losartan + hydrochlorothiazide




Zuellig Pharma
Concise Prescribing Info
Losartan K 100 mg, hydrochlorothiazide 25 mg
HTN. Reduce risk of stroke in patients w/ HTN & left ventricular hypertrophy (LVH).
Dosage/Direction for Use
HTN Initial & maintenance dose: 1 Hyzaar 50/12.5 mg tab once daily, may be increased to max: 1 Fortzaar tab or 2 Hyzaar 50/12.5 mg tab once daily. Hypertensive patient w/ LVH Initially losartan 50 mg once daily, may be titrated w/ combination of losartan & hydrochlorothiazide 12.5 mg. May be increased to 100/12.5 mg or further increased to 100/25 mg once daily if necessary.
May be taken with or without food.
Hypersensitivity to losartan, hydrochlorothiazide or other sulfonamide-derived drugs. Anuria. Not to be used w/ aliskiren in diabetic patients.
Special Precautions
Hypersensitivity. Not to be used for initial therapy. Not to be initiated in intravascular vol-depleted patients (eg, those treated w/ high-dose diuretics). Black patients. Not recommended in hepatic or severe renal impairment (CrCl ≤30 mL/min). Not to be used during pregnancy. Lactation. Childn; neonates. Losartan: Bilateral renal artery stenosis or artery stenosis to solitary kidney. Concomitant use of other drugs increasing serum K. Hydrochlorothiazide: Discontinue use if very rare severe cases of acute resp distress including pneumonitis & pulmonary edema develops. History of allergy or bronchial asthma; symptomatic hypotension, fluid or electrolyte imbalance eg, vol depletion, hyponatremia, hypochloremic alkalosis, hypomagnesemia or hypokalemia; SLE exacerbation or activation; increased cholesterol & triglyceride levels; precipitated hyperuricemia &/or gout. Non-melanoma skin cancer. May impair glucose tolerance; decreased urinary Ca excretion; intermittent & slightly increased serum Ca. Perform periodic determination of serum electrolytes. Discontinue use prior to parathyroid function tests. Limit exposure to sunlight & UV rays.
Adverse Reactions
Dizziness, asthenia/fatigue, vertigo. Choroidal effusion, acute myopia & angle-closure glaucoma.
Drug Interactions
Losartan: Reduced levels of active metabolite by rifampin & fluconazole. Increased serum K w/ K-sparing diuretics (eg, spironolactone, triamterene, amiloride), K supplements, K-containing salt substitutes or other drugs increasing serum K eg, trimethoprim-containing products. Reduced lithium excretion. Attenuated antihypertensive effects w/ NSAIDS including selective COX-2 inhibitors. Not to be co-administered w/ aliskiren. Reduced therapeutic effect w/ grapefruit juice. Hydrochlorothiazide: Potentiated orthostatic hypotension w/ alcohol, barbiturates or narcotics. Adjust dosage w/ oral antidiabetics or insulin. Additive effect w/ other antihypertensive drugs. Impaired absorption w/ cholestyramine & colestipol resins. Intensified electrolyte depletion w/ corticosteroids, ACTH or glycyrrhizin. Decreased response to pressor amines eg, adrenaline. Increased responsiveness to nondepolarizing skeletal muscle relaxants eg, tubocurarine. Reduced renal clearance of lithium. Reduced diuretic, natriuretic & antihypertensive effects w/ NSAIDS including selective COX-2 inhibitors.
MIMS Class
Angiotensin II Antagonists / Diuretics
ATC Classification
C09DA01 - losartan and diuretics ; Belongs to the class of angiotensin II receptor blockers (ARBs) in combination with diuretics. Used in the treatment of cardiovascular disease.
Fortzaar FC tab
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