This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. can be used to treat Parkinson's. Therefore the use ofirbesartan and hydrochlorothiazidetablets isnotTheantihypertensive effects ofthiazide diureticsmaybe increasedinthepostsympathectomypatient.Irbesartan/hydrochlorothiazidetabletsshouldbeusedwithcautioninpatientswithimpairedhepaticfunctionorprogressive liverdisease, sinceminoralterationsin fluid and electrolyte balance mayprecipitate hepaticcoma.Thiazides,includinghydrochlorothiazide,cancausefluidorelectrolyteimbalance(hypokalemia,hyponatremiaandhypochloremicalkalosis).Althoughhypokalemiamaydevelopwhenthiazidediureticsareusedalone,especiallywithhigherdoses,concurrenttherapywithirbesartanreducesthefrequencyofdiuretic-inducedhypokalemia.Chloridedeficitisgenerallymildandusuallydoesnotrequiretreatment.Calciumexcretionisdecreasedbythiazideswhichmaycauseintermittentandslightelevationofserumcalcium.Markedhypercalcemiasuggeststhepossibilityofhyperparathyroidism.Thiazidesshouldbediscontinuedbeforecarryingouttestsforparathyroidfunction.ThiazideshavebeenshowntoincreasetheurinaryexcretionofMonitoringoflaboratoryparameters maybe necessaryin patients atriskofelectrolyteimbalance.Hyperuricemiamayoccur,andanacuteattackofgoutmaybeprecipitatedincertainpatientsreceivingthiazidetherapy.Insulinrequirementsindiabeticpatientsmaybeincreasedandlatentdiabetesmellitusmaybecomemanifestduringthiazideadministration.Increasesincholesterolandtriglyceridelevelshavebeenassociatedwith thiazidediuretictherapy, however,minimalorno effects were reported atthe12.5 mghydrochlorothiazidedosecontained inirbesartan/hydrochlorothiazidetablets.Monitoringoflaboratoryparameters maybe necessaryin patients atriskofmetabolic disturbances.Exacerbationoractivationofsystemiclupuserythematosus hasbeenreported with the useofthiazide diuretics.Sulfonamide,orsulfonamidederivative,drugscancausean idiosyncraticreaction,resultingin transientmyopiaandacuteangle-closureglaucoma.Whilehydrochlorothiazideisasulfonamide,isolatedcasesofacuteangle-closureglaucomawithoutdefinitecausalassociationhavebeenreportedsofarwithhydrochlorothiazide.Symptomsincludeacuteonsetofdecreasedvisualacuityorocularpainandtypicallyoccurwithinhourstoweeksofdruginitiation.Untreatedacuteangle-closureglaucomacanleadtopermanentvisionloss.Theprimarytreatmentistodiscontinuedrugintakeasrapidlyaspossible.Promptmedicalorsurgicaltreatmentsmayneedtobeconsiderediftheintraocularpressureremainsuncontrolled.Riskfactorsfordevelopingacuteangle-closure glaucoma mayincludea historyofsulfonamide orpenicillin allergy.Thesafetyofirbesartaninthepresenceofheartfailurehasnotbeenfullydefined.Suddendeathhasoccurredin some studiesofpatientswith heartfailure, and although such deaths may have reflected the naturalhistoryofthe underlyingheartfailure,cautionisrecommended when treatingsuch patients withirbesartan.Atthistime,experienceislimitedwithirbesartaninthetreatmentofpatientswithventriculardysfunctionorTheeffectsofirbesartan/hydrochlorothiazidetabletsonabilitytodrivemotorvehiclesoroperatemachineryhave not been specifically studied, but based on its pharmacodynamic properties. Amantadine (brand name: Symmetrel) is an antiviral drug used to prevent certain types of the flu by stopping the virus’s growth, and to treat respiratory symptoms of the flu. Get up slowly and steady yourself to prevent a fall.Drinking alcohol with this medicine can cause side effects.Avoid taking diet pills, caffeine pills, or other stimulants (such as ADHD medications) without your doctor's advice. Cardiac glycosides such as digoxin are used in the treatment of chronic heart failure and as antiarrhythmic agents. Irbesartan/hydrochlorothiazidetabletsisunlikelytoaffectthisability.Whendrivingvehiclesoroperatingmachines,itshouldbetakenintoaccountthatoccasionallydizzinessorwearinessmayoccurduringtreatmentTheeffectsofhydrochlorothiazideandtheirbesartan/hydrochlorothiazidecombinationonfertilityhavenotbeenevaluatedinanimalstudies.However,withirbesartanalone,fertilityandreproductiveperformancewerenotaffectedinstudiesofmaleandfemaleratsatoraldosesupto650mg/kg/day(approximately3[male]and8[female]foldhigherexposurebasedonAUC,thanthatofhumansatthemaximumrecommendedclinicalDrugsthatactdirectlyontherenin-angiotensinsystemcancausefoetalandneonatalmorbidityanddeathwhenadministered to pregnantwomen. Theroutineuseofdiuretics inotherwisehealthypregnantwomenisnotrecommendedandexposesmotherandfoetustounnecessaryhazard,includingfoetalorneonataljaundice,thrombocytopenia andpossiblyotheradverse reactions which have occurredinthe adult.Noteratogeniceffectswereseeninratsgivenirbesartanandhydrochlorothiazideincombinationatdosesashighas150/150mg/kg/day.Whenpregnantratsweretreatedwithirbesartanalonefromday0today20ofgestation,atdosesof50mg/kg/dayandhigher,transienteffects(increasedrenalpelviccavitation,hydroureterorsubcutaneousoedema)werenotedinfulltermratfoetusesbutnotinyounganimalsnecropsiedaftersixweeksofage.Inpregnantrabbits,atdosesof30mg/kg/day,maternalmortality,abortionandearlyfoetalresorptions were noted.