Irbesartan (Avapro and others)

How Medicare covers it

Part D (tablets taken/used at home). Part A during a covered inpatient stay. No Part B clinician-administered form in the CMS Part B spending file.

What it treats

Irbesartan (brand name Avapro) treats high blood pressure, and it treats kidney disease caused by type 2 diabetes (diabetic nephropathy) in people who have high blood pressure, raised creatinine, and protein in the urine.

What it is for, in depth

Irbesartan is a once-a-day blood pressure tablet in the ARB family, prescribed for adults with high blood pressure, either on its own or added to other blood pressure medicines when one drug is not enough. Lowering blood pressure lowers the risk of stroke and heart attack. It has a second, specific use: slowing kidney damage in people who have both type 2 diabetes and high blood pressure and who already show early kidney injury (raised creatinine and protein in the urine), where it slowed progression toward kidney failure in studies. It controls blood pressure but does not cure it, and it can take about 2 weeks to feel the full benefit. It comes as 75 mg, 150 mg, and 300 mg tablets.

How it works

Irbesartan is an angiotensin II receptor blocker (ARB). Angiotensin II is a natural chemical that tightens blood vessels and makes the body hold on to salt and water. Irbesartan blocks that chemical at its AT1 receptor, so blood vessels relax, blood pressure falls, and the heart can pump more easily.

How it is taken

A tablet taken by mouth once a day, with or without food. For high blood pressure, the usual starting dose is 150 mg once a day, which can be raised to 300 mg once a day. For diabetic kidney disease, the dose is 300 mg once a day. People who are low on fluids or salt (for example, on high-dose water pills) may start at 75 mg once a day. It can be taken alone or with other blood pressure drugs.

Common side effects

In studies of people with high blood pressure, side effects reported more often than with placebo included diarrhea (3%), heartburn or indigestion (2%), and tiredness (4%). In the diabetic kidney disease study, the more common effects were high potassium, dizziness, dizziness on standing, and low blood pressure on standing. The label notes irbesartan was not linked to more dry cough, the side effect often seen with ACE inhibitors.

Serious warnings

Irbesartan can harm the kidneys, including sudden kidney failure, in people whose kidneys depend on the renin-angiotensin system (such as people with narrowed kidney arteries, severe heart failure, or low body fluids), so kidney function and potassium should be checked from time to time. Low blood pressure can occur in people who are low on fluids or salt. It must not be used in pregnancy (see the boxed warning).

Boxed warning

Irbesartan can injure or kill a developing baby. Drugs that act on the renin-angiotensin system, like irbesartan, can harm the fetus, so if pregnancy is detected, irbesartan should be stopped as soon as possible.

Who should be careful

Anyone who is pregnant or could become pregnant must not take irbesartan. People with kidney disease, severe heart failure, narrowed kidney arteries, or low fluid or salt levels need close monitoring of kidney function and potassium. People allergic to any part of the product must not take it, and people with diabetes must not combine it with aliskiren.

Major interactions

Do not take irbesartan with aliskiren if you have diabetes, and combining two renin-angiotensin system blockers (an ARB, an ACE inhibitor, or aliskiren) raises the risk of low blood pressure, high potassium, and kidney problems. Pain relievers in the NSAID group (including COX-2 inhibitors) can weaken the blood pressure effect and raise the risk of kidney damage, especially in older, dehydrated, or kidney-impaired patients. Irbesartan can raise lithium levels and cause lithium toxicity, and other drugs that raise potassium can cause high potassium when combined with it.

Cost and saving notes

Irbesartan is covered under Medicare Part D and usually sits on a low generic tier, so copays are often small. If your plan charges more than expected, ask about a tier exception. If you have limited income, Extra Help (the Low-Income Subsidy) can lower your Part D premiums and drug costs. In 2027, your total yearly out-of-pocket spending on Part D drugs is capped at $2,400, and you can ask your plan to spread those costs into monthly payments through the Medicare Prescription Payment Plan.

Why it is in its tier

In the CMS plan-year 2027 formulary data, irbesartan's most common (modal) tier is Tier 1, used by 86.0% of the plans that list it, and every Part D plan in the file lists it (100% listing share). Tier 1 is usually a plan's lowest-cost tier, meant for low-cost preferred generics, so cost sharing is typically the smallest copay the plan offers. The data-visible drivers fit: irbesartan is a widely available generic, and its CMS dashboard average cost was low — about $87 per person per year, or about $0.28 per tablet, in 2024. Individual plans vary, so check your own plan's drug list for your exact cost.

Sources

• AVAPRO (IRBESARTAN) TABLET, FILM COATED [SANOFI-AVENTIS U.S. LLC] — DailyMed
• MedlinePlus — National Library of Medicine
• MedlinePlus — Irbesartan

What official patient guides say

Irbesartan comes as a tablet to take by mouth, usually once a day with or without food, at around the same time every day to help you remember. It controls high blood pressure but does not cure it, it may take 2 weeks to notice the full benefit, and you should continue taking it even if you feel well and not stop without talking to your doctor. If you miss a dose, take it as soon as you remember it, but if it is almost time for your next dose, skip the missed dose and do not take a double dose. Keep it in the container it came in, tightly closed, at room temperature and away from excess heat and moisture (not in the bathroom), and out of reach of children.

Source: MedlinePlus — Irbesartan

Part D formulary coverage

Source: CMS Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information Files — Monthly file 2026-10-15 (plan year 2027), file 2027_20261008.zip (data.cms.gov dataset ed1496ea-23e7-41f1-9292-172fa842ccfb): basic drugs formulary file + plan information file, both dated 20261031 inside the zip; downloaded and aggregated 2026-10-30. Medication RxCUI sets resolved through the NLM RxNav (RxNorm) API.

What you pay

Without insurance, the cash benchmark is 0.10897 per unit (IRBESARTAN 150 MG TABLET) — about nan for 30 units. NADAC benchmark — the average price pharmacies pay (CMS, as of 2026-11-04). Pharmacy shelf prices vary.

A tier is not a price; what you pay depends on your plan, pharmacy, and benefit stage; Extra Help or Medicaid can lower it further.

Sources: CMS Plan Benefit Package + formulary data; CMS NADAC · Checked 2026-11-07

Coverage by plan and tier

Of the 5,495 Medicare drug plans we track for 2027, 5,495 list Irbesartan (Avapro and others) — 100% of plans. Most of those plans put it on Tier 1: 4,727 plans, 86.0% of the plans that list it. Other plans place it on Tier 6 (708 plans), Tier 2 (57 plans) or Tier 5 (3 plans). For example: Aetna Medicare Dual Extra (HMO D-SNP) puts it on Tier 1; Aetna Medicare Dual Extra Care (PPO D-SNP) puts it on Tier 1; Aetna Medicare Value Plus (PPO) puts it on Tier 1. You can compare these plans side by side on our Medicare Advantage hub. A tier is not a price. What you pay also depends on whether you have met your plan';s deductible, whether the drug costs a flat copay or a share of the price, and whether you get Extra Help or Medicaid.

Read next

• Part D in 2027: The $700 Deductible, the $2,400 Cap, and the $35 Insulin Rule
• Extra Help in 2027: Lower Drug Copays and Who Qualifies
• Checking Medicare Savings Programs and Extra Help

Part D spending averages (2024)

Source: CMS Medicare Part D Spending by Drug (Drug Spending Dashboard), release RY26 P04 V10, data through 2024 (DSD_PTD_RY26_P04_V10_DY24_BGM.csv), downloaded 2026-10-30

Companies covering this drug

Part D and Medicare Advantage plan sponsors that list this drug on a formulary, 50 at a time.