An angiotensin-receptor blocker (ARB)
Irbesartan
An angiotensin-receptor blocker (ARB) for high blood pressure that also helps protect the kidneys in diabetic kidney disease.
What is Irbesartan?
Irbesartan is an angiotensin-receptor blocker (ARB) that lowers blood pressure. It is particularly used to protect the kidneys in people with type 2 diabetes who have signs of kidney involvement.
Education and reference only. This is a plain-language guide to Irbesartan — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Irbesartan is an angiotensin-receptor blocker (ARB). It lowers blood pressure and is particularly used to protect the kidneys in people with type 2 diabetes who have kidney disease — it is one of the ARBs with good evidence for slowing the decline of diabetic kidney disease. Like other ARBs, it rarely causes the dry cough that ACE inhibitors can, so it is also a common choice for people who could not tolerate an ACE inhibitor. It is a long-term, once-daily tablet, sold as Aprovel in the UK and Avapro in the US.
How it works
Irbesartan blocks the receptor that angiotensin II acts on. Angiotensin II is a hormone that tightens blood vessels and makes the body hold on to salt and water; by stopping it from reaching its receptor, irbesartan lets blood vessels relax and reduces fluid load, so blood pressure falls. The same action lowers the pressure inside the kidney's tiny filters and reduces protein leaking into the urine, which is how it helps protect the kidneys in diabetes. Because it acts further along than an ACE inhibitor, it does not cause the ACE-inhibitor cough.
Company & origin
Originated / developed by: Sanofi (with Bristol-Myers Squibb).
Irbesartan, an angiotensin II receptor blocker, was discovered by Sanofi (France) and co-developed and marketed with Bristol-Myers Squibb. It was first approved in 1997, marketed as Aprovel/Avapro.
What it treats
Conditions Irbesartan is used for
Practical use
How to take Irbesartan
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Usually taken once a day, with or without food, at a regular time.
- Keep taking it even when you feel well, as high blood pressure usually has no symptoms.
- Stand up slowly when you first start, as it can occasionally cause dizziness.
- Your GP will arrange blood tests to check kidney function and potassium levels.
- Tell your doctor if you become unwell with vomiting or diarrhoea, or if you are or might be pregnant.
Weighing it up
Advantages & disadvantages of Irbesartan
Advantages
- Effective at lowering blood pressure and helps protect the kidneys in diabetes.
- Generally well tolerated and, unlike ACE inhibitors, does not usually cause a dry cough.
- Taken once daily and available as a generic.
Disadvantages
- Can raise blood potassium and affect kidney function, so monitoring is needed.
- May cause dizziness, especially when first started.
- Must not be used in pregnancy, as it can harm the developing baby.
- Benefits are preventive rather than something you feel day to day.
Practical use
Good to know
It is taken once a day at a consistent time, often started low and built up, with a blood-pressure and blood-test check after starting and after increases. Its kidney-protecting effect makes it a favoured choice in diabetic kidney disease. It must be stopped before and avoided during pregnancy, as ARBs can harm an unborn baby. Like ACE inhibitors, it can raise blood potassium and needs kidney monitoring. Anti-inflammatory painkillers (NSAIDs), especially alongside a water tablet, can stress the kidneys.
Who should not take it / use with caution
- People who are pregnant or planning pregnancy — ARBs are contraindicated in pregnancy and switched beforehand.
- Used with caution in significant kidney artery narrowing, low blood pressure, or a high blood potassium level.
- It is not normally combined with an ACE inhibitor, as together they raise the risk of kidney problems and high potassium.
Monitoring
- Blood pressure
- Kidney function and blood potassium before and after starting/increasing
- Protein in the urine where kidney protection is the goal
Side effects
- Dizziness or light-headedness, especially on standing or when starting.
- A rise in blood potassium or a change in kidney function (watched with blood tests).
- Generally well tolerated; unlike ACE inhibitors it rarely causes a dry cough, and angioedema is very rare.
Key interactions
- NSAID painkillers (e.g. ibuprofen) can reduce its effect and stress the kidneys, especially alongside a diuretic.
- Potassium supplements, potassium-based salt substitutes and certain diuretics can push potassium too high.
- Care with other blood-pressure-lowering medicines, with ACE inhibitors, and with lithium.
Available as: Tablets (several strengths), sometimes combined with a water tablet (diuretic) in one tablet.
Answers
Irbesartan: frequently asked questions
Why has irbesartan been chosen for my kidneys, not just my blood pressure?
Irbesartan is an ARB with good evidence for protecting the kidneys in people with type 2 diabetes and kidney disease — it lowers the pressure inside the kidney filters and reduces protein leaking into the urine, which helps slow the decline. So even if your blood pressure is reasonable, it may be prescribed mainly to protect your kidneys.
Why must I avoid irbesartan in pregnancy?
ARBs like irbesartan can harm an unborn baby, particularly later in pregnancy, so it is contraindicated in pregnancy and is usually stopped if you are planning to conceive. If you are pregnant, think you might be, or are planning a pregnancy, tell your prescriber promptly so it can be switched to a safer option — but do not simply stop blood-pressure treatment without advice.
Does irbesartan cause a dry cough like some blood-pressure tablets?
Rarely. The persistent dry cough is linked to ACE inhibitors (such as ramipril or lisinopril). Irbesartan is an ARB, which acts one step further along the same system and very seldom causes that cough — which is why ARBs are often used when an ACE inhibitor cough is a problem.
Will I need blood tests on irbesartan?
Yes. Because irbesartan can raise blood potassium and affect kidney function, your team will check your kidney function and potassium before starting and after any dose increase, and then periodically. Where it is used to protect the kidneys, they may also monitor protein in your urine.
What is the difference between irbesartan, Aprovel and Avapro?
They are the same medicine — irbesartan is the generic (active-ingredient) name, Aprovel is the UK brand name and Avapro is the US brand name. Generic irbesartan contains the identical active ingredient.
The wider class
About ARBs
Irbesartan belongs to the arbs class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
Browse by body system
Authoritative sources
- BNF: Irbesartan.
- electronic Medicines Compendium (SmPC): Aprovel.
- NICE CKS: Irbesartan.
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