CoAprovel

How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.

This medicine may enhance the effect of other medicines to treat high blood pressure. In particular, people taking diuretic medicines, eg furosemide, may have a large drop in blood pressure with the first dose. Since this may cause dizziness or fainting, if you are taking a diuretic medicine your doctor may reduce its dose or ask you to stop taking it two to three days before starting this medicine. This is to prevent your blood pressure from dropping too low.

Irbesartan and hydrochlorothiazide may increase the blood level of the medicine lithium, and this medicine is therefore not recommended for people taking lithium. If your doctor feels the combination is necessary, your lithium level should be closely monitored.

Irbesartan may increase blood potassium levels, therefore if this medicine is taken with other medicines that can increase blood potassium, this effect may be enhanced. These medicines include the following:

- ciclosporin
- potassium-sparing diuretics (eg spironolactone, triamterene, amiloride)
- potassium supplements
- potassium salts, eg potassium citrate
- potassium-containing salt substitutes, eg Lo-salt
- heparin.

Hydrochlorothiazide can decrease blood potassium levels, therefore if this medicine is taken with other medicines that can lower blood potassium, this effect may be enhanced. These medicines include the following:

- other diuretics
- amphotericin
- carbenoxolone
- corticosteroids
- beta agonist bronchodilators such as salbutamol.

If you are taking any of these medicines that could affect your potassium level, your potassium level should be monitored. This is particularly important if you are taking digoxin or a medicine for abnormal heart beats.

Non-steroidal anti-inflammatory drugs (NSAIDs, eg indometacin) may reduce the blood pressure lowering effect of this medicine. They may also increase the risk of raised blood potassium and kidney problems when used in combination with this medicine. NSAIDs should be used with caution in people taking this medicine, particularly elderly people, and your doctor may want to monitor your kidney function.

Hydrochlorothiazide may raise blood glucose levels. People with diabetes should therefore carefully monitor their blood sugar while taking this medicine, as the effectiveness of antidiabetic medicines may be reduced. This effect may be enhanced if diazoxide or beta-blockers are also being taken. Dose adjustments of the antidiabetic medicine may be required. Discuss this with your doctor.

Hydrochlorothiazide may also raise uric acid levels. People with gout may therefore need adjustments to the doses of their gout medicines to keep them effective.

This medicine should not be taken within four hours of colestipol or colestyramine, as if they are taken at the same time they may reduce the absorption of hydrochlorothiazide from the gut.

Hydrochlorothiazide can increase blood calcium levels. Therefore if calcium or vitamin D supplements are taken with this medicine, blood calcium levels should be monitored.

Other medicines containing the same active ingredients

There are currently no other medicines available in the UK that contain both irbesartan and hydrochlorothiazide as the active ingredients.

Aprovel contains just irbesartan.

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