How does Avalide work?

Avalide is a two-in-one blood pressure–lowering medication that combines an angiotensin II receptor blocker (ARB) and a thiazide diuretic. The ARB works in the blood vessels to allow blood to flow more easily, which allows the heart to pump more efficiently and lowers blood pressure. The diuretic works by increasing urination to eliminate the additional fluids and salt in the body.

What drugs should not be taken with Avalide?

Several medications may interact with Avalide, including diabetes drugs, other blood pressure-lowering agents, and NSAIDs. Tell your healthcare provider about other medications you take so they can adjust your dosages if necessary or tell you to avoid certain medications altogether.

How long does it take for Avalide to work?

Avalide can take full effect as soon as two to four hours after taking it and last as long as 24 hours. It may take longer to notice the full improvements in your blood pressure control.

How do I stop taking Avalide?

Do not stop taking Avalide without first consulting your primary healthcare provider. You will generally need to keep taking your medication if you have not yet reached your blood pressure goal. You can stop taking Avalide once your healthcare provider has further evaluated your health and blood pressure to see if this medication is no longer needed.

Should I stop my other medications while taking Avalide?

Do not stop taking your other medications unless directed by your healthcare provider first.

Avalide (Irbesartan/Hydrochlorothiazide) – Oral: Uses, Side Effects, Dosages

Warning:

Pregnant people in their second or third trimester should discontinue Avalide (irbesartan and hydrochlorothiazide) as soon as possible to prevent any risk or injury to the developing fetus. This medication can cause severe injury and possibly death to the developing fetus if continued throughout pregnancy.

…

What Is Avalide?

Avalide (irbesartan and hydrochlorothiazide) is a combination prescription medication used to reduce high blood pressure in those who have not seen significant results from single medication therapy. Avalide is a combination of two medications: irbesartan (an angiotensin II receptor blocker, ARB) and hydrochlorothiazide (a thiazide diuretic).

The medication primarily affects the blood vessels (the circulatory system) to lower blood pressure and prevent a stroke or a heart attack. It is available in tablet form to take by mouth.

Drug Facts

Generic Name: Irbesartan and hydrochlorothiazide

Brand Name(s): Avalide

Drug Availability: Prescription

Administration Route: Oral

Therapeutic Classification: Antihypertensive

Available Generically: N/A

Controlled Substance: No

Active Ingredient: Irbesartan and hydrochlorothiazide

Dosage Form(s): Tablets

What Is Avalide Used For?

A combination therapy, Avalide treats high blood pressure in those who have not achieved adequate control with a single medication (monotherapy). It might also be used as a first option in people who are likely to need multiple drug therapy to reach their blood pressure goals.

How to Take Avalide

Take Avalide as instructed by your prescribing healthcare provider, usually once a day.

Take it by mouth at around the same time daily and drink water throughout the day. As a diuretic, one of the main ingredients, hydrochlorothiazide, increases the need to urinate, which can lead to dehydration.

Storage

Store Avalide at room temperature (68 to 77 degrees F). It is best to keep this medication in a closed and tight container away from direct sunlight. Do not store this medication in the bathroom or any area that may build up moisture. Do not freeze this medication. Store in high or hard-to-reach areas to keep away from children and pets.

Off-Label Uses

There is limited information on the use of this product for anything other than its intended use.

How Long Does Avalide Take to Work?

The irbesartan within Avalide may take effect in the body within four hours and can last as long as 24 hours. The other component of Avalide is the water pill hydrochlorothiazide. This drug can work within two hours, peak at four hours, and last about six to 12 hours.

What Are the Side Effects of Avalide?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the Food and Drug Administration (FDA) at www.fda.gov/medwatch or 800-FDA-1088.

This medication, like many others, comes with side effects. Possible side effects may be mild, serious, or long term.

Common Side Effects

Common side effects associated with Avalide include:

Dizziness
Fatigue
Headache
Muscle pain

Severe Side Effects

Call your healthcare provider immediately if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects can include the following:

Low blood pressure (hypotension)
Syncope (fainting)
Hives or swelling of the face
Electrolyte imbalance, specifically low potassium levels (hypokalemia)
Jaundice (yellowing of the skin or whites of the eyes)

Although these serious side effects are rare or may be due to highly sensitive/allergic reactions, it is always best to speak with your healthcare provider before taking this medication.

Long-Term Side Effects

Low potassium levels could develop due to the diuretic (water pill) ingredient present in Avalide.

Vision problems may occur when taking medications that contain hydrochlorothiazide long term. Contact your healthcare provider immediately if you have intense pressure in the eye or difficulty seeing things further away.

Report Side Effects

Avalide may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

(800) 332-1088

Dosage: How Much Avalide Should I Take?

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For oral dosage form (tablets):
- For high blood pressure:
  - Adults—At first, 150 milligrams (mg) irbesartan and 12.5 mg hydrochlorothiazide once a day. Your doctor may adjust your dose as needed.
  - Children—Use and dose must be determined by your doctor.

Modifications

Certain factors may affect how you take your medication. Common dose modifications in the context of Avalide are below.

Children

The safety and efficacy of this medication have not been established in children.

Pregnant People

People who are pregnant or who are trying to become pregnant should not take this medication as it may cause harm and possibly death to the fetus.

Adults 65 and Older

There are no special modifications needed for those 65 years or older.

Chronic Kidney Disease

Since Avalide contains a diuretic, this medication may not be the best choice if you are in the late stages of chronic kidney disease. Increased urination could be helpful for those with blood pressure; however, if your kidney health is worsening, then the side effects associated with this medication could have more risks than benefits.

Missed Dose

If you miss a dose, do not take two doses the next day to make up for the missed dose. Instead, skip the missed dose and continue with your normal dosing schedule.

Overdose: What Happens If I Take Too Much Avalide?

Taking too much irbesartan has not been proven to affect people significantly. However, if you experience low blood pressure or a fast heartbeat after a high dose, then contact a healthcare professional immediately. A severe overdose can lead to shock, which is an extremely dangerous level of low blood pressure.

Too much hydrochlorothiazide can significantly increase urination, which may lead to severe electrolyte loss and dehydration.

If you experience painful urination or feel like you are about to faint due to a high dose, then call your healthcare provider or 911 immediately.

What happens if I Overdose on Avalide?

If you think you or someone else may have overdosed on Avalide, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Avalide, call 911 immediately.

911

Precautions

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby, especially in your second or third trimester. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using this medicine, tell your doctor right away. You may need to stop using this medicine.

This medicine may cause dizziness, lightheadedness, or fainting, especially when you get up suddenly from a lying or sitting position. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy. If you feel dizzy, lie down so you do not faint. Then sit for a few moments before standing to prevent the dizziness from returning. If you faint, call your doctor right away.

Check with your doctor right away if you become sick while taking this medicine, especially if you have severe or continuing nausea, vomiting, or diarrhea. These conditions may cause you to lose too much water and lead to low blood pressure. You can also loose water by sweating, so drink plenty of water during exercise or in hot weather.

Check with your doctor right away if you have bloody urine, a decrease in frequency or amount of urine, an increase in blood pressure, increased thirst, loss of appetite, lower back or side pain, nausea, swelling of the face, fingers, or lower legs, trouble breathing, unusual tiredness or weakness, vomiting, or weight gain. These could be symptoms of a serious kidney problem.

Check with your doctor immediately if blurred vision, difficulty with reading, eye pain, or any other change in vision occurs during or after treatment. These could be signs of serious eye problems (eg, angle-closure glaucoma, myopia, and choroidal effusion). Your doctor will want you to have your eyes checked by an ophthalmologist (eye doctor).

This medicine may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests, or if you have any questions, check with your doctor.

This medicine may increase your risk of getting skin cancer (eg, non-melanoma skin cancer). Avoid sun exposure. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds. Talk to your doctor if you have concerns about this risk.

Hyperkalemia (high potassium in the blood) may occur while you are using this medicine. Check with your doctor right away if you have stomach pain, confusion, irregular heartbeat, nausea or vomiting, nervousness, numbness or tingling in the hands, feet, or lips, trouble breathing, or weakness or heaviness of the legs. Ask your doctor before you use medicines, supplements, or salt substitutes that contain potassium.

Alcohol, narcotic pain relievers, or sleeping pills may cause you to feel more lightheaded, dizzy, or faint when used with this medicine. Tell your doctor if you are drinking alcohol or using pain relievers or sleeping pills.

Do not take other medicines unless they have been discussed with your doctor. This especially includes over-the-counter (nonprescription) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may tend to increase your blood pressure.

What Are Reasons I Shouldn’t Take Avalide?

Do not take Avalide if:

You are pregnant or planning to become pregnant during treatment. This medication can be harmful to the fetus. If you become pregnant while on Avalide, contact your healthcare provider immediately and stop treatment.
You are allergic to Avalide or any ingredient in the medication.
You have anuria (failure to produce urine) or hypersensitivity to other sulfonamide-derived drugs

If you have any kidney disease, talk with your healthcare provider to make sure your kidneys are healthy enough to start this medication.

What Other Medications Interact with Avalide?

Several other medications may interfere with Avalide when taken together. Before starting treatment, Tell your provider about any other medicines you take or plan to take, including over-the-counter (OTC) nonprescription products, vitamins, herbs, supplements, and plant-based medicines.

Below are a few medications that interact with Avalide:

Tekturna (aliskiren), a direct renin inhibitor used to lower blood pressure
Diabetes drugs, including oral medications and insulin
Lithium, a mood stabilizer used to treat bipolar disorder
Angiotensin-converting enzyme (ACE) inhibitors, such as Lotensin (benazepril) and Zestril (lisinopril), which are other blood pressure-lowering agents
Birth control pills (specifically those containing drospirenone)
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as Motrin or Advil (ibuprofen) and Aleve or Naprosyn (naproxen)
Tegretol (carbamazepine)
Cholestyramine and colestipol resins: Separate doses to take Avalide at least four hours before or four to six hours after the resin.

Your healthcare provider may also tell you to avoid taking potassium supplements or salt substitutes containing potassium to prevent excessively high potassium levels in the body.

This is not a complete list of interactions, and others may occur. Talk to your healthcare provider or pharmacist for more detailed information on potential medication and supplement interactions with Avalide.

What Medications Are Similar?

Many other ARB and thiazide diuretic combination blood pressure medications are available. Similar to Avalide, the following drugs also contain hydrochlorothiazide:

Hyzaar (losartan and hydrochlorothiazide)
Diovan HCT (valsartan and hydrochlorothiazide)
Benicar HCT (olmesartan and hydrochlorothiazide)
Micardis HCT (telmisartan and hydrochlorothiazide)
Atacand HCT (candesartan and hydrochlorothiazide)

Frequently Asked Questions

What is Avalide used for?

Avalide is used to treat high blood pressure, also known as hypertension.
How does Avalide work?

Avalide is a two-in-one blood pressure–lowering medication that combines an angiotensin II receptor blocker (ARB) and a thiazide diuretic. The ARB works in the blood vessels to allow blood to flow more easily, which allows the heart to pump more efficiently and lowers blood pressure. The diuretic works by increasing urination to eliminate the additional fluids and salt in the body.
What drugs should not be taken with Avalide?

Several medications may interact with Avalide, including diabetes drugs, other blood pressure-lowering agents, and NSAIDs. Tell your healthcare provider about other medications you take so they can adjust your dosages if necessary or tell you to avoid certain medications altogether.
How long does it take for Avalide to work?

Avalide can take full effect as soon as two to four hours after taking it and last as long as 24 hours. It may take longer to notice the full improvements in your blood pressure control.
What are the side effects of Avalide?
Common side effects associated with taking Avalide include:
- Dizziness
- Headache
- Upset stomach
- Fatigue
- Muscle pain or cramps
Tell your healthcare provider if you are experiencing side effects that become bothersome or severe.
How do I stop taking Avalide?

Do not stop taking Avalide without first consulting your primary healthcare provider. You will generally need to keep taking your medication if you have not yet reached your blood pressure goal. You can stop taking Avalide once your healthcare provider has further evaluated your health and blood pressure to see if this medication is no longer needed.
Should I stop my other medications while taking Avalide?

Do not stop taking your other medications unless directed by your healthcare provider first.

How Can I Stay Healthy While Taking Avalide?

If you've been prescribed Avalide, you likely had difficulty controlling your blood pressure. While hypertension can sometimes be symptomless, that does not mean there isn't a problem. Taking your medication as prescribed is important to achieving your health goals.

In addition to medication, healthy lifestyle choices can go a long way toward improving your blood pressure. Certain lifestyle and behavioral changes can be a beneficial addition to your blood pressure–lowering regimen. These might include:

Stress reduction
Improving sleep
Quitting smoking
Regular exercise
Diet changes, such as following the DASH (Dietary Approaches to Stop Hypertension) diet
Weight management

Blood pressure control is often a long-term endeavor. Talk to your healthcare about the best methods to help lower your blood pressure and improve your overall health.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

The author would like to recognize and thank Jaycob Mathew Peña for contributing to this article.

4 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

DailyMed. Label: Avalide- irbesartan and hydrochlorothiazide tablet, film coated.
Roh YR, Woo SJ, Park KH. Acute-onset bilateral myopia and ciliochoroidal effusion induced by hydrochlorothiazide. Korean J Ophthalmol. 2011;25(3):214-217. doi:10.3341/kjo.2011.25.3.214
Reungjui S, Pratipanawatr T, Johnson RJ, Nakagawa T. Do thiazides worsen metabolic syndrome and renal disease? The pivotal roles for hyperuricemia and hypokalemia. Curr Opin Nephrol Hypertens. 2008;17(5):470-476. doi:10.1097/MNH.0b013e328305b9a5
Smith DK, Lennon RP, Carlsgaard PB. Managing hypertension using combination therapy. Am Fam Physician. 2020;101(6):341-349.

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Avalide (Irbesartan and Hydrochlorothiazide) – Oral