Cavapro 300 mg

Description

Indications
Cavapro Tablet is prescribed for the management of essential hypertension. It is also indicated for the treatment of renal complications associated with hypertension in patients with type 2 diabetes mellitus as part of an antihypertensive regimen.
Take the medication as per the guidance of a registered physician.

Pharmacology
Irbesartan, the active ingredient in Cavapro, is an angiotensin II receptor antagonist. It works by blocking the vasoconstricting and aldosterone-secreting effects of angiotensin II, which helps in reducing blood pressure. Irbesartan binds to AT1 receptors to counteract these effects.

Dosage & Administration

• Adults: The standard recommended dose is 150 mg of Irbesartan taken once daily, with or without food. A dose of 150 mg offers better 24-hour blood pressure control compared to 75 mg. However, initiating treatment with 75 mg may be considered for elderly patients over 75 years of age or those undergoing haemodialysis.
  If blood pressure remains uncontrolled with 150 mg, the dose can be increased to 300 mg or other antihypertensive medications can be added. The combination of Irbesartan with a diuretic, such as hydrochlorothiazide, has shown an enhanced blood pressure-lowering effect.
  In hypertensive patients with type 2 diabetes and renal disease, therapy should start at 150 mg daily and can be increased to 300 mg daily for optimal management. Irbesartan, in conjunction with other antihypertensive drugs, helps achieve the target blood pressure in these patients.

• Elderly: Although starting with 75 mg may be considered for patients over 75 years, dosage adjustments are generally not needed for the elderly.

• Pediatrics: Irbesartan is not recommended for children and adolescents due to insufficient safety and efficacy data.
  Take the medication as per the guidance of a registered physician.

Interactions

• Diuretics and other antihypertensive drugs: If high-dose diuretics have been used previously, there may be volume depletion, leading to a risk of hypotension when starting Cavapro.
• Potassium supplements and potassium-sparing diuretics: The combined use of potassium-sparing diuretics, potassium supplements, or other drugs that elevate potassium levels, such as heparin, can increase serum potassium levels. Therefore, this combination is not recommended.
• Lithium: Increased serum lithium levels and toxicity have been observed when used with angiotensin-converting enzyme inhibitors. While this has been rarely reported with Cavapro, it is advisable to monitor lithium levels closely if this combination is necessary.
• Non-steroidal anti-inflammatory drugs (NSAIDs): The concurrent use of NSAIDs with angiotensin II antagonists like Cavapro may reduce the antihypertensive effect.
• Other Interactions: No significant pharmacokinetic or pharmacodynamic interactions were observed when Cavapro was taken with warfarin, a drug metabolized by CYP2C9. However, the impact of CYP2C9 inducers, such as rifampicin, on Cavapro’s pharmacokinetics is yet to be determined. Co-administration with digoxin does not affect its pharmacokinetics.

Contraindications
Cavapro should not be used concurrently with aliskiren in patients who have diabetes or renal impairment (GFR <60 ml/min) and should not be used during pregnancy.

Side Effects
Cavapro is known for its low incidence of side effects, particularly the cough commonly associated with ACE inhibitors.

• Common side effects: Headache, dizziness, fatigue, nausea, and vomiting.
• Less common side effects: Anxiety, nervousness, belching, heartburn, stomach discomfort, diarrhea, muscle or bone pain, and unusual tiredness.

Pregnancy & Lactation

• Pregnancy: Irbesartan is contraindicated during the second and third trimesters of pregnancy as it can cause fetal or neonatal renal failure, skull hypoplasia, or even fetal death. It is recommended to switch to an alternative treatment before planning a pregnancy. If pregnancy is confirmed, Irbesartan should be discontinued immediately, and renal function and fetal development should be monitored.
• Lactation: Irbesartan is contraindicated during breastfeeding. It is not clear if Irbesartan passes into human breast milk, though it has been detected in the milk of lactating rats.

Precautions & Warnings

• Patients with unilateral or bilateral renal artery stenosis, aortic or mitral stenosis, or obstructive hypertrophic cardiomyopathy should exercise caution.
• In patients with renal impairment, the dose of Cavapro should be adjusted as needed, but no specific adjustments are required in cases of mild to moderate hepatic impairment.
• Hyperkalemia: Cavapro may increase potassium levels, particularly in patients with renal disease or heart failure. Regular monitoring of serum potassium is advised.
• Primary Aldosteronism: Cavapro is not recommended for patients with primary aldosteronism as they typically do not respond to drugs targeting the renin-angiotensin system.

Overdose Effects
In cases of overdose, the most common symptoms are hypotension and tachycardia, though bradycardia may also occur. No specific antidote for overdose is available. Treatment is symptomatic and supportive. Activated charcoal may be useful in overdose situations. Hemodialysis is not effective in removing Cavapro from the body.

Therapeutic Class
Angiotensin II receptor blocker (ARB)

Storage Conditions
Store in a cool, dry place away from light.