Avalide

Do not take hydrochlorothiazide and irbesartan without first talking to your doctor if you have an allergy to sulfa-based drugs such as sulfa antibiotics. You may have an allergic reaction to hydrochlorothiazide.

Before taking hydrochlorothiazide and irbesartan, tell your doctor if you

• have diabetes;

• have gout;

• have a collagen vascular disease such as systemic lupus erythematosus;

• have pancreatitis;

• have kidney disease;

• have liver disease;

• have high levels of cholesterol or triglycerides in your blood;

• have high levels of potassium in your blood; or

• are taking potassium a supplement (e.g., K-Dur, Klor-Con, others), or a potassium-sparing diuretic such as amiloride (Midamor), triamterene (Dyrenium, Dyazide, Maxzide), or spironolactone (Aldactone).

You may not be able to take hydrochlorothiazide and irbesartan, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Hydrochlorothiazide and irbesartan is in the FDA pregnancy category D. This means that it is known to cause birth defects in an unborn baby. When used during the second and third trimesters of pregnancy, irbesartan can cause injury and even death of the developing baby. Do not take this medication if you are pregnant.

Hydrochlorothiazide passes into breast milk and may harm a nursing infant. It is not known whether irbesartan passes into breast milk. Do not take this medication without first talking to your doctor if you are breast-feeding a baby.

Take hydrochlorothiazide and irbesartan exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water.

Hydrochlorothiazide and irbesartan can be taken with or without food.

Stop taking hydrochlorothiazide and irbesartan and contact your doctor if lightheadedness or fainting occurs.

Do not stop taking this medication without first talking to your doctor. If you stop taking this medication suddenly, your condition could become worse.

Store hydrochlorothiazide and irbesartan at room temperature away from moisture and heat.

Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take only your next regularly scheduled dose. Do not take a double dose of this medication.

If you experience any of the following serious side effects, stop taking this medication and call your doctor immediately or seek emergency medical treatment:

• an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);

• fast heartbeats;

• little or no urine;

• unusual fatigue, abnormal bleeding or bruising;

• yellow skin or eyes;

• confusion; or

• fainting.

Other, less serious side effects may be more likely to occur. Continue to take the medication and talk to your doctor if you experience

• dizziness;

• nausea or upset stomach;

• diarrhea;

• headache;

• cough;

• muscle pain or cramps;

• rash; or

• anxiety or nervousness.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

Do not take hydrochlorothiazide and irbesartan if you are pregnant or planning a pregnancy. When used during the second and third trimesters of pregnancy, irbesartan can cause injury and even death to the developing baby. Notify your doctor immediately if you think you might be pregnant.

Use caution when driving, operating machinery, or performing other hazardous activities. Hydrochlorothiazide and irbesartan may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. Also use caution when rising from a sitting or lying position.

Stop taking hydrochlorothiazide and irbesartan and contact your doctor if lightheadedness or fainting occurs.

Use alcohol cautiously. Alcohol may increase the drowsiness and dizziness that may occur while you are taking an hydrochlorothiazide and irbesartan.

Avoid prolonged exposure to sunlight. Hydrochlorothiazide and irbesartan may increase the sensitivity of your skin to sunlight. Use a sunscreen and wear protective clothing when exposure to the sun is unavoidable.

Use caution when driving, operating machinery, or performing other hazardous activities. Hydrochlorothiazide and irbesartan may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. Also, use caution when rising from a sitting or lying position.

Stop taking hydrochlorothiazide and irbesartan and contact your doctor if lightheadedness or fainting occurs.

Use alcohol cautiously. Alcohol may increase the drowsiness and dizziness that may occur while you are taking hydrochlorothiazide and irbesartan.

Avoid a diet high in salt. Too much salt may cause your body to retain water. Talk to your doctor before making changes in your diet.

Do not use salt substitutes or take potassium supplements without first talking to your doctor. Hydrochlorothiazide and irbesartan can affect potassium levels in your body.

Avoid prolonged exposure to sunlight. Hydrochlorothiazide and irbesartan may increase the sensitivity of your skin to sunlight. Use a sunscreen and wear protective clothing when exposure to the sun is unavoidable.

Avoid becoming overheated in hot weather. It is easy to become dangerously dehydrated while you are taking hydrochlorothiazide and irbesartan.

Before taking hydrochlorothiazide and irbesartan, tell your doctor if you are taking

• a potassium supplement such as K-Dur, Klor-Con, and others;

• a potassium-sparing diuretic (water pill) such as amiloride (Midamor), spironolactone (Aldactone), or triamterene (Dyrenium, Dyazide, Maxzide);

• a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Motrin, Advil, Nuprin), ketoprofen (Orudis, Orudis KT, Oruvail), diclofenac (Cataflam, Voltaren), indomethacin (Indocin), nabumetone (Relafen), oxaprozin (Daypro), naproxen (Naprosyn, Anaprox, Aleve), and others;

• an oral diabetes medication such as glipizide (Glucotrol), glyburide (Micronase, Glynase, Diabeta), chlorpropamide (Diabinese), tolazamide (Tolinase), or tolbutamide (Orinase);

• a steroid medicine such as prednisone (Orasone, Deltasone, others), methylprednisolone (Medrol), prednisolone (Pediapred, Prelone), and others;

• cholestyramine (Questran) or colestipol (Colestid);

• lithium (Lithobid, Eskalith, others); or

• digoxin (Lanoxin).

You may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.

Drugs other than those listed here may also interact with hydrochlorothiazide and irbesartan or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Seek emergency medical attention.

Symptoms of an overdose of hydrochlorothiazide and irbesartan are not well known but may include dizziness, weakness, fainting, fatigue, low blood pressure, and changes in heart rate.