7 Avalide Side Effects You Should Know About

Avalide (irbesartan/hydrochlorothiazide) is a medication that’s FDA approved to treat high blood pressure. Avalide is a unique blood pressure medication because it’s a combination tablet. It combines hydrochlorothiazide (Microzide), a diuretic, with irbesartan (Avapro), an angiotensin II receptor blocker (ARB). 

While Avalide is effective at lowering blood pressure, there are some possible side effects when taking it. Since Avalide combines a diuretic and an ARB, it can cause side effects from both medications. Fortunately, most Avalide side effects are mild. But other side effects can be serious and need medical attention.

Here, we’ll cover seven important Avalide side effects and how you might manage them.

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1. Dizziness

Dizziness is one of the most common side effects of Avalide. In clinical trials, about 1 in 12 people reported dizziness while taking Avalide. This is a common side effect of all blood pressure medications. That’s because lower blood pressure can make you dizzy. You might especially feel dizzy or lightheaded when standing up from a sitting or lying down position.

If your dizziness is mild and only happens occasionally, you can likely manage it at home. Staying hydrated and getting up slowly can help reduce dizziness. 

Your healthcare provider will check your blood pressure during your regular visits. And they may also ask you to check it at home. For most adults, blood pressure less than 90/60 mmHg is too low. Talk with your healthcare provider to check what a safe blood pressure range is for you. If your blood pressure is consistently dropping too low, your healthcare provider may want to change your Avalide dose or switch medications. 

2. Fatigue

Fatigue is another common Avalide side effect. About 1 in 17 people taking Avalide in trials reported feeling weakness or fatigue. This can be another effect of having lower blood pressure. But it can also be caused by an imbalance in your electrolytes, like low potassium, that Avalide can also cause.

Sometimes, fatigue goes away on its own after taking Avalide for a while. But there are a few things you can do in the meantime that may increase your energy levels. Regular exercise, eating a nutrient-rich diet, and getting enough sleep can all help combat fatigue. 

If you’re feeling extremely tired or your fatigue isn’t going away after a few weeks, talk to your healthcare provider. They can help determine the cause and whether your Avalide dose should be adjusted.

3. Pain

Pain is another possible side effect of Avalide. This usually occurs as muscle or joint pain. An over-the-counter pain reliever, like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) may help with occasional pain relief, but check with your pharmacist or healthcare provider to make sure they’re OK for you to take.

If you’re having unusual or frequent muscle pain or spasms, check with your healthcare provider. It could be a sign of low electrolytes. Low levels of potassium or magnesium could cause muscle spasms, cramps, or weakness, and this can be dangerous if left untreated (more on this below). While taking Avalide, you’ll likely also have your labs checked regularly to measure your electrolyte levels.

4. Nausea

Some people taking Avalide report having nausea. This is often mild, and usually temporary. In fact, getting an upset stomach could happen with many medications. 

You can take Avalide with or without food. But if you’re having nausea or an upset stomach, try taking it with a meal or a small snack. This could help your symptoms. If your nausea gets worse or doesn’t go away, talk to your healthcare provider. They may suggest a nausea medication, or they may want to try a different medication for your blood pressure.

5. High or low potassium levels

As mentioned above, Avalide may lower potassium levels in your body. This is mainly due to the diuretic part of the medication, hydrochlorothiazide. Rarely, you could have very low potassium levels (hypokalemia), which can lead to heart rhythm problems.

But the other part of Avalide, irbesartan, can actually raise your potassium levels. When combined with other medications that raise potassium, your levels may rise too much. For example, potassium supplements and some diuretics, like spironolactone, can also raise your potassium. Severe effects of high potassium (hyperkalemia) include nausea, heart rhythm changes, and weakness.

The two medications in Avalide usually balance out potassium and help keep your levels normal. This is likely one reason why low or high potassium levels are rare with Avalide. Your healthcare provider should regularly check your potassium while you’re taking Avalide. If you notice any signs of muscle weakness, numbness or tingling, or your heart beating strangely, talk to your healthcare provider right away. These can be signs your potassium levels are not what they should be. 

6. Liver damage

In rare situations, Avalide can worsen liver damage. If you have any liver problems, make sure your healthcare provider is aware of them before you take Avalide. Changes in your fluid and electrolyte balance could be dangerous for you. But this isn’t always the case, so be sure to check with your care team about your specific situation.

Your healthcare provider may check your liver function while you’re taking Avalide. Be sure to let them know if you notice your skin or the whites of your eyes turning yellow. This can be a sign of liver problems. Other symptoms include dark-colored urine or loss of appetite. Your healthcare provider may switch you to another medication if this happens.

7. Kidney failure

The irbesartan part of Avalide can affect the kidneys. In some situations, it could make kidney disease worse. It could also cause kidney problems even if you didn’t have any before. This is more likely in people living with health conditions like severe heart failure. The hydrochlorothiazide part of Avalide can make your kidneys worse if you have severe kidney disease.

If you’re going to the bathroom less often or notice your legs or ankles are swollen, let your healthcare provider know right away. These could be signs of kidney issues.

Your healthcare provider will check your kidney function labs before starting Avalide and periodically while you’re taking it. This will help them make sure it’s safe for you to take. If there is evidence of worsening kidney damage after starting the medication, you may be asked to stop taking it.

When should I contact my healthcare provider about Avalide side effects?

Your healthcare provider and pharmacist are always willing to answer your questions about side effects. So it’s never the wrong decision to ask about Avalide side effects. Most side effects are mild and can be managed at home. Your care team can help you manage any side effects you may be experiencing.

But if you’re having serious side effects, like bothersome muscle pain, severe dizziness, or yellow skin or eyes, let your healthcare provider know right away. These symptoms could be a sign of a dangerous health problem. You may need immediate medical care.

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Written by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

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