Last Updated on February 19, 2017 by Dr.Derek Fhisher
Most popular brand: Cozaar
Active ingredient: Losartan
Available dosage forms: 25, 50, 100 mg
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Losartan general information
Losartan belongs to a category of drugs called angiotensin II receptor antagonists. Taking Losartan when pregnant, especially in the last six months, could result in death or serious injury to the fetus. Be sure to inform your doctor of any healthcare conditions you might have, or some family history of health troubles. Don’t start or stop employing any medicine without consulting your own doctor. This is really not a comprehensive list of all side consequences. Generally, however, they’ll be required to take Losartan one or two times each day.
Take losartan completely as directed. Losartan could be taken with or without food, but ought to be taken the exact way daily. Hyzaar may increase your blood sugar. Check blood sugar closely. Hyzaar may increase the aggregate of urine or permit you to urinate more often when you first begin taking it. Those who are explicitly the identical dose and anabolism as your own present iguana.
For those who have high blood pressure, don’t use nonprescription products that have stimulants. All medicines might cause unwanted effects, but many have no, or minor, unwanted effects. Blood pressure needs to be checked more frequently in these situations.
It’s used in some specific patients to take care of kidney problems due to diabetes (diabetic nephropathy). It’s also used to diminish the risk of coronary attack, stroke, or death because of heart problems in some patients. This helps to decrease blood pressure. It aids the kidneys to eliminate fluid from the body.
High blood glucose may cause you to feel confused, drowsy, or thirsty. Don’t take a double dose at once. If it’s time for your subsequent dose, forget the missed dose and return to your routine schedule. Your blood pressure has to be checked often. Store at common indoor temperature, away from excess heat along with moisture (not within the bathroom). That’s pretty difficult to enrage, I need to borrow.
Hydrochlorothiazide is utilized for healing high blood pressure. Losartan can also be taken by those who have type 2 diabetes together with hypertension and protein within the urine (proteinuria). In these instances, losartan is utilized to look after the kidneys from further damage because of diabetes. In such instances, treatment should begin with a lowly dose of losartan. You definitely should not utilize losartan if you’re allergic to it. Keep taking losartan even should you feel well.
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Don’t stop taking losartan without speaking to your doctor. Use Hyzaar as instructed by your doctor. Use Cozaar as instructed by your doctor. Use Hydrochlorothiazide as instructed by your doctor.
Ask your wellbeing care provider any questions that may have regarding how exactly to utilize Hyzaar. Ask your wellbeing care provider any questions that may have regarding the way to use Hydrochlorothiazide. Ask your wellbeing care provider any questions which may have concerning the best way to utilize Cozaar. If it’s almost time for your subsequent dose, forget the missed dose and return to your routine dosing timetable.
Stop using and tell your own doctor straight away if you get pregnant. Practice the directions on your own prescription label very carefully and ask your own doctor or pharmacist to clearly explain any part you don’t understand. Make sure your doctor and lab personnel know you’re taking Hyzaar. Use Micardis as instructed by your doctor.
Where to acquire Losartan no prescription fast shipping. This isn’t a comprehensive list of all side effects that might occur. Hyzaar may lead to drowsiness, dizziness, or lightheadedness. Manufacturers, managed care organizations and regulatory agencies join toils to reach each customer in the appropriate way so as to assist you and boost your health!
You might need to utilize blood pressure medication for the remainder of your whole life. If you believe you might be pregnant, get in touch with your doctor immediately. Don’t forget to take the medicine even when you may not feel normal.” Your pharmacist might be able to counsel you on managing side outcomes.
Before you start using a medication, make sure to inform your doctor of any health care conditions or allergies you might have, any medications you’re taking, whether you’re pregnant or breast-feeding, and any other critical facts about your own health. In the event your child cannot swallow a tablet, talk with your doctor or pharmacist. For those who have questions regarding side effects, get in touch with your health care provider. Ask your wellbeing care provider if Hyzaar may interact with several other medicines which you take.
A lot of things can impact the dose of the medication that someone requirements, including body weight, other health conditions, and other medications. If your physician has recommended a dose different from those listed here, don’t alter the way that you’re taking the medication without consulting your own doctor. Speak with your doctor in case your symptoms don’t improve after 3 weeks of cure. For outstanding results, keep utilizing the medication as directed.
Losartan (Losartan): instruction, and the use of a formula
2 – Butyl – 4 – chloro – 1 – [[2 ‘- (1H – tetrazol – 5 – yl) [1,1’ – biphenyl] – 4 – yl] – methyl] – 1H – imidazole – 5 – methanol (as potassium salt)
Gross – formula
Therapeutic substances Losartan
angiotensin receptor antagonists II (AT 1 – subtype)
The nosological classification (ICD – 10)
Feature substance Losartan
Losartan Potassium ; white or almost white crystalline powder. It is soluble in water, soluble in ethanol, sparingly soluble in organic solvents (acetonitrile and methyl ethyl ketone). Molecular weight 461,01.
Mode of action -. Antihypertensive
It blocks receptors of angiotensin II (AT subtype 1 ) in various tissues, including adrenal cortical substance, brain, kidney, liver, vascular smooth muscle, heart, and hinders the development of the effects of angiotensin II. It reduces arterial vasoconstriction, PR. the pressure in the pulmonary circulation, lowers the pulmonary wedge pressure vessels, inhibits the release of aldosterone, prevents sodium and water retention in the body. Increases exercise tolerance in heart failure patients.
After a single dose of the hypotensive effect (lowering Sad Dad) reaches a maximum at 6 hours and gradually (within 24 hours) decreases. Stable lowering of blood pressure in the majority of patients have a 3 – 6 – week course application.
In the experiments on rats and mice for 2 years treated with the maximum tolerated dose (200 mg / kg / day) carcinogenic effects were found. However, in female rats revealed a slight increase in the incidence of pancreatic acini adenomas. In studies of in vitro and in vivo mutagenic properties were found. Fertility and reproductive function of male rats treated with oral dose of 150 mg / kg / day. not changed. When administered to female rats doses of 100 mg / kg / day and observed a decrease in the number of corpora lutea, fetuses, and implants.
Rapidly absorbed from the gastrointestinal tract. The bioavailability is low (about 33%), because the “first pass” through the liver biotransformation losartan by carboxylation with participation of cytochrome P450 3A4 and 2C9 to form a major metabolite, 10 – 40 times more active than the starting material. C max is achieved after 1 h (losartan) and 3-4 hours (active metabolite), a plasma protein binds to 98.7% (losartan) and 99.8% (metabolite), T 1/2 is 1,5 – 2 hours and 6 – 9 hours, respectively. In addition to the active carboxy derivative formed several inactive metabolites. Excreted by the kidneys approximately 35% (including 4% unchanged, and about 6% of the active metabolite), with faeces ; approximately 60%.
Application of the substance Losartan
Hypertension; Chronic heart failure (in a combination therapy, in case of intolerance or failure of therapy with ACE inhibitors); reducing the risk of stroke in patients with hypertension and left ventricular hypertrophy; protection of renal function in patients with type 2 diabetes mellitus with proteinuria to reduce proteinuria, reduce the progression of renal disease, end-stage reduction of the risk (to prevent the need for dialysis, the probability of increasing the level of creatinine in serum).
Hypersensitivity, pregnancy, breast-feeding.
Restrictions on the use
Children’s age (safety and efficacy of the children are not identified).
Application of pregnancy and breastfeeding
is contraindicated in pregnancy.
Category effects on the fetus by FDA ; D.
breast-feeding should be discontinued at the time of treatment.
Side effects of substance Losartan
From the nervous system and sensory organs: & ge; 1% ; dizziness, asthenia / fatigue, headache, insomnia; & Lt; 1% ; anxiety, sleep disturbance, drowsiness, memory disorders, peripheral neuropathy, paresthesia, hypoesthesia, migraine, tremor, ataxia, depression, syncope, tinnitus, taste disturbance, changes in vision, conjunctivitis.
From the respiratory system: & ge; 1% ; nasal congestion, cough, upper respiratory tract infection (fever, sore throat, etc.), sinusopatiya, sinusitis, pharyngitis; & Lt; 1% ; dyspnoea, bronchitis, rhinitis.
From the digestive tract: & ge; 1% ; nausea, diarrhea, dyspepsia, abdominal pain; & Lt; 1% ; anorexia, dry mouth, toothache, vomiting, flatulence, gastritis, constipation.
From the musculo – skeletal system: & ge; 1% ; cramps, myalgia, back pain, chest, legs; & Lt; 1% ; arthralgia, pain in the shoulder, knee, arthritis, fibromyalgia.
From the cardio – vascular system and blood (blood, hemostasis): < 1% ; orthostatic reactions (dose-dependent), hypotension, palpitations, tachycardia – or bradycardia, arrhythmia, angina, anemia.
With the genitourinary system: < 1% ; urgent need to urinate, urinary tract infection, renal failure, weakening of libido, impotence.
For the skin: < 1% ; dry skin, erythema, flushing, photosensitivity, increased sweating, alopecia.
Allergic reactions: < 1% ; urticaria, rash, pruritus, angioedema, including face, lips, throat and / or tongue.
Other: & ge; 1% ; hyperkalemia; & Lt; 1% ; fever, gout, increased liver transaminases and bilirubin in the blood.
(mutually) the effect of other antihypertensive agents (diuretics, beta – blockers, simpatolitikov). It increases the risk of hyperkalemia when combined with potassium-sparing diuretics and potassium drugs.
There was no significant pharmacokinetic interaction with hydrochlorothiazide, digoxin, warfarin, cimetidine, phenobarbital, ketoconazole and erythromycin. During simultaneous reception with rifampicin and fluconazole was observed decrease of the active metabolite of losartan in plasma. The clinical implications of this phenomenon are not known.
Interaction with NSAIDs. including selective inhibitors of COX – 2
In elderly patients with dehydration (caused by diuretics including treatment) or with impaired renal function, combined use of NSAIDs. including selective COX – 2 with angiotensin II receptor blockers (including losartan) can lead to a deterioration of renal function, including the possibility of acute renal failure. These effects are usually reversible. In patients treated with losartan together with NSAIDs. should periodically monitor renal function.
The antihypertensive effect of angiotensin II receptor antagonists, including losartan, may be attenuated NSAIDs. including selective inhibitors of COX – 2.
Dual RAAS blockade
Dual RAAS blockade of angiotensin receptor antagonists, ACE inhibitors or aliskiren is associated with an increased risk of hypotension, syncope, hyperkalaemia and renal dysfunction (including acute renal failure) compared with monotherapy. It is necessary to carefully monitor blood pressure. renal function and electrolyte balance in patients receiving losartan, and other drugs. affecting RAAS.
Interact with aliskiren
Do not use this losartan with aliskiren in patients with diabetes mellitus. It is necessary to eliminate the use of aliskiren with losartan in patients with renal insufficiency (glomerular filtration rate less than 60 mL / min).
Symptoms: hypotension, changes in heart rate (tachycardia or bradycardia caused by the excitation of the vagus nerve).
Treatment: Forced diuresis, symptomatic therapy. Hemodialysis is ineffective.
Dosing and Administration
Inside, for adults, regardless of the meal, 1 time a day.
When hypertension ; 50 mg, if necessary, may gradually increase the dose (in some cases up to a maximum daily ; 100 mg), against the background of dehydration initial dose of 25 mg.
In chronic heart failure ; 12.5 mg with a gradual increase in stage 2 (after 1 week ; to 25 mg, and even after 1 week ; 50 mg) to the usual maintenance dose 50mg.
Precautions substance Losartan
Patients with liver disease (especially in cirrhosis), including: history, should be prescribed lower doses. To use caution in bilateral renal artery stenosis or stenosis of the renal artery to a solitary kidney (increased risk of renal impairment) with moderate or severe renal impairment, congestive heart failure, in patients with dehydration (likely to develop symptomatic hypotension) or hyponatremia.
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