Hypertension
Hypertension associated with palpitation
Hypertension associated with edema
How it works
Losartan belongs to a group of drugs called angiotensin II receptor antagonists. It keeps blood vessels from narrowing, which lowers blood pressure and improves blood flow.
Hydrochlorothiazide is a thiazide diuretic often considered the prototypical member of this class. It reduces the reabsorption of electrolytes from the renal tubules. This results in increased excretion of water and electrolytes, including sodium, potassium, chloride, and magnesium. It has been used in the treatment of several disorders including edema, hypertension, diabetes insipidus, and hypoparathyroidism.
Indications
Hypertension
Hypertension associated with palpitation
Hypertension associated with edema
Dosage
Hypertension
Adult: Per tablet contains losartan 50 mg and hydrochlorothiazide 12.5 mg. For patients who are not adequately controlled on losartan or hydrochlorothiazide monotherapy: 1 tab once daily. May increase to 2 tabs once daily 2-4 wk later if needed. Max: 2 tabs/day.
Renal impairment: Dialysis patients: Avoid.
Side Effects
Losartan
Upper resp infection, nasal congestion, sinusitis, headache, dizziness, back pain, leg pain, muscle cramps, asthenia or fatigue, neutropenia, chest pain, cough, bronchitis, UTI, diarrhoea, gastritis, anaemia, hypoglycaemia, diabetic vascular disease, cataracts, cellulitis, hyperkalaemia, myalgia, arthralgia, hypotension, muscular weakness, hypoaesthesia, infection, knee pain. Rarely, pruritus, rash, urticaria, angioedema, elevated liver enzyme values, rhabdomyolysis.
Hydrochlorothiazide
Volume depletion and electrolyte imbalance (especially hyperkalaemia); dry mouth, thirst; lethargy, drowsiness; muscle pain and cramps; rashes, photosensitivity, thrombocytopenia, jaundice, pancreatitis; fatigue, weakness; may precipitate an attack of gout; impotence; hyperglycaemia; anorexia, nausea, vomiting, constipation, diarrhoea; sialdenitis; raised urinary calcium concentration; headache, dizziness; back pain, myalgia; first-dose hypotension; angiodema; neutropenia; GI disturbances; transient elevation of liver enzymes; taste disturbances, cough; exacerbation or activation of systemic lupus erythematous; palpitations; xanthopsia; leucopenia, agranulocytosis, aplastic anaemia; necrotising angiitis; glucosuria; renal dysfunction, interstitial nephritis, renal failure; migraine; hyponatraemia; UTI; chest pain; gastritis, wt gain, dyspepsia, abdominal pain; bronchitis, upper respiratory infection, nasal congestion, sinusitis; rise in cholesterol and/or triglycerides.
Potentially Fatal: Hypersensitivity reactions; hemolytic anaemia; toxic epidermal necrolysis.
Contraindication
Losartan
Concomitant use w/ aliskiren in patients w/ diabetes and renal impairment (GFR <60 mL/min). Severe hepatic impairment. Pregnancy.
Hydrochlorothiazide
Pregnancy, lactation; intravascular volume depletion.
Pregnancy Category D: There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).
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