losartan + hydrochlorothiazide




Zuellig Pharma
Concise Prescribing Info
Per 50/12.5 tab Losartan K 50 mg, hydrochlorothiazide 12.5 mg. Per 100/12.5 tab Losartan K 100 mg, hydrochlorothiazide 12.5 mg
HTN when combination therapy is appropriate. Reduction of the risk of CV morbidity & mortality in HTN w/ left ventricular hypertrophy.
Dosage/Direction for Use
HTN Usual starting & maintenance dose: 1 Hyzaar 50/12.5 tab once daily, may be increased to 1 Fortzaar tab once daily or 2 Hyzaar 50/12.5 tab once daily. Max: 1 Fortzaar tab once daily or 2 Hyzaar 50/12.5 tab once daily. Hyzaar 100/12.5 is available for patients titrated to 100 mg Cozaar requiring additional BP control. Reduction in the risk of CV morbidity & mortality in hypertensive patients w/ left ventricular hypertrophy Usual starting dose: Losartan 50 mg once daily, may be increased if necessary to losartan 100 mg & hydrochlorothiazide 12.5-25 mg once daily.
May be taken with or without food.
Hypersensitivity to losartan, hydrochlorothiazide & other sulfonamide-derived drugs. Anuria. Do not co-administer w/ aliskiren in patients w/ diabetes. Pregnancy.
Special Precautions
Fetal toxicity during 2nd & 3rd trimesters of pregnancy. Discontinue when pregnancy is detected. Angioedema. Hepatic & severe renal impairment (CrCl ≤30 mL/min). Renovascular disease eg, bilateral renal artery stenosis or stenosis of the artery to a solitary kidney. Concomitant use w/ other drugs that may increase serum K. Observe for signs of fluid or electrolyte imbalance eg, vol depletion, hyponatremia, hypochloremic alkalosis, hypomagnesemia or hypokalemia which may occur during intercurrent diarrhea or vomiting. Perform periodic determination of serum electrolytes. May impair glucose tolerance, decrease urinary Ca excretion; intermittent & slight elevation of serum Ca, increase in cholesterol & triglyceride levels, & precipitate hyperuricemia &/or gout. Discontinue use prior to parathyroid function test. Reduce sun & UVA exposure. History of allergy or bronchial asthma. Exacerbation or activation of SLE. Avoid use of aliskiren in patients w/ renal impairment (GFR <60 mL/min). Lactation. Childn; neonates.
Adverse Reactions
Dizziness, asthenia/fatigue, vertigo.
Drug Interactions
Aliskiren. Losartan: Reduced levels of active metabolite w/ rifampin & fluconazole. May increase serum K level w/ K-sparing diuretics (eg, spironolactone, triamterene, amiloride), K supplements salt substitutes containing K, or other drugs that may increase serum K (eg, trimethoprim-containing products). May reduce lithium excretion. Antihypertensive effects may be attenuated by NSAIDs including COX-2 inhibitors. Further deterioration of renal function w/ ACE inhibitors. Dual blockade of RAAS w/ angiotensin receptor blockers, ACE inhibitors or aliskiren is associated w/ increased risk of hypotension, syncope, hyperkalemia & changes in renal function. Hydrochlorothiazide: Potentiation of orthostatic hypotension w/ alcohol, barbiturates or narcotics. Antidiabetics (oral agents & insulin). Additive effects w/ other antihypertensives. Impaired absorption w/ cholestyramine & colestipol resins. Intensified electrolyte depletion particularly hypokalemia w/ corticosteroids, ACTH, or glycyrrhizin. Possible decreased response to pressor amines eg, adrenaline. Possible increased responsiveness to nondepolarizing skeletal muscle relaxants eg, tubocurarine. Reduced renal clearance of lithium & high risk of lithium toxicity. Reduced diuretic, natriuretic & antihypertensive effects by NSAIDs including COX-2 inhibitors.
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.
Hyzaar 100/12.5 mg tab
Hyzaar 50/12.5 mg tab
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