Losartan + hydrochlorothiazide

HTN.

Adult: PO Per tab contains losartan 50 mg and hydrochlorothiazide 12.5 mg: 1 tab once daily. Up to 2 tab once daily 2-4 wk later if needed. Max: 2 tab/day.

Pregnancy, lactation; intravascular volume depletion.

Existing electrolyte disturbances; hepatic cirrhosis; severe hepatic failure; oedema; elderly (>75 yr); renal impairment; hepatic impairment; diabetes, gout, hyperlipidaemia; hyperuricaemia; ECG: LVH and/or ventricular ectopics extrasystoles); volume depleted patients; patients on diuretics and salt restriction; renal artery stenosis; aortic and mitral stenosis. Monitor potassium concentration. Discontinue before performing tests for parathyroid function.

Volume depletion and electrolyte imbalance (especially hyperkalaemia); dry mouth, thirst; lethargy, drowsiness; muscle pain and cramps; rashes, photosensitivity, thrombocytopenia, jaundice, pancreatitis; fatigue, weakness; may precipitate an attack of gout; impotence; hyperglycaemia; anorexia, nausea, vomiting, constipation, diarrhoea; sialdenitis; raised urinary calcium concentration; headache, dizziness; back pain, myalgia; first-dose hypotension; angiodema; neutropenia; GI disturbances; transient elevation of liver enzymes; taste disturbances, cough; exacerbation or activation of systemic lupus erythematous; palpitations; xanthopsia; leucopenia, agranulocytosis, aplastic anaemia; necrotising angiitis; glucosuria; renal dysfunction, interstitial nephritis, renal failure; migraine; hyponatraemia; UTI; chest pain; gastritis, wt gain, dyspepsia, abdominal pain; bronchitis, upper respiratory infection, nasal congestion, sinusitis; rise in cholesterol and/or triglycerides.
Potentially Fatal: Hypersensitivity reactions; hemolytic anaemia; toxic epidermal necrolysis.

Hydrochlorothiazide increases plasma concentration fluconazole. Increased hypotensive effect with: ACE inhibitors, alcohol, adrenergic neurone blockers, aldesleukin, α-blockers, alprostadil, general anaesthetics, antipsychotics, anxiolytics and hypnotics, baclofen, β-blockers, calcium-channel blockers, clonidine, diazoxide, epoetin, hydralazine, levodopa, MAOIs, methyldopa, minoxidil, monoxidine, nitrates, NSAIDs, oestrogens, sodium nitroprusside, tizanidine, phenothiazines. Increased risk of renal impairment with aspirin (in doses >300 mg daily), NSAIDs. Hypotensive effect antagonised by aspirin, corticosteroids, indomethacin, ketorolac. Increased risk of hyperkalaemia with potassium-sparing and aldosterone antagonists, drospirenone (monitor serum potassium during 1st cycle), epoetin, heparin, ketorolac, potassium salts. Increased risk of hypersensitivity with allopurinol (especially in renal impairment). May antagonise hypoglycaemic effects of antidiabetics. Increased risk of hypercalcaemia with calcium salts and vitamin D. Increased risk of hyponatraemia with chlorpropamide. Increased risk of hypermagnesaemia with ciclosporin. Absorption may be reduced by colestipol and colestyramine (take at least 2 hr apart).

Angiotensin II Antagonists / Diuretics

C03AA03 - hydrochlorothiazide ; Belongs to the class of low-ceiling thiazide diuretics.
C09CA01 - losartan ; Belongs to the class of angiotensin II antagonists. Used in the treatment of cardiovascular disease.