CoAprovel can be used once daily, with or without food in patients whose blood pressure is not adequately controlled by irbesartan or hydrochlorothiazide alone. In patients with severe hypertension, CoAprovel 150/12.5 mg once daily may be initiated.
Dose titration with the individual components (ie, irbesartan and hydrochlorothiazide) can be recommended.
When clinically appropriate, direct change from monotherapy to the fixed combinations may be considered: CoAprovel 150/12.5 mg may be administered in patients whose blood pressure is not adequately controlled with hydrochlorothiazide or irbesartan 150 mg alone; CoAprovel 300/12.5 mg may be administered in patients insufficiently controlled by irbesartan 300 mg or by CoAprovel 150/12.5 mg; CoAprovel 150/12.5 mg, 2 tabs once a day or CoAprovel 300/25 mg, 1 tab once daily, may be administered in patients insufficiently controlled by CoAprovel 300/12.5 mg; CoAprovel 150/12.5 mg, 2 tabs once daily, may be administered in patients insufficiently controlled by CoAprovel 150/12.5 mg (see Pharmacodynamics under Actions).
Doses higher than irbesartan 300 mg/hydrochlorothiazide 25 mg once daily are not recommended. When necessary, CoAprovel may be administered with another antihypertensive drug (see Interactions).
Renal Impairment: Due to the hydrochlorothiazide component, CoAprovel is not recommended for patients with severe renal dysfunction (creatinine clearance <30 mL/min). Loop diuretics are preferred to thiazides in this population. No dosage adjustment is necessary in patients with renal impairment whose renal creatinine clearance is ≥30 mL/min (see Contraindications and Precautions).
Intravascular Volume Depletion: Volume and/or sodium depletion should be corrected prior to administration of CoAprovel.
Hepatic Impairment: CoAprovel is not indicated in patients with severe hepatic impairment. Thiazides should be used with caution in patients with impaired hepatic function. No dosage adjustment of CoAprovel is necessary in patients with mild to moderate hepatic impairment (see Contraindications).
Elderly: No dosage adjustment of CoAprovel is necessary in elderly patients.