Pharmacologic Category: Angiotensin II Receptor Blocker/Diuretic. Pharmacology: Angiotensin converting enzyme is a non-specific enzyme and plays a crucial role in the conversion of Angiotensin I to Angiotensin II. Angiotensin II (ANG II) is a potent vasoconstrictor and an important component incriminated in the pathophysiology of hypertension. It elicits its actions through two known membrane receptors, ATI and AT2. The effects mediated through ATI receptors include vasoconstriction, aldosterone stimulation and salt and water retention. The role of AT2 receptors in cardiovascular homeostasis is not yet established. Losartan potassium selectively antagonizes binding of ANG II to ATI receptors. Consequently, further effects of ANG II are blocked. As a supporting role, Losartan potassium's carboxylic acid metabolite also selectively blocks ATI receptors. One of the strategies in the management of hypertension is to alter body sodium levels by restriction of salt in the diet. Pharmacologically also, sodium levels can be altered with the help of diuretics. Hydrochlorothiazide affects electrolyte reabsorption at the level of distal convoluted tubule and increases the excretion of sodium and chloride in approximately amounts by its inhibitory effects on NaCl symport located in luminal membrane.
Indications/Uses
Losartan + Hydrochlorothiazide (AnzaPlus) is indicated for the treatment of hypertension.
Dosage/Direction for Use
The usual dosage recommended is one tablet daily in the morning. The usual daily dosage recommended for the treatment of hypertension is 25-100 mg and 25-50 mg for Losartan and Hydrochlorothiazide, respectively. Use lower starting doses in patients having impaired renal or hepatic function. Adjust the doses to a minimum effective strength in elderly patients on Hydrochlorothiazide. Losartan potassium can be given with or without food. Or as prescribed by the physician.
Contraindications
Losartan + Hydrochlorothiazide is contraindicated in patients who are sensitive to either drug & to other sulfonamide derived drugs; anuria; pregnancy and breastfeeding mothers.
Special Precautions
In patients having intravascular volume depletion, either lower dose of Losartan potassium should be used, or salt and volume depletion should be corrected prior to Losartan potassium therapy.
Adverse Reactions
The adverse effects reported frequently include headache, dizziness, asthenia/fatigue. Other effects include first dose hypotension, skin rash, oedema, transient elevation of liver enzymes, hyperkalemia and taste disturbances. According to clinical trials, albeit cough has not been reported as a specific drug-related event with Losartan potassium, the incidence of cough experienced is comparable to that of placebo. The adverse effects frequently experienced with Hydrochlorothiazide include electrolyte imbalance, glycosuria, hyperglycaemia, hyperuricemia and weakness. Other side effects include gastrointestinal disturbances, headaches, dizziness, photosensitivity reactions, postural hypotension, paresthesia, impotence, xanthopsia, hypersensitivity, cholestatic jaundice, pancreatitis and blood dyscrasias. Hypokalemia may be produced by hydrochlorothiazide.
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.
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