Angiotensin II receptor blocker (ARB, sartan)
Updated · Methodology
First line
First-line for hypertension per 2024. Dose 150–300 mg once daily. Particularly effective in patients with type 2 diabetes and nephropathy – IDNT (2001) showed 33% slowing of diabetic nephropathy progression vs amlodipine.
Sources
ICD-10: I10 · ICD-11: BA00
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
Not recommended
Irbesartan is an angiotensin II receptor blocker. It is prescribed for hypertension and diabetic nephropathy in type 2 diabetes ( 2023, KDIGO 2024, SEH-LELHA). In anti-aging regimens, irbesartan is given to healthy normotensives to protect vessels and rejuvenate them. In people with normal blood pressure and no diabetic nephropathy, no clinical studies of prophylactic use exist. The drug can cause dizziness, hyperkalemia, acute kidney injury, and teratogenicity (contraindicated in pregnancy). If irbesartan was prescribed to a healthy person, consider seeking a second opinion.
A selective and competitive angiotensin II AT1 receptor antagonist. Reduces peripheral vascular resistance, aldosterone secretion, and sodium reabsorption. Among ARBs, has the longest half-life (11–15 hours) – stable BP control with once-daily dosing. No CYP metabolism – minimal drug interactions.
Absolute contraindication. T2 and T3 use causes oligohydramnios, lung and kidney hypoplasia, limb contractures, fetal demise.
Not used during lactation. Enalapril or captopril with more data are preferred.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Verbatim lines from the interaction sections, in the language of the label
«Dual Blockade of the Renin-Angiotensin System (RAS): Dual blockade of the RAS with angiotensin receptor blockers, ACE inhibitors, or aliskiren is associated with increased risks of hypotension…»FDA, section 7 · Open on DailyMed
«Suplementos de potasio y diuréticos ahorradores de potasio : dado que los medicamentos que actúan sobre el sistema renina-angiotensina pueden producir hiperkalemia, el uso concomitante de diuréticos…»AEMPS, section 4.5 · Open on CIMA
«Litio : durante la administración concomitante de litio e inhibidores del enzima conversor de la angiotensina, se han descrito incrementos reversibles en las concentraciones séricas de litio y…»AEMPS, section 4.5 · Open on CIMA
«Suplementos de potasio y diuréticos ahorradores de potasio : dado que los medicamentos que actúan sobre el sistema renina-angiotensina pueden producir hiperkalemia, el uso concomitante de diuréticos…»AEMPS, section 4.5 · Open on CIMA
«Como con los inhibidores de la ECA , la administración concomitante de los antagonistas de la angiotensina II y AINEs podría provocar un incremento del riesgo de empeoramiento de la función renal…»AEMPS, section 4.5 · Open on CIMA
«Lithium: Increases in serum lithium concentrations and lithium toxicity have been reported with concomitant use of irbesartan and lithium. Monitor lithium levels in patients receiving irbesartan and…»FDA, section 7 · Open on DailyMed
«Lithium: In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, coadministration of NSAIDs, including selective COX-2 inhibitors, with…»FDA, section 7 · Open on DailyMed
«Diuréticos y otros agentes antihipertensivos: otros agentes antihipertensivos pueden potenciar los efectos hipotensores de irbesartán; sin embargo no se han observado interacciones al administrar…»AEMPS, section 4.5 · Open on CIMA
«Información adicional sobre las interacciones con irbesartán : en ensayos clínicos, la hidroclorotiazida no modifica la farmacocinética de irbesartán. Irbesartán se metaboliza principalmente por el…»AEMPS, section 4.5 · Open on CIMA
«Información adicional sobre las interacciones con irbesartán : en ensayos clínicos, la hidroclorotiazida no modifica la farmacocinética de irbesartán. Irbesartán se metaboliza principalmente por el…»AEMPS, section 4.5 · Open on CIMA
«Información adicional sobre las interacciones con irbesartán : en ensayos clínicos, la hidroclorotiazida no modifica la farmacocinética de irbesartán. Irbesartán se metaboliza principalmente por el…»AEMPS, section 4.5 · Open on CIMA
«Diuréticos y otros agentes antihipertensivos: otros agentes antihipertensivos pueden potenciar los efectos hipotensores de irbesartán; sin embargo no se han observado interacciones al administrar…»AEMPS, section 4.5 · Open on CIMA
«Información adicional sobre las interacciones con irbesartán : en ensayos clínicos, la hidroclorotiazida no modifica la farmacocinética de irbesartán. Irbesartán se metaboliza principalmente por el…»AEMPS, section 4.5 · Open on CIMA
Opens the checker prefilled with this drug. Pick the second one from your regimen.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Irbesartan is evaluated for the following indications with varying evidence strength: Hypertension (evidence tier A), Anti-aging and longevity (evidence tier F). See the full indication matrix with dosing and citations above on this page.
Common side effects of Irbesartan (≥ 1 in 100): Dizziness, Fatigue, Hyperkalemia, Elevated creatinine, Headache. See the Safety section for uncommon and serious reactions.
Absolute contraindication. T2 and T3 use causes oligohydramnios, lung and kidney hypoplasia, limb contractures, fetal demise.
Not used during lactation. Enalapril or captopril with more data are preferred.
Irbesartan is contraindicated in: Irbesartan hypersensitivity; Pregnancy (all trimesters); Severe hepatic impairment; Combination with aliskiren in diabetes or CKD with eGFR under 60. Full list in the Safety section.
Direct links to regulator labels. Open in a new tab.
Irbesartan + Hydrochlorothiazide, Lisinopril, Losartan, Losartan + Hydrochlorothiazide, Olmesartan medoxomil, Telmisartan, Amlodipine + Olmesartan + Hydrochlorothiazide, Beetroot juice / dietary nitrate (Beta vulgaris)