Cavazide 75 mg+12.5 mg

Description

Indications

Cavazide tablet is indicated for the treatment of hypertension in patients for whom combination therapy is deemed appropriate.

Always use this medication according to the advice of a registered healthcare provider.

Pharmacology

Cavazide is a combination of Irbesartan and Hydrochlorothiazide, each acting through different mechanisms to reduce blood pressure.

• Irbesartan: A selective angiotensin II receptor blocker (ARB), Irbesartan works by binding to the AT1 receptor of angiotensin II, preventing its vasoconstrictor and aldosterone-secreting effects. Angiotensin II is a potent vasoconstrictor and a key regulator in blood pressure. Irbesartan’s blockade of these effects helps lower blood pressure without affecting ACE or other important hormonal systems involved in blood pressure regulation. It has more than 8500 times greater affinity for the AT1 receptor than the AT2 receptor and does not have any agonist activity.

• Hydrochlorothiazide: A thiazide diuretic, Hydrochlorothiazide works by increasing the excretion of sodium and chloride in the urine. This diuretic effect reduces plasma volume, which consequently increases plasma renin activity, aldosterone secretion, and urinary potassium loss. By combining it with Irbesartan, which helps mitigate potassium loss, Cavazide works to control blood pressure effectively without significant potassium depletion.

Dosage & Administration

• Initial Therapy: Patients who have inadequate blood pressure control with Irbesartan or Hydrochlorothiazide alone may be switched to Cavazide. The recommended starting doses are:

  • 150/12.5 mg (one Cavazide-150 tablet)
  • 300/12.5 mg (one Cavazide-300 tablet)
  • 300/25 mg (two Cavazide-150 tablets)

  The dose adjustments should be made according to the patient’s response, and full blood pressure stabilization may take 2-4 weeks after a dose change. Typically, one tablet of Cavazide-150 once daily is the standard starting dose.

• Renal Impairment: Usual regimens may be followed as long as the patient’s creatinine clearance is above 30 mL/min.

• Hepatic Impairment: No dosage adjustment is necessary for patients with hepatic impairment.

Interaction

• Irbesartan: There are no significant pharmacokinetic or pharmacodynamic interactions when Irbesartan is co-administered with common medications such as warfarin, digoxin, or Nifedipine. However, lithium concentrations may increase with Irbesartan, so regular monitoring is advised if both are used together.

• Hydrochlorothiazide: This diuretic may have additive effects when used with other antihypertensive medications. Alcohol, barbiturates, and narcotics can increase the risk of orthostatic hypotension. Additionally, dosage adjustments may be needed for antidiabetic medications (insulin or oral agents) when combined with Hydrochlorothiazide.

Contraindications

Cavazide is contraindicated in patients:

• Hypersensitive to Irbesartan or Hydrochlorothiazide.
• During pregnancy, particularly in the second and third trimesters.

Side Effects

Possible side effects may include:

• Gastrointestinal: Anorexia, nausea, vomiting, abdominal cramps, diarrhea, constipation, jaundice (intrahepatic cholestatic), and pancreatitis.

• Central Nervous System: Dizziness, vertigo, headache, and yellow vision.

• Cardiovascular: Hypotension, bradycardia, syncope, ECG abnormalities, atrial arrhythmias, and potential myocardial infarction.

• Others: Fatigue, electrolyte imbalance, and flushing.

Pregnancy & Lactation

• Pregnancy: Cavazide is contraindicated in pregnancy, especially in the second and third trimesters, as Irbesartan can cause harm or death to the developing fetus.

• Lactation: Thiazides are excreted in human milk, and since Irbesartan’s excretion in breast milk is not well known, discontinuing breastfeeding is recommended if the medication is deemed necessary.

Precautions & Warnings

• Renal Function: Caution is advised in patients with renal artery stenosis or severe congestive heart failure, as these patients are more prone to renal impairment and severe complications like acute renal failure.

• Hyperkalemia: While Irbesartan does not typically cause hyperkalemia in uncomplicated hypertension, it can increase potassium levels, especially in patients with renal impairment or heart failure. Monitoring of potassium levels is recommended.

• Heart Failure: Caution is required in patients with heart failure, as Irbesartan has been associated with sudden death in some studies. Its safety profile in heart failure patients is not fully established.

• Electrolyte Imbalance: Regular monitoring of electrolyte levels is necessary, especially serum potassium, when using this combination therapy.

Therapeutic Class

Combined antihypertensive preparations.

Storage Conditions

• Store below 30°C, in a dry place, away from light and moisture.
• Keep out of reach of children.