Hydrochlorothiazidedosage

General Considerations Maximum effects within 2 to 4 weeks after dose change.

Renal impairment: Not recommended for patients with severe renal impairment (creatinine clearance <30 mL/min). Hypertension Initiate with 150/12.5 mg. Titrate to 300/12.5 mg then 300/25 mg if needed.

Replacement therapy: May be substituted for titrated components.

2.1 General

Considerations The side effects of irbesartan are generally rare and apparently independent of dose; those of hydrochlorothiazide are a mixture of dose-dependent (primarily hypokalemia) and dose-independent phenomena (e.g., pancreatitis), the former much more common than the latter. Maximum antihypertensive effects are attained within 2 to 4 weeks after a change in dose. AVALIDE may be administered with or without food. AVALIDE may be administered with other antihypertensive agents. Renal Impairment The usual regimens of therapy with AVALIDE may be followed as long as the patient's creatinine clearance is >30 mL/min. In patients with more severe renal impairment, loop diuretics are preferred to thiazides, so AVALIDE is not recommended. Hepatic Impairment No dosage adjustment is necessary in patients with hepatic impairment.

2.2 Add-On Therapy

In patients not controlled on monotherapy with irbesartan or hydrochlorothiazide, the recommended doses of AVALIDE, in order of increasing mean effect, are (irbesartan and hydrochlorothiazide) 150/12.5 mg, 300/12.5 mg, and 300/25 mg. The largest incremental effect will likely be in the transition from monotherapy to 150/12.5 mg.

2.3 Replacement

Therapy AVALIDE may be substituted for the titrated components.

2.4 Initial

Therapy The usual starting dose is AVALIDE 150/12.5 mg once daily. The dosage can be increased after 1 to 2 weeks of therapy to a maximum of 300/25 mg once daily as needed to control blood pressure. AVALIDE is not recommended as initial therapy in patients with intravascular volume depletion.