Drug Detail:Azilsartan and chlorthalidone (Azilsartan and chlorthalidone [ ay-zil-sar-tan-and-klor-thal-i-done ])
Drug Class: Angiotensin II inhibitors with thiazides
Usual Adult Dose for Hypertension
Initial dose: Azilsartan 40 mg-Chlorthalidone 12.5 mg orally once a day
Maximum dose: Azilsartan 40 mg-Chlorthalidone 25 mg orally once a day
Comments:
- Correct any volume depletion prior to administration, especially in patients with impaired renal function or those on high diuretic doses.
- May increase dose after 2 to 4 weeks as needed to achieve blood pressure goal.
- Patients not controlled with azilsartan 80 mg monotherapy may achieve additional systolic and diastolic blood pressure reduction of 13 and 6 mmHg, respectively, when switched to the initial dose of this drug; patients not controlled with chlorthalidone 25 mg monotherapy may achieve additional systolic and diastolic blood pressure reduction of 10 and 7 mmHg, respectively, when switched to the initial dose of this drug.
- This drug may be used as initial therapy if multiple drugs are likely needed to achieve blood pressure goals.
Renal Dose Adjustments
Mild to moderate renal dysfunction (GFR 30 to 90 mL/min/1.73 m2): No adjustment recommended
Severe renal dysfunction (GFR less than 30 mL/min/1.73 m2)): Unknown
Liver Dose Adjustments
Mild to moderate liver dysfunction: No adjustment recommended
Severe liver dysfunction: Unknown
Precautions
US BOXED WARNING:
- FETAL TOXICITY: If pregnancy is detected, discontinue this drug as soon as possible. Drugs that act directly on the renin angiotensin system (RAS) can cause injury and death to the developing fetus.
Safety and efficacy have not been established in patients younger than 18 years.
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Other Comments
Administration advice:
- Administer with or without food.
- Administer a missed dose later in the same day; do not double the dose the following day.
General: Some antihypertensive drugs have smaller blood pressure effects as monotherapy in black patients; however, the blood pressure effect of this drug in blacks is similar to that in non-blacks.
Monitoring:
- Monitor serum electrolytes periodically.
- Monitor renal function in patients with renal impairment.
Patient advice:
- Females of childbearing age should be informed of the consequences of exposure to this drug during pregnancy; ask these patients to report pregnancies as soon as possible.
- Encourage patients to report any lightheadedness that may occur during treatment initiation and to stop taking this drug until consulting a physician if syncope occurs.
- Dehydration may lead to excess blood pressure reduction; inform patients to contact their healthcare provider if they experience excessive perspiration, vomiting, or diarrhea.
- Advise patients to report gout symptoms.
