, or faint. Tell your doctor if you are drinking alcohol or using pain relievers or sleeping pills.

Warnings While Using This Medicine:

• Using this medicine while you are pregnant (especially in your second or third trimester) can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using this medicine, tell your doctor right away.
• Make sure your doctor knows if you are breastfeeding, or if you have kidney problems, liver disease (including cirrhosis), asthma, congestive heart failure, diabetes, glaucoma, gout, high cholesterol, or systemic lupus erythematosus (SLE or lupus). Tell your doctor if you have an electrolyte imbalance (such as high or low calcium, potassium, magnesium, or sodium in the blood), or if you are dehydrated or experiencing diarrhea or vomiting. Tell your doctor if you are on a dialysis treatment.
• This medicine will not cure your high blood pressure, but it does help control it. You must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life.
• This medicine may make you feel lightheaded, dizzy, or faint, especially when you get up from a lying or sitting position suddenly. Getting up slowly may help. These symptoms are more likely to occur when you begin taking this medicine, or when the dose is increased.
• Check with your doctor right away if you become sick while taking this medicine, especially with severe or continuing nausea, vomiting, or diarrhea. These conditions may cause you to lose too much water or salt which may cause low blood pressure.
• Check with your doctor right away if you experience dizziness, fainting, confusion, muscle pain, weakness, and/or a fast heartbeat. Use extra care if you exercise or if the weather is hot. Heavy sweating can cause dehydration (loss of too much water) or electrolyte imbalances (loss of potassium, magnesium, or sodium in the body).
• This medicine may make you dizzy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.
• Stop using this medicine and check with your doctor immediately if blurred vision, difficulty in reading, eye pain, or any other change in vision occurs during or after treatment. This could be a sign of a serious eye problem. Your doctor will want you to have your eyes checked by an ophthalmologist (eye doctor).
• This medicine may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests, or if you have any questions, check with your doctor.
• If you stop using this medicine, your blood pressure may go up. High blood pressure usually has no symptoms. Even if you feel well, do not stop using the medicine without asking your doctor.
• Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests.
• Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to keep all appointments. Blood and urine tests may be needed to check for unwanted effects.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blistering, peeling, or red skin rash.
• Blood in the urine, lower back pain, side pain, or sharp back pain just below the ribs.
• Blurred vision and eye pain.
• Chest pain.
• Confusion, body weakness, and muscle twitching.
• Decrease in how much or how often you urinate.
• Dry mouth, increased thirst, or muscle cramps.
• Fast, slow, pounding, or uneven heartbeat.
• Lightheadedness, dizziness, or fainting.
• Nausea, vomiting, loss of appetite, or pain in your upper stomach.
• Numbness or tingling in your hands, feet, or lips.
• Rapid weight gain.
• Swelling in your hands, ankles, or feet.
• Unusual bleeding, bruising, or weakness.
• Yellowing of your skin or the whites of your eyes.

If you notice these less serious side effects, talk with your doctor:

• Dry cough, runny or stuffy nose, or sore throat.
• Mild nausea, vomiting, heartburn, or stomach pain or upset.
• Mild skin rash.
• Muscle or joint pain.
• Tiredness.

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088