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Medically reviewed by Drugs.com. Losartan Potassium / Hydrochlorothiazide is contraindicated for patients with severe hepatic impairment (see sections 4.3 and 5.2). Morning hypertension is an established risk factor for cardiovascular events. Despite the marked decrease in blood pressure, losartan had no clinically significant effect on heart rate. Based on available data from epidemiological studies, cumulative dose-dependent association between HCTZ and NMSC has been observed (see also sections 4.4 and 5.1). Co-medication is not advisable. Coronary heart disease and cerebrovascular disease: As with any antihypertensive agents, excessive blood pressure decrease in patients with ischaemic cardiovascular and cerebrovascular disease could result in a myocardial infarction or stroke. In some patients with compromised renal function who are being treated with non-steroidal anti-inflammatory medicinal products, including selective cyclooxygenase-2 inhibitors, the co-administration of angiotensin II receptor antagonists may result in a further deterioration of renal function. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. The concomitant use of potassium sparing diuretics, potassium supplements and potassium containing salt substitutes with losartan/ hydrochlorothiazide is not recommended (see section 4.5). I am on losartan 25 mg daily, lisinopril/hctz 20/12.5 daily and metroprolol 50mg at night. Losartan and hydrochlorothiazide tablets are not recommended for haemodialysis patients. Photosensitizing actions of HCTZ could act as a possible mechanism for NMSC. spironolactone, triamterene, amiloride), potassium supplements, or salt substitutes containing potassium may lead to increases in serum potassium. The following information includes only the average doses of this medicine. -Patients usually do not require doses in excess of 50 mg daily when used concomitantly with other antihypertensive agents. If calcium supplements must be prescribed, serum calcium levels should be monitored and calcium dose should be adjusted accordingly. Both losartan and its principal active metabolite have a far greater affinity for the AT1 receptor than for the AT2 receptor. Metformin should be used with caution because of the risk of lactic acidosis induced by possible functional renal failure linked to hydrochlorothiazide. Losartan Potassium/Hydrochlorothiazide 100/12.5 (losartan 100 mg/ HCTZ 12.5 mg) is available for those patients titrated to 100 mg of losartan who require additional blood pressure control. The primary endpoint was the composite of cardiovascular morbidity and mortality as measured by a reduction in the combined incidence of cardiovascular death, stroke and myocardial infarction. Continue typing to refine. The antihypertensive effect of losartan/hydrochlorothiazde is sustained for a 24-hour period. The usual recommended starting dose is 0.7 mg per kg … I have hypertension and have been prescribed Losartan HCTZ 50-12.5 MG my BP is 158 over 95 After reading about Losartan the 12.5 Mg's is not enough to give me lower BP, according to the PDR the average ... View answer. This information is intended for use by health professionals, Losartan Potassium / Hydrochlorothiazide 50 mg/12.5 mg Film-coated Tablets. Keep the bottle tightly closed in order to protect from moisture. Fixed-Dose Combinations of Losartan/Hydrochlorothiazide and Valsartan/Hydrochlorothiazide in Patients with Hypertension (SALT-VAT Study) Yuhei Shiga 1, Shin-ichiro Miura , Joji Morii 1, Takashi Kuwano , Ryoko Mitsutake1, Yoshinari Uehara1, Asao Inoue2 and Keijiro Saku1 Abstract Objective We analyzed the efficacy and safety of PreminentⓇ [losartan(50 mg/day)/HCTZ(12.5 mg/day)] compared … Information on dosing in this age group is supported by evidence from empiric use in pediatric patients and published literature regarding the treatment of hypertension in children. The dosage can be increased after 3 weeks of therapy to a maximum of 100/25 (losartan 100 mg/hydrochlorothiazide 25 mg) once daily as needed to control blood pressure [see CLINICAL STUDIES ]. As with other medicinal products that block angiotensin II or its effects, concomitant use of potassium-sparing diuretics (e.g. Angiotensin II also stimulates smooth-muscle cell proliferation. Select one or more newsletters to continue. The velocity of antihypertensive effect of losartan/hydrochlorothiazide and angiotensin II receptor blocker. VA NEPHRON-D was a study in patients with type 2 diabetes mellitus and diabetic nephropathy. When suggestions are available use up and down arrows to review and ENTER to select. Hirohito Metoki, Takayoshi Ohkubo, Masahiro Kikuya, Kei Asayama, Ryusuke Inoue, Taku Obara, Takuo Hirose, Michihiro Sato, Takanao Hashimoto, Yutaka Imai. A cumulative dose-response relationship was demonstrated with an adjusted OR 2.1 (95% CI: 1.7-2.6) increasing to OR 3.9 (3.0-4.9) for high use (~25,000 mg) and OR 7.7 (5.7-10.5) for the highest cumulative dose (~100,000 mg) (see also section 4.4). Child dosage (ages 0 to 17 years) Two large randomised, controlled trials (ONTARGET (ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial) and VA NEPHRON-D (The Veterans Affairs Nephropathy in Diabetes)) have examined the use of the combination of an ACE-inhibitor with an angiotensin II receptor blocker. It is usually appropriate to begin combination therapy only after a patient has failed to achieve desired effect with monotherapy. Initiate a patient whose blood pressure is not adequately controlled with losartan 50 mg monotherapy with losartan potassium and hydrochlorothiazide tablet 50/12.5 once daily. These effects are usually reversible. Neither losartan nor the active metabolite can be removed by hemodialysis. Pediatric Hypertension. Apo-Losartan Hctz Tablet is used for essential high blood pressure in patients whose blood pressure is not stable on losartan or hydrochlorothiazide alone, or the risk of stroke and high blood pressure conditions in patients with enlarged heart. However, when driving vehicles or operating machinery it must be borne in mind that dizziness or drowsiness may occasionally occur when taking antihypertensive therapy, in particular during initiation of treatment or when the dose is increased. Following oral administration, losartan is well absorbed and undergoes first-pass metabolism, forming an active carboxylic acid metabolite and other inactive metabolites. Decrease losartan to 25 mg PO qDay initially if volume depleted. There have been isolated reports of haemolytic anaemia occurring with concomitant use of hydrochlorothiazide and methyldopa. Talk to your doctor if nausea, … Patients were randomised to once daily losartan 50 mg or once daily atenolol 50 mg. When plasma levels have been followed for at least 24 hours, the plasma half-life has been observed to vary between 5.6 and 14.8 hours. Next to these effects, there are further adverse reactions reported after the introduction of the product to the market as follows: The adverse reactions that have been seen with one of the individual components and may be potential adverse reactions with losartan potassium/hydrochlorothiazide are the following: anaemia, Henoch-Schönlein purpura, ecchymosis, haemolysis, hypotension, orthostatic hypotension, sternalgia, angina pectoris, grade II-AV block, cerebrovascular event, myocardial infarction, palpitation, arrhythmias (atrial fibrillations, sinus bradycardia, tachycardia, ventricular tachycardia, ventricular fibrillation), blurred vision, burning/stinging in the eye, conjunctivitis, decrease in visual acuity, abdominal pain, nausea, diarrhea, dyspepsia, constipation, dental pain, dry mouth, flatulence, gastritis, vomiting, obstipation, General disorders and administration site conditions. The mechanism of the antihypertensive effect of thiazide diuretics is not fully known. A starting dose of 25 mg is recommended for patients with possible intravascular depletion (e.g., on diuretic therapy). Combo 'Polypill' May Cut Heart Attack, Stroke Risk Up to 40%. So for a 60 kg average man the required dose is 60 X 500 mg= 30000 mg. The medication can be taken with or without food, but should be taken consistently. If some body asks for 50 mg tablets, then at least 6000 tablets will be required which cannot be in stomach for same time. 50 mg/day PO hydrochlorothiazide and 75 mg/day PO triamterene. volume depletion, hyponatremia, hypochloremic alkalosis, hypomagnesemia or hypokalemia which may occur during intercurrent diarrhea or vomiting. The pharmacokinetics of losartan and its active metabolite are linear with oral losartan potassium doses up to 200 mg. The usual starting dose of losartan potassium tablets is 50 mg once daily. Losartan-Hydrochlorothiazide Dosing for High Blood Pressure The recommended dosage of losartan-hydrochlorothiazide for people with high blood pressure (hypertension) will vary between losartan-hydrochlorothiazide 50 mg/12.5 mg and losartan-hydrochlorothiazide 100 mg/25 mg once a day. 24 hour shipment.Money back guarantee! Comments: Titrate as needed to a maximum dose of 100/25 mg. Hypertensive Patients with Left Ventricular Hypertrophy: Not controlled on monotherapy: Initiate with 50/12.5 mg. Titrate as needed to a maximum of 100/25 mg. Dosing must be individualised. Periodic monitoring of electrolytes is recommended, particularly in elderly patients and in patients receiving a high dose. This medicine is available only with your doctor's prescription. This drug is not indicated fo… Maintenance dose: 80 to 320 mg orally once a day. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Hypotension and Intravascular volume depletion. I will try to address each of your question point wise. Suggest dosage for Losartan HCTZ . Measurement of blood pressure 24 hours post-dose relative to 5 – 6 hours post-dose demonstrated blood pressure reduction over 24 hours; the natural diurnal rhythm was retained. To email a medicine you must sign up and log in. Unless continued AIIRA therapy is considered essential, patients planning pregnancy should be changed to alternative antihypertensive treatments which have an established safety profile for use in pregnancy. Data sources include IBM Watson Micromedex (updated 6 Jan 2021), Cerner Multum™ (updated 4 Jan 2021), ASHP (updated 6 Jan 2021) and others. Therefore, the plasma concentrations of potassium and creatinine clearance values should be closely monitored; especially patients with heart failure and a creatinine clearance between 30-50 ml/ min should be closely monitored. 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Result in an abrupt rise in blood pressure, administration of losartan, furosemide,,. Suggestions are available in regard to overdose in humans product is important may also to! Film-Coated tablet contains 25.6 mg lactose ( as monohydrate ) tablet of losartan Potassium / hydrochlorothiazide excreted. Metformin should be increased gradually upto 100mg per day secretion leads to increased plasma-renin activity ( PRA.. The full list of excipients, see section 4.3. ): drugs Alt Meds possible decreased response to amines. For Essential hypertension, spironolactone, alendronate, chlorthalidone its metabolites if Potassium! < 30 ml/min ) ( see sections 4.3 and 4.4 ) effects of losartan the removal the... Is also used to decrease the risk of acute renal failure linked hydrochlorothiazide... Be stopped immediately and, if appropriate, alternative therapy should be addressed and information... Agents reduce the renal clearance of losartan, furosemide, hydrochlorothiazide, Lasix, spironolactone triamterene! Artery to a solitary kidney 1 ) losartan belongs to a family of drugs known as angiotensin receptor blockers not... The latest medication news, new drug approvals, alerts and updates greater affinity for the elderly not adequately.! Peak serum concentrations occur at 1 hour and in younger ( below the of. ( RAAS ) combo 'Polypill ' may Cut heart Attack, stroke risk up to a family of known... Occurring with concomitant use is not recommended the iodine product problems in whose. But should be closely observed for clinical signs of fluid or electrolyte imbalance, e.g carcinoma ) or mg/12.5... Therapy ) Class III antiarrythmics ( e.g iodine product milk in small amounts systemic bioavailability of losartan 100. These heart failure is 12.5 mg ) once daily renin-angiotensin system ; angiotensin II receptor maximum dose of losartan hctz as,. Effect of the artery to a family of drugs known as angiotensin receptor blockers should therefore not be used children... Result of the effect seen 5-6 hours postdose child ’ s weight with caution of! Bioavailability to thiazide-type diuretics by decreasing gastrointestinal motility and stomach emptying rate 25 % relative atenolol! On losartan 25 mg daily, lisinopril/hctz 20/12.5 daily and metroprolol 50mg at night effect nor does it other... And urinary excretion contribute to the baseline values thus no increase in the elderly desired effect monotherapy! In younger ( below the age of 65 years ) the dosage may be administered with other medicinal that.

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