- Stock: In Stock
- Brand: NIPRO JMI Pharma Ltd.
- Product ID: Losartan Potassium + Hydrochlorothiazide
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Losarva Plus 50 mg+12.5 mg Tablet, 1 Strip
Description:
Angiotensin II (formed from angiotensin I in a reaction catalyzed by angiotensin converting enzyme ACE), is a potent vasoconstrictor, the primary vasoactive hormone of the renin-angiotensin system and an important component in the pathophysiology of hypertension. It also stimulates aldosterone secretion by the adrenal cortex. Losartan and its principal active metabolite block the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor found in many tissues, (e.g. vascular smooth muscle, adrenal gland). In vitro binding studies indicate that losartan is a reversible, competitive inhibitor of the AT1 receptor. Neither Losartan nor its active metabolite inhibits ACE (kinase II, the enzyme that converts angiotensin I to angiotensin II and degrades bradykinin); nor do they bind to or block other hormone receptors or ion channels known to be important in cardiovascular regulation.
Hydrochlorothiazide is a thiazide diuretic. Thiazides affect the renal tubular mechanisms of electrolyte reabsorption, directly increasing excretion of sodium and chloride in approximately equivalent amounts. Indirectly, the diuretic action of Hydrochlorothiazide reduces plasma volume, with consequent increases in plasma renin activity, increases in aldosterone secretion, increases in urinary potassium loss, and decreases in serum potassium. The renin-aldosterone link is mediated by angiotensin II, so co-administration of an angiotensin II receptor antagonist tends to reverse the potassium loss associated with these diuretics.
Indication
Dosage & Administration
Use in Patients with Renal Impairment: The usual regimens of therapy with Losarva Plus may be followed as long as the patient's creatinine clearance is > 30 ml/min. In patients with more severe renal impairment, loop diuretics are preferred to thiazides. In that case, hydrochlorothiazide is not recommended.
Use in patients with Hepatic Impairment: The combination of Losartan and Hydrochlorothiazide is not recommended for titration in patients with hepatic impairment because starting dose of Losartan (25 mg) cannot be given in this case.
Severe Hypertension: The starting dose for initial treatment of severe hypertension is one tablet of Losarva Plus once daily. For patients who do not respond adequately to this dose after 2 to 4 weeks of therapy, the dosage may be increased to Losarva Plus two tablets once daily. The maximum dose is two tablets once daily. Losarva Plus may be administered with other antihypertensive agents. Losarva Plus may be administered with or without food.
Contraindication
Precaution
- Periodic determination of serum electrolytes to detect possible electrolyte imbalance should be performed at appropriate intervals.
- Hypokalemia may develop, especially with brisk diuresis, when severe cirrhosis is present, or after prolonged therapy.
- Impaired renal function.
- Symptomatic hypotension.
Side Effects
Drug Interaction
Hydrochlorothiazide: Alcohol, barbiturates, or narcotics - potentiation of orthostatic hypotension may occur.
Antidiabetic drugs (oral agents and Insulin) - dosage adjustment of the antidiabetic drug may be required.
Other antihypertensive drugs - additive effect or potentiation. Cholestyramine and colestipol resins - absorption of Hydrochlorothiazide is impaired in the presence of anionic exchange resins.
Pregnancy & Lactation
Nursing Mother: Not recommended.
Use in pediatric: Safety and effectiveness in pediatric patients have not been established.
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