07/04/2009 16:22


Brand Name: Avapro


Pregnancy Category C (first trimester), Pregnancy Category D (second and third trimesters)

Drug classes: Angiotensin II receptor antagonist (ARB), Antihypertensive



Therapeutic actions

Selectively blocks the binding of angiotensin II to specific tissue receptors found in the vascular smooth muscle and adrenal gland; this action blocks the vasoconstriction effect of the renin-angiotensin system as well as the release of aldosterone, leading to decreased blood pressure.




· Treatment of hypertension as monotherapy or in combination with other antihypertensives

· Slowing of the progression of kidney disease in patients with hypertension and type 2 diabetes




· Contraindicated with hypersensitivity to irbesartan, pregnancy (use during the second or third trimester can cause injury or even death to the fetus), lactation.

· Use cautiously with hepatic or renal dysfunction, hypovolemia.



Adverse effects

Headache, dizziness, syncope, muscle weakness

Hypotension, orthostatic hypotension

Rash, inflammation, urticaria, pruritus, alopecia, dry skin

Diarrhea, abdominal pain, nausea, constipation, dry mouth, dental pain

URI symptoms, cough, sinus disorders

Cancer in preclinical studies, back pain, fever, gout, fatigue



Nursing considerations

· Administer without regard to meals.

· Ensure that patient is not pregnant before beginning therapy; suggest the use of barrier birth control while using irbesartan; fetal injury and deaths have been reported.

· Find an alternative method of feeding the baby if giving drug to a nursing mother. Depression of the renin-angiotensin system in infants is potentially very dangerous.

· Alert surgeon and mark patient's chart with notice that irbesartan is being taken. The blockage of the renin-angiotensin system following surgery can produce problems. Hypotension may be reversed with volume expansion.

· Monitor patient closely in any situation that may lead to a decrease in blood pressure secondary to reduction in fluid volume (excessive perspiration, dehydration, vomiting, diarrhea); excessive hypotension can occur.