Irbesartan has a good antihypertensive effect by blocking renin, angiotensin and aldosterone system. Irbesartan can dilate glomerular efferent arterioles, resulting in decreased glomerular filtration rate and increased creatinine and blood potassium levels.
Hydrochlorothiazide mainly acts on the beginning of distal convoluted tubule, reducing the reabsorption of sodium chloride and water and lowering blood pressure. It is suitable for the initial and maintenance treatment of most patients with hypertension without contraindications, especially for elderly patients with hypertension, refractory hypertension, heart failure complicated with hypertension and salt-sensitive hypertension. The daily dose of hydrochlorothiazide is generally not more than 25mg (even if the dose is increased, the antihypertensive effect is limited and the adverse reactions increase).
Long-term use of diuretics can cause electrolyte disorder (decreased blood potassium). Because diuretic monotherapy can only make the blood pressure of a small number of hypertensive patients reach the standard, diuretics are rarely used alone, and most patients need combined medication. Low-dose diuretic combined with sartan has more obvious antihypertensive effect, less adverse reactions and more clinical benefits than sufficient single drug. Diuretics can enhance the antihypertensive effect of other antihypertensive drugs, and sartan can also reduce the occurrence of hypokalemia caused by hydrochlorothiazide. Therefore, hypertension-related guidelines recommend the use of an effective dose of Pulitzer or sartan in combination with diuretics.
The 20 17 edition of Guidelines for Rational Use of Hypertension points out that the application of antihypertensive drugs should follow the following four principles: 1 dose principle (general conventional dose, small dose for the elderly), 2 priority principle (long-acting preparation, single compound preparation), 3 combination principle (substandard, moderate and severe), and 4 individualization principle (complications, curative effect, and so on).
From the above analysis, it can be seen that irbesartan hydrochlorothiazide conforms to the priority principle and the joint principle. As for their specifications, irbesartan hydrochlorothiazide is generally irbesartan 150mg and hydrochlorothiazide 12.5mg (mostly), but there are also irbesartan 300mg and hydrochlorothiazide 12.5mg, irbesartan 75mg and hydrochlorothiazide 6.25mg.
Irbesartan 150mg and hydrochlorothiazide 12.5mg/tablet are generally taken once a day; Irbesartan 75mg, hydrochlorothiazide 6.25mg, generally two tablets once a day. For this usage, the blood pressure is still not up to standard, and the instructions do not recommend increasing the dose. Instead, it is suggested to choose irbesartan 300mg 1 tablet and hydrochlorothiazide 12.5mg.
Although irbesartan hydrochlorothiazide is not a sustained and controlled release preparation, it can be taken in half in theory. However, this will make the dose division inaccurate and reduce compliance. Therefore, it is suggested that patients with hypertension choose appropriate medication according to their blood pressure level.
Irbesartan usually suggests that the initial dose and maintenance dose are 150mg per day, and diet has no effect on medication. Generally speaking, irbesartan 150mg once a day can control 24-hour blood pressure better than 75mg. But for some special patients, especially those who are undergoing hemodialysis and are over 75 years old, the initial dose can be considered as 75mg. Patients who cannot effectively control their blood pressure by using irbesartan 150mg once a day can increase the dosage of this product to 300mg or add other antihypertensive drugs.
Irbesartan Hydrochlorothiazide Tablets: Suitable for the treatment of essential hypertension. The fixed-dose compound is used for treating patients whose blood pressure cannot be effectively controlled by single irbesartan or hydrochlorothiazide. Its specifications mainly include:
75/6.25mg: each tablet contains irbesartan 75mg and hydrochlorothiazide12.5mg..
150/ 12.5mg: each tablet contains irbesartan 150mg and hydrochlorothiazide 12.5mg..
Administration and dosage: daily/kloc-0 times, taken on an empty stomach or during meals, for the treatment of patients whose blood pressure cannot be effectively controlled by irbesartan or hydrochlorothiazide alone. It is suggested that patients can adjust a single component (i.e. irbesartan or hydrochlorothiazide). Under the following circumstances, we can consider directly changing from a single component to a fixed combination therapy:
150/ 12.5mg irbesartan hydrochlorothiazide can be used for patients who cannot effectively control their blood pressure by hydrochlorothiazide alone or irbesartan 150mg.
300/ 12.5mg irbesartan hydrochlorothiazide can be used for patients who cannot effectively control their blood pressure by using irbesartan 300mg alone or using 150mg/ 12.5mg compound.
300/25mg irbesartan hydrochlorothiazide can be used for patients whose blood pressure can't be controlled with 300mg/ 12.5mg irbesartan. It is not recommended to use a daily dose of more than 300mg/irbesartan/25mg hydrochlorothiazide. When necessary, irbesartan hydrochlorothiazide can be combined with other antihypertensive drugs:
Hydrochlorothiazide in the compound preparation of irbesartan and hydrochlorothiazide can activate sympathetic nervous system and renin-angiotensin system, have antihypertensive effect and reduce blood potassium level. Irbesartan can antagonize the compensation mechanism induced by diuretics, thus enhancing the antihypertensive effect of diuretics, and at the same time selectively blocking AT 1 subtype receptors from exerting antihypertensive effect. In addition, irbesartan can alleviate the increase of serum uric acid and the decrease of serum potassium caused by hydrochlorothiazide. Irbesartan hydrochlorothiazide can effectively reduce the blood pressure of patients with mild, moderate and severe hypertension, and the degree of reduction is equivalent to that of hydrochlorothiazide alone or in combination with Pulitzer drugs, β -blockers and calcium antagonists. The increased efficacy of irbesartan combined with hydrochlorothiazide is very important to achieve the target blood pressure in the treatment guidelines (JNC7 and WHO /ISH). In addition, the tolerance of long-term use of irbesartan hydrochlorothiazide and the simple medication method of 1 tablet per day may help patients adhere to treatment. Therefore, irbesartan hydrochlorothiazide is a reasonable choice for patients who must be combined with drugs to reduce blood pressure.
Different patients have different blood pressure levels and complicated diseases, so the choice of drug dosage should be based on their own situation. It is suggested that the dosage of drugs should not be adjusted without authorization, and should be used under the guidance of a specialist.
(This answer is provided by Liu Zhijian, Sun Yat-sen Memorial Hospital of Sun Yat-sen University.)
Welcome to pay attention to "Yixian Pharmacist", which contains articles on rational drug use for various diseases! Irbesartan hydrochlorothiazide tablets can be disassembled, but if it needs to be disassembled, the dosage regimen may need to be adjusted.
First of all, the commonly used antihypertensive drug irbesartan hydrochlorothiazide tablets contain two commonly used antihypertensive components, irbesartan and hydrochlorothiazide. Among them, irbesartan is the most commonly used sartan drug, and its professional name is angiotensin converting enzyme receptor antagonist, while hydrochlorothiazide is a commonly used diuretic, and the commonly used dose is 12.5 mg.
If irbesartan hydrochlorothiazide tablets are disassembled, irbesartan is reduced to 75 mg and hydrochlorothiazide is reduced to 6.25 mg. Some patients with hypertension can consider using 75 mg irbesartan, but usually the dosage of hydrochlorothiazide is 12.5 mg, and the dosage of 6.25mg is too small.
Therefore, it is not recommended for individuals to take irbesartan hydrochlorothiazide tablets separately, which may lead to uneven drug dosage.
If the blood pressure is well controlled by using irbesartan hydrochlorothiazide tablets, you can consider taking irbesartan or hydrochlorothiazide alone, such as using irbesartan alone. Of course, it depends on the patient's blood pressure.
I am Hui, deputy chief physician of Cardiovascular Department of Dalian Central Hospital. I hope the above suggestions can help you.
Answer first: the compound preparation of irbesartan hydrochlorothiazide can be disassembled.
The combination of irbesartan and hydrochlorothiazide is a good example of the combination of antihypertensive drugs. Irbesartan is an angiotensin inhibitor, which can inhibit vascular tension. Irbesartan can dilate both arterial and venous blood vessels, coronary and peripheral blood vessels, which will bring blood flow resistance and reduce hypertension. Hydrochlorothiazide is a thiazide diuretic, which can effectively reduce water and sodium retention, reduce blood volume and lower blood pressure. These two drugs complement each other in mechanism and are a good combination of antihypertensive drugs. So at present, there are also compound preparations of these two drugs in use.
Under the synergistic effect of the two drugs, there will generally be better antihypertensive effect. But if you take one tablet every day, if there will be hypotension, it may be caused by excessive dose. At this time, you can consider breaking this medicine and taking half a tablet. Because irbesartan and hydrochlorothiazide are both long-acting drugs, the compound preparations of these two drugs are common tablets, and there is no need to make special dosage forms such as sustained-release tablets or enteric-coated tablets, and half of the common tablets can be taken.
Ordinary tablets are usually taken apart without problems, but attention should be paid to the therapeutic effect after reducing the dose. For example, if we take half of the irbesartan hydrochlorothiazide tablets mentioned above, we should pay more attention to daily blood pressure monitoring to ensure that we can achieve the actual effect of lowering blood pressure by taking half. If you can control your blood pressure smoothly, of course, it is no problem to take half of it, but as the weather gets cold, your blood pressure often becomes more difficult to control. Therefore, if half of them can't effectively control blood pressure, it is better to take one.
Many friends are confused about whether the medicine can be disassembled. Actually, the difference is simple. Usually, ordinary pills can be disassembled. For some pharmaceutical preparations that often need to be broken, there will be an easily broken notch on the tablet. Enteric-coated tablets cannot be disassembled. Enteric-coated preparations usually have an enteric coating on the outer layer of drugs. If disassembled, it will destroy the integrity of the enteric coating, make the drug disintegrate in the stomach, affect the efficacy or stimulate the gastric mucosa. Most sustained and controlled release preparations will not be broken if coated with sustained and controlled release matrix, but for some drugs, the sustained and controlled release technology of microsphere encapsulation technology is used to compress the coated microspheres into tablets. In this case, such sustained and controlled release tablets can be taken in pieces. Give two examples, such as betaloc, such as nifedipine sustained-release tablets II. These drugs are generally marked in the middle. Description.
Dr. Wang Cardiovascular told you that irbesartan and hydrochlorothiazide can be eaten in half.
But it's very troublesome to stop taking medicine. Sometimes it will be uneven, sometimes it will fall to the ground, which will be very troublesome. There is no need for everyone to stop taking medicine. We can completely change the drug.
Since you have decided to take half of irbesartan hydrochlorothiazide, it means that half of the drugs can effectively control blood pressure. Naturally, there is no need to continue taking this medicine. You can switch to other antihypertensive drugs, once a day, one tablet at a time, which can control blood pressure ideally.
Irbesartan hydrochlorothiazide is a compound preparation. The antihypertensive drugs of sartan are loved by clinicians and patients because of their relatively small side effects and good antihypertensive effect. Adding 12.5mg hydrochlorothiazide has a better antihypertensive effect.
But since half a tablet of compound preparation can control blood pressure, why take compound preparation? It can be completely replaced by a single preparation.
Therefore, irbesartan hydrochlorothiazide can take one and a half tablets at a time, but it is not necessary, and it is also troublesome for yourself.
If you think it's fun to stop taking medicine, and you are used to taking half a pill, your blood pressure is ideal, and taking half a pill is no problem!
1. If you take ambonor, there are two dosage forms (150 mg/ 12.5 mg and 300 mg/ 12.5 mg), which can be adjusted according to your existing dosage forms. If you have eaten 150mg/ 12.5mg, in principle, you can break it as long as it is not a sustained-release or controlled-release dosage form!
2. If you use a small dosage form with low blood pressure, you can also use a single drug instead, so you don't need to take a compound preparation!
3, it is recommended to go to the hospital to adjust, try not to adjust the medicine yourself!
Irbesartan hydrochlorothiazide tablet is a single compound antihypertensive drug, which contains irbesartan and hydrochlorothiazide as two first-line antihypertensive drugs. Irbesartan belongs to angiotensin Ⅱ receptor antagonist. By selectively binding with AT 1 receptor of angiotensin Ⅱ, irbesartan antagonizes the vasoconstrictive effect of angiotensin Ⅱ, reduces the level of aldosterone in blood, and reduces the retention of water and sodium, thus lowering blood pressure. Its antihypertensive effect is slow, but stable and lasting. Long-term administration can effectively reduce the risk of cardiovascular and cerebrovascular events in patients with hypertension and reduce microalbuminuria and proteinuria in patients with nephropathy or diabetes, and is especially suitable for patients with left ventricular hypertrophy, coronary heart disease, heart failure, atrial fibrillation, diabetic nephropathy, metabolic syndrome, microalbuminuria or proteinuria and patients who cannot tolerate "Puli" antihypertensive drugs.
Hydrochlorothiazide is an intermediate diuretic, which mainly reduces volume load, dilates peripheral blood vessels, reduces peripheral resistance and plays a role in lowering blood pressure. The antihypertensive effect is rapid, stable and lasting. Long-term administration can reduce the risk of stroke in patients with hypertension, especially for elderly patients with hypertension, patients with isolated systolic hypertension or heart failure, and it is also one of the basic drugs for the treatment of refractory hypertension.
Irbesartan combined with hydrochlorothiazide has synergistic effect, which is beneficial to improve the antihypertensive effect. In addition, hydrochlorothiazide can cause sympathetic nerve activation at the same time, which affects the antihypertensive effect. Irbesartan acts on the renin-angiotensin-aldosterone system, which can inhibit the excessive activation of sympathetic nerve and offset this unfavorable factor. In addition, irbesartan can slightly increase the blood potassium level and antagonize the adverse reactions such as hypokalemia caused by long-term use of hydrochlorothiazide. Long-term use of hydrochlorothiazide can easily lead to disorder of blood lipid, blood sugar and purine metabolism. Combined with irbesartan, the dosage of hydrochlorothiazide can be reduced, thus reducing the incidence of these adverse reactions.
Irbesartan hydrochlorothiazide tablets have two specifications, namely 150mg/ 12.5mg and 300mg/ 12.5mg, and 150mg/ 12.5mg, which means that each tablet contains irbesartan/kloc-0. 300mg/ 12.5mg means that each tablet contains irbesartan 300mg, hydrochlorothiazide 12.5mg, the dosage range of irbesartan is 150-300mg, and hydrochlorothiazide is 12.5-25mg. In clinic, irbesartan hydrochlorothiazide can be taken in half in the following three cases, and 1 case is not recommended:
First of all, let's understand the function of irbesartan hydrochlorothiazide tablets, which is a drug used to lower blood pressure. Irbesartan is an angiotensin receptor antagonist and hydrochlorothiazide is a diuretic, both of which are antihypertensive drugs. When the two are mixed together, it is a compound preparation, which can be used in combination, which is convenient to use and improves the compliance of medication, that is, remember to take medicine when taking medicine.
In addition, learn about tablets. Tablets are solid preparations in the form of tablets or irregular tablets made by uniformly mixing drugs and excipients. Tablets are mainly oral tablets, but there are also other types of tablets, such as buccal tablets, sublingual tablets, oral patches, chewable tablets, dispersible tablets, effervescent tablets, vaginal tablets, quick-release or slow-release or controlled-release tablets and enteric-coated tablets.
Irbesartan hydrochlorothiazide tablets are commonly used in oral administration, which are made by mixing irbesartan, hydrochlorothiazide and excipients evenly and pressing them. That is, the two drugs are evenly mixed and dispersed in tablets. For example, an elderly person with hypertension has a regular life and takes one tablet when he gets up, while irbesartan hydrochlorothiazide can always control his blood pressure. Later, it was discovered that the blood pressure of the elderly had dropped. In order to avoid missing medicine, the medicine was stopped and the compound preparation was used. Blood pressure didn't drop too much, and it remained within the controllable range.
The medicine can be broken, because irbesartan and hydrochlorothiazide are evenly dispersed in tablets, which can be broken if necessary in clinic, that is, one and a half tablets a day. It should be noted that some drugs cannot be broken in clinic, such as nifedipine controlled-release tablets. Breaking the controlled release preparation will cause the sudden release of drugs, leading to a sudden drop in blood pressure, and it is not recommended to break it. For example, aspirin enteric-coated tablets should not be broken, so as not to destroy its enteric structure.
Authoritative interpretation of pharmaceutical affairs network, unauthorized reprint, plagiarism will be investigated. Ms. Wang is 59 years old. She has been diagnosed with hypertension for more than 65,438+00 years. For various reasons, she changed a lot of antihypertensive drugs. This time she was given irbesartan hydrochlorothiazide tablets 150/ 12.5mg. Repeated measurements within half a year showed that her blood pressure was stable and normal, and there was no discomfort. However, some time ago, the specification of 150/ 12.5mg was gone, leaving only the specification of 300/ 12.5mg. Can I take half a tablet a day?
The answer is yes, but we should continue to monitor the patient's blood pressure to ensure that the blood pressure fluctuates little and is within the normal range!
Irbesartan hydrochlorothiazide tablet is a compound preparation, which consists of irbesartan and hydrochlorothiazide. The two components have synergistic antihypertensive effect, and the effect is better than that of using one component alone.
Irbesartan hydrochlorothiazide tablets have two specifications, namely 150/ 12.5mg and 300/ 12.5mg. 150/ 12.5mg specifications contain irbesartan 150mg and hydrochlorothiazide12.5mg; The specification of 300/ 12.5mg contains irbesartan 300mg and hydrochlorothiazide 12.5mg.
Irbesartan hydrochlorothiazide tablets daily 1 time, can be used on an empty stomach or during meals. It is mainly used for patients whose blood pressure cannot be effectively controlled by irbesartan or hydrochlorothiazide alone. The daily dose should not exceed 300mg irbesartan/25mg hydrochlorothiazide. If the blood pressure is still not well controlled by using the maximum dose, it is not recommended to continue to increase the dose of the drug, but to use it in combination with one of the antihypertensive drugs!
The advantages of irbesartan hydrochlorothiazide tablets are as follows:
1. Blood pressure can reach1+1>; Role 2: Irbesartan belongs to ARB drugs, which dilates blood vessels and lowers blood pressure by blocking vascular smooth muscle and corresponding receptors. Hydrochlorothiazide can reduce the absorption of sodium and water by renal tubules and reduce blood volume by inhibiting sodium chloride transporters, which has antihypertensive effect.
The combination of the two can achieve1+1> The effect of 2.
2. Improve patients' medication compliance: Hypertension patients generally suffer from other chronic diseases and need long-term medication, so the more medication they take, the worse their medication compliance. Irbesartan hydrochlorothiazide tablets combine the two drugs, and then they are made into 1 tablet, which is taken 1 time every day, which greatly improves the compliance of patients.
Irbesartan hydrochlorothiazide tablets should also pay attention to some matters in the use process, because the adverse reactions of the two drugs themselves will be reflected in the compound preparation, except for the "blood potassium" supplement to offset a part. Electrolyte should be monitored during use to prevent adverse reactions, and the initial dose should start from the lowest dose to prevent hypotension caused by excessive dose.
Prohibition: due to the existence of thiazine, patients with severely impaired renal function, especially those with creatinine clearance below 30ml/min, patients with intractable hypokalemia, hypercalcemia, biliary cirrhosis and cholestasis are prohibited. In addition, patients who are allergic to sulfonamides or any of their components are prohibited from using them.
Irbesartan hydrochlorothiazide tablet is a compound antihypertensive preparation. The synergy between them can better control blood pressure. For ordinary tablets, it is possible to use half of them.
Irbesartan is an angiotensin receptor inhibitor, and hyperkalemia has many adverse reactions. Hydrochlorothiazide is a diuretic, which leads to the decrease of blood potassium in the body. When they are combined into a compound preparation, they can antagonize the blood potassium level, reduce blood pressure cooperatively, and help to maintain a good blood pressure level within 24 hours.
Generally, the specifications of tablet computers produced by different manufacturers will be different. When the dose is small, it will reduce the compliance of taking medicine and increase the trouble when stopping taking medicine. When tablets are artificially broken, the dosage is not very accurate, and it is easy to have more than half and less than half. In this case, you can choose drugs with similar specifications and take them as a whole to effectively control blood pressure for a long time.