Aprovel (irbesartan) is an angiotensin II receptor antagonist used to treat hypertension and to inhibit progression of diabetic nephropathy in type 2 diabetics who also have hypertension. In simple terms, the medication dilates narrowed blood vessels, which improves blood flow, lowers blood pressure, and reduces the heart's workload.

The medication can be used on its own or in combination with other medications to manage hypertension; either case is normal. In the majority of cases hypertension does not produce any symptoms until in very severe stages; patients diagnosed with hypertension and prescribed Aprovel should continue to take the medication even if feeling fine. The medication helps prevent very serious outcomes, such as heart failure, kidney failure, stroke, and heart attack.

Aprovel is safe for adults age 18 and up. Effects in younger patients have not been studied, and it should not be used in individuals below age 18 without explicit doctor approval.

Lowering High Blood Pressure

Managing hypertension---lowering high blood pressure---is Aprovel's most widespread use. The medication comes in tablets, typically taken just once per day. Food is optional, though a glass of fluid is recommended with each dose.

Treatment is typically:

• If taking Aprovel alone, most patients are started on 150 mg per day, taken once per day.
• Patients who are also being treated with diuretics or on dialysis are usually started on 75 mg per day.
• After a couple weeks of treatment dosage may be increased to 150 or 300 mg per day.
• Do not exceed 300 mg per day without explicit doctor approval.

It will take about two weeks before effects of Aprovel can be evaluated, hence the wait before making dosage adjustments. The medication can be taken for years at a stretch, and medication may need to continue for the remainder of life if other changes are not made or prove insufficient.

Use in Diabetes

Aprovel is also used to slow or halt progression of diabetic nephropathy in type 2 diabetes. The medication will have little effect on type 1 diabetics. It should likewise not be used by type 2 diabetics who do not also have high blood pressure; while hypertension is common among diabetics, it is not always present.

Diabetic nephropathy refers to the kidney damage experienced by about 20 to 30 percent of type 2 diabetics. Individuals of Hispanic, black, or Native American lineage are at increased risk of serious kidney damage compared to whites and Asians, though it is still a risk. Most type 2 diabetics are screened for kidney function at the time of diagnosis.

In this case, treatment is typically:

• Take 300 mg Aprovel once per day.
• Dosage may be lower in patients who are also being treated with diuretics or on dialysis.

With respect to kidney function, results from Aprovel may take longer to see, since intent is to stop or prevent progression. Variation between individuals is also significant; attending regular doctor checkups is the best way to be sure the medication is working properly. A doctor may decide to try other medications after a few months of Aprovel if it does not seem to be helping significantly.

Lifestyle Changes

Patients diagnosed with hypertension or type 2 diabetes---or both---are almost always encouraged to make lifestyle changes involving diet and exercise. A doctor can make recommendations customized to each individual, and patients are encouraged to at least make an effort at complying. Lifestyle changes are often the only way to get control of these conditions naturally, and end dependency on medications.

Common recommendations include:

• Reach and maintain a healthy weight
• Eat a healthier diet
• Get regular exercise
• Cut back on salt intake
• Quit smoking
• Manage blood cholesterol

There are many other changes that can also be beneficial; again, a doctor can make customized recommendations for an individual, or there is an abundance of advice to be found online.

While making such changes will certainly provide some benefit, for a few individuals it will not be enough, or the patient is unable or unwilling to make sufficient changes. These individuals will need to take Aprovel or a similar medication for the remainder of life.

Precautions & Adverse Effects

Regardless of what it's taken for, Aprovel will lower blood pressure. It is common for patients to experience some symptoms of low blood pressure, even if only going from high to normal ranges. These symptoms---lightheadedness, dizziness, mild confusion, weakness---should pass after the first few weeks of treatment, as the body adjusts to its new blood pressure. If persistant beyond the first few weeks of treatment, speak with a doctor. If severe---or if it is determined that blood pressure is lower than normal ranges---seek medical attention.

The doctor should also be made aware if there is a history of heart disease or kidney or liver impairment.

Aprovel can interact with a range of other medications, including over-the-counter varieties. Of greatest concern are:

• Aliskiren
• Lithium
• Diuretics
• NSAIDs

Other medications can also cause complications; always double-check with a doctor or pharmacist before mixing other treatments with Aprovel.