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Other brands with the same active ingredient
These brands contain the same active ingredient (Irbesartan + Hydrochlorothiazide). Same strength and form. Confirm the switch with your doctor or pharmacist.
More from Arbitan Plus
Other strengths and forms by Opsonin Pharma Limited
Indications & Uses
This Irbesartan + Hydrochlorothiazide tablet is used to treat hypertension in patients for whom a combination of medicines is appropriate.
Pharmacology
Irbesartan: Angiotensin II is a potent vasoconstrictor. It forms from angiotensin I in a reaction catalyzed by angiotensin-converting enzyme (ACE, kininase II). It is the principal pressor agent of the RAS, and it also stimulates aldosterone synthesis and secretion by the adrenal cortex, cardiac contraction, renal resorption of sodium, activity of the sympathetic nervous system, and smooth muscle cell growth. Irbesartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by binding selectively to the AT1 angiotensin II receptor. Many tissues also have an AT2 receptor, but it is not involved in cardiovascular homeostasis.
Irbesartan is a specific competitive antagonist of the AT1 receptor and has no agonist activity. Its affinity for the AT1 receptor is much greater than for the AT2 receptor (more than 8500-fold). Blockade of the AT1 receptor removes the negative feedback of angiotensin II on renin secretion. Plasma renin activity and circulating angiotensin II then rise, but this does not overcome the effects of irbesartan on blood pressure.
Irbesartan does not inhibit ACE or renin, and it does not affect other hormone receptors or ion channels known to be involved in the cardiovascular regulation of blood pressure and sodium homeostasis. Because it does not inhibit ACE, it does not affect the response to bradykinin (whether this has clinical relevance is not known).
Hydrochlorothiazide: Hydrochlorothiazide is a thiazide diuretic. Thiazides act on the renal tubular mechanisms of electrolyte reabsorption and directly increase the excretion of sodium and chloride in approximately equivalent amounts. Indirectly, the diuretic action of hydrochlorothiazide reduces plasma volume. This brings increases in plasma renin activity, increases in aldosterone secretion, increases in urinary potassium loss, and decreases in serum potassium. The renin-aldosterone link is mediated by angiotensin II, so giving an angiotensin II receptor antagonist together with the diuretic tends to reverse the potassium loss associated with these diuretics.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
A patient whose blood pressure isn't controlled well enough by irbesartan or hydrochlorothiazide alone may be switched to Irbesartan + Hydrochlorothiazide taken once daily, which helps keep dose independent side effects down. The recommended doses (irbesartan and hydrochlorothiazide) are 150-12.5 mg (one 150 tablet), 300-12.5 mg (one 300 tablet) and 300-25 mg (two 150 tablets).
The biggest added effect is likely to come when a patient moves from a single medicine to 150-12.5 mg (one 150 tablet). Blood pressure takes 2 to 4 weeks to settle after the dose of this tablet is changed. The usual dose of the 150 tablet is one tablet once daily. More than two tablets once daily is not recommended. The maximal antihypertensive effect is reached about 2 to 4 weeks after starting treatment.
Use in patients with renal impairment
The usual regimens can be followed as long as the patient's creatinine clearance is 30 mL/min.
Patients with hepatic impairment
No dose adjustment is necessary in patients with hepatic impairment.
Side Effects
Gastro-intestinal system: loss of appetite, gastric irritation, nausea, vomiting, cramps, diarrhoea, constipation, jaundice (intrahepatic cholestatic jaundice), pancreatitis and inflammation of the salivary glands. Central nervous system: dizziness, vertigo, headache and yellow vision. Cardiovascular: a feeling of irregular heartbeat (subjective rhythm disturbance), flushing, ECG abnormality, cardiac murmur, cardiac rhythm disturbance, orthostatic hypotension, atrial rhythm disturbance, bradycardia, hypotension, syncope, conduction disorder and myocardial infarction.
Cautions & Contraindications
Warnings & Precautions
Because Irbesartan + Hydrochlorothiazide works by inhibiting the renin-angiotensin-aldosterone system, kidney function may change in people who are susceptible. Some patients depend on this system to keep their kidneys working, for example hypertensive patients with renal artery stenosis in one or both kidneys, or patients with severe congestive heart failure. In these patients, drugs that affect the system have been linked with oliguria and/or progressive azotemia, and rarely with acute renal failure and/or death. An angiotensin II receptor antagonist, irbesartan included, could have a similar effect, and this cannot be excluded. Experience with irbesartan is limited in patients with moderate to severe renal impairment, so careful monitoring of renal function and potassium is advised for them. Hyperkalaemia has not been reported with irbesartan in uncomplicated patients with hypertension. It may occur, though, with other drugs that affect the renin-angiotensin-aldosterone system, especially when renal impairment and/or heart failure is present. Patients at risk should have their serum potassium monitored adequately. The safety of irbesartan in heart failure has not been fully defined. Sudden death has occurred in some studies of patients with heart failure. Such deaths may have reflected the natural history of the heart failure itself, but caution is still recommended when treating these patients with irbesartan. Experience is also limited in patients with ventricular dysfunction or cardiac arrhythmias, and caution is advised there too.
Contraindications
Irbesartan and Hydrochlorothiazide tablet must not be given to people who are hypersensitive to irbesartan or to Hydrochlorothiazide. It must also not be used in pregnancy.
Pregnancy & Breastfeeding
Irbesartan and Hydrochlorothiazide must not be used in pregnancy, because it is contraindicated. When irbesartan is used during the second and third trimesters, it can cause injury and even death of the developing baby. Thiazides appear in human milk. If the doctor decides the medicine is essential, the patient should stop breast feeding.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Storage
Store Irbesartan + Hydrochlorothiazide below 30°C, and keep it away from light and moisture. Keep it out of the reach of children.
Drug Interactions
Common questions about Arbitan Plus 150 mg+12.5 mg
What is Arbitan Plus 150 mg+12.5 mg Tablet?
Arbitan Plus 150 mg+12.5 mg Tablet is a medicine that contains Irbesartan + Hydrochlorothiazide. It is made by Opsonin Pharma Limited. It belongs to the Combined antihypertensive preparations group of medicines.
What is Arbitan Plus used for?
This Irbesartan + Hydrochlorothiazide tablet is used to treat hypertension in patients for whom a combination of medicines is appropriate.
What are the side effects of Arbitan Plus?
Gastro-intestinal system: loss of appetite, gastric irritation, nausea, vomiting, cramps, diarrhoea, constipation, jaundice (intrahepatic cholestatic jaundice), pancreatitis and inflammation of the salivary glands. Central nervous system: dizziness, vertigo, headache and yellow vision.
Can I take Arbitan Plus during pregnancy or while breastfeeding?
Irbesartan and Hydrochlorothiazide must not be used in pregnancy, because it is contraindicated. When irbesartan is used during the second and third trimesters, it can cause injury and even death of the developing baby. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
How should I store Arbitan Plus?
Store Irbesartan + Hydrochlorothiazide below 30°C, and keep it away from light and moisture. Keep it out of the reach of children.
Can I take other medicines with Arbitan Plus?
Some medicines can interact with Irbesartan + Hydrochlorothiazide, for example: Nifedipine, Insulin (Human) 30/70, Digoxin, Warfarin Sodium. Tell your doctor or pharmacist about every medicine you take.
Is there a cheaper medicine with the same ingredient?
Cavazide by Unimed Unihealth Pharmaceuticals Ltd. has the same ingredient and strength for ৳12.00 per unit, compared with ৳12.05 for Arbitan Plus. Ask your doctor or pharmacist before switching.
Do I need a prescription for Arbitan Plus?
Arbitan Plus is a prescription (Rx) medicine. Take it as your doctor advises.