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Avalide (irbesartan/hydrochlorothiazide)
Irbesartan, Hydrochlorothiazide
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Irbesartan / Hydrochlorothiazide (Generic)
Irbesartan, Hydrochlorothiazide
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Prescription Required.

Product of Canada.

Shipped from Canada.

Prescription Required.Product of Canada.Shipped from Canada.

What is Avalide?

Avalide (irbesartan/hydrochlorothiazide) treats high blood pressure (hypertension). It combines two drugs: irbesartan, which helps relax blood vessels, and hydrochlorothiazide, which helps reduce water retention.

While taking Avalide, you should avoid using it together with any medications that contain Aliskiren, such as Tekturna or Tekamlo, especially if you have diabetes or kidney disease. Combining Avalide with aliskiren can increase the risk of serious side effects.

The decision to use Avalide first should be based on the potential benefits and risks for the patient.

How Does Avalide Work?

Avalide works by combining two medications that lower blood pressure in different ways. The first medicine, irbesartan, blocks a substance in the body called angiotensin II, which normally makes blood vessels tighten.

By blocking this substance, irbesartan helps relax and widen the blood vessels, making it easier for blood to flow and lowering blood pressure.

The second medication, hydrochlorothiazide, is a diuretic that helps the body get rid of extra salt and water through urine. This reduces fluid volume in the blood vessels, which also helps lower blood pressure.

Together, these two medicines help control high blood pressure more effectively than either would alone.

Dosage Information and Usage

Dosage Form and Strengths

  • 150/12.5 mg film-coated tablets
    • Peach, biconvex, and oval
    • Heart debossed on one side
    • “2875” on the reverse side
  • 300/12.5 mg film-coated tablets
    • Peach, biconvex, and oval
    • Heart debossed on one side
    • “2876” on the reverse side


Avalide can be taken with or without food and may be used alongside other blood pressure-lowering medications.

For patients whose condition isn’t well managed with either irbesartan or hydrochlorothiazide alone, Avalide can be started at 150/12.5 mg once daily. If necessary, the dosage can be increased to 300/25 mg once daily. The maximum effect on lowering blood pressure is usually seen within 2 to 4 weeks after changing the dose.

Swallow Avalide whole with a glass of water. Do not crush or chew the tablets, as this may release too much of the drug at once, potentially causing undesirable effects. Avalide should be stored at room temperature, away from direct sunlight and heat.

Avoid prescribing Avalide to patients with severe kidney issues. No dosage adjustments are needed for individuals with liver problems. It is not advisable as the initial treatment for patients with low blood count.

Storage Information

Avalide should be stored at a temperature of 25°C (77°F). However, it can safely handle short-term temperature changes between 15°C and 30°C (59°F and 86°F). Keep it in a cool, dry place away from direct sunlight and moisture to ensure it remains effective.

Side Effects

Common Side Effects

  • Dizziness
  • Fatigue
  • Nausea/Vomiting
  • Muscle pain
  • Flu-like symptoms
  • Chest pain
  • Heartburn
  • Abdominal pain

Serious but Rare Side Effects

  • Severe allergic reactions (rash, itching, swelling)
  • Severe dizziness or fainting
  • Signs of kidney problems (such as change in the amount of urine)
  • Signs of high potassium levels (such as muscle weakness, slow or irregular heartbeat)
  • Severe skin reactions (such as blistering, peeling, or red skin rash)
  • Pancreatitis (severe abdominal pain, nausea, vomiting)
  • Blood disorders (such as unusual tiredness, easy bruising or bleeding)

Warnings and Precautions

Boxed Warnings for Avalide

Avalide has a serious warning about the risk of fetal toxicity. If you become pregnant while taking Avalide, stop using it as soon as possible. Medications like Avalide, which affects the renin-angiotensin system, can harm or even cause the death of an unborn baby.

General Precautions for Avalide Medication

  • Fetal Toxicity: Avalide can harm an unborn baby if taken during pregnancy, especially in the second and third trimesters. It can reduce kidney function in the fetus, leading to serious health issues or death. It may also cause low amniotic fluid, affecting lung development and causing skeletal deformities. Other risks include poor skull development, lack of urine production, low blood pressure, kidney failure, and death in newborns. Stop taking Avalide as soon as you find out you’re pregnant.
  • Low Blood Pressure in Dehydrated or Salt-Depleted Patients: Avalide can significantly lower blood pressure, especially in patients with low blood volume or salt levels, like those on dialysis or taking high-dose diuretics (water pills). If this occurs, lie down and get medical help to restore blood pressure, usually with an intravenous saline solution. Treatment can typically continue once blood pressure is stable.
  • Hypersensitivity Reaction: Some people may have an allergic reaction to hydrochlorothiazide, even if they have no history of allergies or asthma. Those with a history of such conditions are more likely to experience a reaction.
  • Systemic Lupus Erythematosus: Hydrochlorothiazide, a component of Avalide, can worsen or trigger symptoms of systemic lupus erythematosus, an autoimmune disease affecting the skin, joints, and organs.
  • Electrolyte and Metabolic Imbalances: Avalide can cause electrolyte imbalances, such as low potassium (hypokalemia) and high potassium (hyperkalemia) if taken with other potassium-raising medications. Regular blood electrolyte monitoring is necessary. Hydrochlorothiazide may also raise blood sugar, cholesterol, and triglycerides, and reduce calcium excretion in urine, sometimes leading to high blood calcium levels.
  • Hepatic Impairment: Patients with liver issues should use Avalide carefully since it can disrupt fluid and electrolyte balance, possibly leading to liver coma.
  • Impaired Renal Function: Avalide can impact kidney function, particularly in those with heart failure or kidney disease. It may lead to reduced urine output, increased waste in the blood, and severe cases, kidney failure. Thiazides in Avalide can accumulate in patients with severe kidney disease, resulting in adverse effects.
  • Acute Angle-Closure Glaucoma, Acute Myopia, and Choroidal Effusion: Hydrochlorothiazide can lead to a sudden rise in eye pressure (acute angle-closure glaucoma) and vision issues. Symptoms like sudden vision loss or eye pain can show up within hours to weeks of starting the medication. Stopping the medication and seeking medical or surgical help right away may be needed to avoid permanent vision loss. Patients with a history of sulfonamide or penicillin allergies are at higher risk.


Taking too much Avalide can cause very low blood pressure (hypotension) and a rapid heartbeat (tachycardia). In some cases, a slow heartbeat (bradycardia) might also occur.

High doses of irbesartan, up to 900 mg per day for 8 weeks, have been well-tolerated, but it is not removed by dialysis.

An overdose of hydrochlorothiazide can lead to severe dehydration and electrolyte imbalances, such as potassium, chloride, and sodium.

This can result in serious heart problems, especially if the person is also taking digitalis. If an overdose happens, it’s important to contact a Poison Control Center for the latest treatment advice.

Drug Interactions With Other Medications

  • Nonsteroidal Anti-inflammatory Agents Including Selective Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors): Taking NSAIDs or COX-2 inhibitors with irbesartan can harm kidney function in older patients, those who are dehydrated, or those with kidney issues. NSAIDs like ibuprofen and naproxen reduce inflammation and pain. COX-2 inhibitors are a type of NSAID that targets an enzyme involved in inflammation. Monitoring kidney function and blood pressure regularly is crucial to detect problems early. NSAIDs can lessen the effectiveness of hydrochlorothiazide in lowering blood pressure and removing excess water from the body. Hydrochlorothiazide is a diuretic that helps eliminate extra salt and water by increasing urine production.
  • Dual Blockade of the Renin-Angiotensin System (RAS): Using two medications that affect the renin-angiotensin system (RAS) alongside Avalide can up the risk of low blood pressure (hypotension), high potassium levels (hyperkalemia), and kidney issues, including acute kidney failure. The renin-angiotensin system is key for regulating blood pressure and fluid balance in the body. Combining these meds can overstimulate the system, leading to problems.
  • Agents Increasing Serum Potassium: Combining Avalide with other drugs that increase potassium levels can result in dangerously high potassium levels (hyperkalemia), which may lead to heart issues like irregular heartbeats. Monitoring potassium levels in patients using these medications concurrently is crucial to avoid severe complications.
  • Antidiabetic Drugs (Oral Agents and Insulin): Hydrochlorothiazide may impact blood sugar levels. Patients on diabetes medications, including oral drugs or insulin, might need to tweak doses alongside Avalide. This is due to hydrochlorothiazide’s potential to raise blood sugar levels or hinder control.
  • Cholestyramine and Colestipol Resins: These substances that lower cholesterol can decrease hydrochlorothiazide absorption, potentially affecting its effectiveness. To ensure proper absorption, take Avalide either 4 hours before or 4 to 6 hours after these resins.
  • Lithium: Taking lithium (used for bipolar disorder) with Avalide can raise lithium levels in the blood, which may lead to toxicity. High lithium levels can result in symptoms such as tremors, confusion, and kidney issues. Thus, patients on both medications should have their lithium levels checked to prevent harmful effects.
  • Carbamazepine: Combining carbamazepine (for seizures and nerve pain) with hydrochlorothiazide may lead to low blood sodium levels (hyponatremia). Sodium is crucial for water balance and nerve function. Low sodium can cause headaches, confusion, and in severe cases, seizures. Monitor electrolyte levels in patients on both medications.

Cost & Discounts

Avalide Canada

Pharma Giant is focused on making healthcare affordable and accessible. We understand the financial burden that medical expenses can place on individuals and families.

Check out our Avalide options:

Avalide (Irbesartan, Hydrochlorothiazide)

  • 150mg/12.5mg – 28 tabs – $65.95
  • 300mg/12.5mg – 28 tabs – $63.95
  • 150mg/12.5mg – 90 tabs – $145.00
  • 300mg/12.5mg – 90 tabs – $145.00

Irbesartan / Hydrochlorothiazide (Generic)

  • 150mg/12.5mg – 100 tabs – $40.95
  • 300mg/12.5mg – 100 tabs – $40.95
  • 300mg/25mg – 100 tabs – $50.95

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Avalide is used to treat high blood pressure (hypertension). It combines two medications, irbesartan and hydrochlorothiazide, to help lower blood pressure and reduce the risk of complications like heart attacks and strokes.

No, Avalide should not be cut in half. It is important to swallow the tablet whole without breaking, crushing, or chewing it. This ensures the medication is released properly into your body.

If you forget to take a dose of Avalide, take it as soon as you remember. If it’s almost time for your next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses at the same time.

While using Avalide, it’s important to avoid taking it with any medications that contain Aliskiren, such as Tekturna or Tekamlo. This is especially crucial if you have diabetes or kidney disease, as combining Avalide with Aliskiren can lead to severe complications.

Avalide is typically taken once daily as directed by your healthcare provider. The initial dose is usually Avalide 150/12.5 mg, and it may be increased to Avalide 300/25 mg after 1 to 2 weeks if necessary to achieve optimal blood pressure control.

Yes, Avalide contains hydrochlorothiazide, a diuretic that helps reduce blood pressure by eliminating excess water and salt from the body.

Avalide can make you urinate more often because it contains a water pill.

Avalide, which contains irbesartan and hydrochlorothiazide, typically starts working within about 2 hours to lower high blood pressure. However, it may take 4 to 6 weeks to achieve its full effect.

You should stop taking Avalide immediately and inform your doctor if you become pregnant. It’s also important to discontinue this medicine if you are unable to urinate or if you have a known allergy to sulfa drugs