Absorption of hydrochlorothiazide is impaired in the presence of anionic exchange resins. Single doses of either cholestyramine or colestipol resins bind the hydrochlorothiazide and reduce its absorption from the gastrointestinal tract by up to 85 and 43 percent, respectively. Stagger the dosage of hydrochlorothiazide and the resin such that hydrochlorothiazide is administered at least 4 hours before or 4 to 6 hours after the administration of the resin. Well absorbed. Food decreases absorption but has only minor effects on losartan AUC or AUC of active metabolite. Systemic bioavailability is about 33%. T max is 1 h losartan and 3 to 4 h metabolite. cyclophosphamide
Enzalutamide: May decrease the serum concentration of CYP2C9 Substrates. Management: Concurrent use of enzalutamide with CYP2C9 substrates that have a narrow therapeutic index should be avoided. Use of enzalutamide and any other CYP2C9 substrate should be performed with caution and close monitoring. At the end of study or at the last visit before a primary endpoint, 77% of the group treated with losartan and 73% of the group treated with atenolol were still taking study medication. At baseline, 1195 13% had diabetes, 1326 14% had isolated systolic hypertension, 1469 16% had coronary heart disease, and 728 8% had cerebrovascular disease.
The gene, AGTR1, caused normal cells to act like highly invasive cells, both in the laboratory and in mice. Ceritinib: May increase the serum concentration of CYP2C9 Substrates. Losartan Potassium and Hydrochlorothiazide tablets. See a complete list of ingredients in Losartan Potassium and Hydrochlorothiazide tablets at the end of this leaflet. Take Losartan Potassium and Hydrochlorothiazide tablets exactly as prescribed by your doctor. Your doctor may change your dose if needed.
Keep Losartan Potassium and Hydrochlorothiazide tablets and all medicines out of the reach of children. Use of drugs that act on the renin-angiotensin system during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death. Resulting oligohydramnios can be associated with fetal lung hypoplasia and skeletal deformations. Potential neonatal adverse effects include skull hypoplasia, anuria, hypotension, renal failure, and death. When pregnancy is detected, discontinue losartan as soon as possible. These adverse outcomes are usually associated with use of these drugs in the second and third trimester of pregnancy. Most epidemiologic studies examining fetal abnormalities after exposure to antihypertensive use in the first trimester have not distinguished drugs affecting the renin-angiotensin system from other antihypertensive agents. Appropriate management of maternal hypertension during pregnancy is important to optimize outcomes for both mother and fetus.
Fluconazole: May decrease the serum concentration of Losartan. Specifically, fluconazole may decrease the serum concentration of E3174, the more potent active metabolite of losartan. Genetic testing alone cannot tell you if you have Marfan syndrome, as there are other connective tissue disorders. Losartan Potassium and Hydrochlorothiazide tablets contain 2 prescription medicines, an angiotensin receptor blocker ARB and a diuretic water pill. Co, Inc, Whitehouse Station, NJ, 2015. Siltuximab: May decrease the serum concentration of CYP3A4 Substrates. When losartan is taken with grapefruit juice, the grapefruit juice may decrease the ability of your body to activate losartan. This decreased amount of activated losartan may be insufficient to control your blood pressure. MiFEPRIStone: May increase the serum concentration of CYP2C9 Substrates. Management: Use CYP2C9 substrates at the lowest recommended dose, and monitor closely for adverse effects, during and in the 2 weeks following mifepristone treatment. Take this medication by mouth as directed by your doctor, usually once daily with or without food. The dosage is based on your medical condition and response to treatment. It may require surgery. Losartan Potassium and Hydrochlorothiazide tablets have not been studied in children less than 18 years old. CYP3A4 Inducers Moderate: May decrease the serum concentration of CYP3A4 Substrates. Marfan syndrome is caused by a change in the gene that controls how the body makes fibrillin, an essential component of connective tissue that contributes to its strength and elasticity. Hypersensitivity reactions to hydrochlorothiazide may occur in patients with or without a history of allergy or bronchial asthma, but are more likely in patients with such a history.
If you miss a dose, take it as soon as you remember. If it is close to your next dose, do not take the missed dose. Just take the next dose at your regular time. What should I tell my doctor before taking Losartan Potassium and Hydrochlorothiazide tablets? It is not known whether losartan is excreted in human milk, but significant levels of losartan and its active metabolite were shown to be present in rat milk. Thiazides appear in human milk. Because of the potential for adverse effects on the nursing infant, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother. Long arms, legs, fingers, and toes and flexible joints. Nitroprusside: Blood Pressure Lowering Agents may enhance the hypotensive effect of Nitroprusside. If you take too much Losartan Potassium and Hydrochlorothiazide tablets, call your doctor or Poison Control Center, or go to the nearest hospital emergency room right away. Blood pressure reduction measured at trough was similar for both treatment groups but blood pressure was not measured at any other time of the day. At the end of study or at the last visit before a primary endpoint, the mean blood pressures were 144. Tell your doctor about all of the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Brimonidine Topical: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Use caution in treating patients whose renal function may depend on the renin-angiotension-aldosterone system eg, patients with severe CHF. What Is Losartan and How Does It Work? If surgery is needed, you should consult with a surgeon who is experienced in surgery for Marfan syndrome. People who have surgery for Marfan syndrome still require life-long follow-up care to prevent future complications associated with the disease. Losartan Potassium and Hydrochlorothiazide contains hydrochlorothiazide which can cause hypokalemia, hyponatremia and hypomagnesemia. Hypomagnesemia can result in hypokalemia which may be difficult to treat despite potassium repletion. Losartan Potassium and Hydrochlorothiazide also contains losartan which can cause hyperkalemia. The AUC of active metabolite following oral losartan was not affected by erythromycin, an inhibitor of P450 3A4, but the AUC of losartan was increased by 30%. Nervous system disorders: Dysgeusia, headache, migraine, paraesthesias. Angiotensin II receptor AR antagonists can cause renal impairment in patients whose renal function depends on the activity of the renin-angiotensin-aldosterone system. In addition, symptomatic hypotension can occur in susceptible individuals, which may compromise renal and myocardial perfusion. clarinex
What are the ingredients in Losartan Potassium and Hydrochlorothiazide tablets? Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. Absorption: Following oral administration, losartan is well absorbed and undergoes substantial first-pass metabolism. The systemic bioavailability of losartan is approximately 33%. Mean peak concentrations of losartan and its active metabolite are reached in 1 hour and in 3 to 4 hours, respectively. While maximum plasma concentrations of losartan and its active metabolite are approximately equal, the AUC area under the curve of the metabolite is about 4 times as great as that of losartan. Advise patient that medication may cause dizziness or light-headedness and to use caution while driving or performing other tasks requiring mental alertness until tolerance is determined. Store tablets at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets. Persistent dry cough has been associated with ACE-inhibitor use and in practice can be a cause of discontinuation of ACE-inhibitor therapy. Two prospective, parallel-group, double-blind, randomized, controlled trials were conducted to assess the effects of losartan on the incidence of cough in hypertensive patients who had experienced cough while receiving ACE-inhibitor therapy. No carcinogenicity studies have been conducted with the losartan potassium-hydrochlorothiazide combination. Inactive ingredients: colloidal silicon dioxide, hydroxypropyl cellulose, hypromellose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, pregelatinised starch maize and titanium dioxide. Nicorandil: May enhance the hypotensive effect of Blood Pressure Lowering Agents. There was no significant effect on heart rate. Phosphodiesterase 5 Inhibitors: May enhance the hypotensive effect of Blood Pressure Lowering Agents. CYP3A4 Inducers Strong: May increase the metabolism of CYP3A4 Substrates. Management: Consider an alternative for one of the interacting drugs. Some combinations may be specifically contraindicated. Consult appropriate manufacturer labeling. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. Losartan Potassium and Hydrochlorothiazide. Monitor renal function periodically in these patients. buy generic lotrisone from india online lotrisone
Patients on monotherapy were titrated from losartan 50 mg to losartan 100 mg to losartan 150 mg, as needed. Food and Drug Administration. WebMD does not endorse any specific product, service, or treatment. Hydrochlorothiazide, a sulfonamide, can cause an idiosyncratic reaction, resulting in acute transient myopia and acute angle-closure glaucoma. Symptoms include acute onset of decreased visual acuity or ocular pain and typically occur within hours to weeks of drug initiation. Untreated acute angle-closure glaucoma can lead to permanent vision loss. The primary treatment is to discontinue hydrochlorothiazide as rapidly as possible. Prompt medical or surgical treatments may need to be considered if the intraocular pressure remains uncontrolled. Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. These considerations may guide selection of therapy. Inform patient that drug controls, but does not cure, hypertension and to continue taking drug as prescribed even when BP is not elevated. Before having surgery, tell your doctor or dentist about all the products you use including prescription drugs, nonprescription drugs, and herbal products. Increases in serum lithium concentrations and lithium toxicity have been reported with concomitant use of angiotensin II receptor antagonists or thiazide diuretics. Monitor lithium levels in patients receiving Losartan Potassium and Hydrochlorothiazide and lithium. Minor increases in BUN or serum creatinine, small decreases in Hgb and Hct, occasional elevations in liver enzymes and serum bilirubin postmarketing. Vascular disorders: Dose-related orthostatic effects, necrotizing angiitis vasculitis, cutaneous vasculitis. Documentation of allergenic cross-reactivity for angiotensin receptor blockers is limited. Digestive: Hepatitis has been reported rarely in patients treated with losartan. Black patients: When used to reduce the risk of stroke in patients with HTN and LVH, may not be effective in the black population. Respective AUCs for losartan, its active metabolite and hydrochlorothiazide at these dosages in rats were approximately 35, 10 and 10 times greater than those achieved in humans with the administration of 100 mg of losartan in combination with 25 mg hydrochlorothiazide. buy generic phenazopyridine online australia
Scapa E. Effect of grapefruit juice on the pharmacokinetics of losartan and its active metabolite E3174 in healthy volunteers. Trimethoprim: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Blocks vasoconstriction and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the angiotensin II receptor AT 1 receptor in vascular smooth muscle and the adrenal gland. CYP2C8 Substrates: CYP2C8 Inhibitors Moderate may decrease the metabolism of CYP2C8 Substrates. The opinions expressed in WebMD User-generated content areas like communities, reviews, ratings, or blogs are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. User-generated content areas are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. II receptor blocker acting on the AT 1 receptor subtype and a diuretic, hydrochlorothiazide. femara price turkey femara
The goal of surgery for Marfan syndrome is to prevent aortic dissection or rupture and to treat problems affecting the heart's valves, which control the flow of blood in and out of the heart and between the heart's chambers. LVH. Losartan Potassium and Hydrochlorothiazide tablets may not help Black patients with this problem. Discuss specific use of drug and side effects with patient as it relates to treatment. HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Ames microbial mutagenesis assay and the V-79 Chinese hamster lung cell mutagenesis assay. In addition, there was no evidence of direct genotoxicity in the in vitro alkaline elution assay in rat hepatocytes and in vitro chromosomal aberration assay in Chinese hamster ovary cells at noncytotoxic concentrations. Use cautiously, if at all, with these agents and monitor potassium closely. Bosentan: CYP2C9 Inhibitors Moderate may increase the serum concentration of Bosentan. Management: Concomitant use of both a CYP2C9 inhibitor and a CYP3A inhibitor or a single agent that inhibits both enzymes with bosentan is likely to cause a large increase in serum concentrations of bosentan and is not recommended. See monograph for details. Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, severe loss of body water and minerals dehydration. TiZANidine: CYP1A2 Inhibitors Weak may increase the serum concentration of TiZANidine. Management: Avoid these combinations when possible. If combined use cannot be avoided, initiate tizanidine at an adult dose of 2 mg and increase in 2-4 mg increments based on patient response. Monitor for increased effects of tizanidine, including adverse reactions. Canadian labeling: Use is not recommended. The administration of a non-steroidal anti-inflammatory agent including a selective COX-2 inhibitor can reduce the diuretic, natriuretic, and antihypertensive effects of loop, potassium-sparing and thiazide diuretics. Therefore, when Losartan Potassium and Hydrochlorothiazide and non-steroidal anti-inflammatory agents including selective COX-2 inhibitors are used concomitantly, observe closely to determine if the desired effect of the diuretic is obtained. Antifungal Agents Azole Derivatives, Systemic: May decrease the metabolism of Losartan. Applicable Isavuconazonium considerations are addressed in separate monographs. Exceptions: Isavuconazonium Sulfate.
Bosentan: May decrease the serum concentration of CYP3A4 Substrates. The scans can also be used to check the lower back for signs of dural ectasia, a back problem that is common in people with Marfan syndrome. CYP2C9 Inducers Strong: May increase the metabolism of CYP2C9 Substrates. Management: Consider an alternative for one of the interacting drugs. Some combinations may be specifically contraindicated. Consult appropriate manufacturer labeling. It also stimulates aldosterone secretion by the adrenal cortex. These studies demonstrate that the incidence of cough associated with losartan therapy, in a population that all had cough associated with ACE inhibitor therapy, is similar to that associated with hydrochlorothiazide or placebo therapy. RxList is part of the WebMD Health Network. The opinions expressed in the WebMD User Reviews are solely those of the User, who may or may not have medical or scientific training, and do not represent the opinions of WebMD. These member reviews have not been reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other purpose except for compliance with our Terms and Conditions. kkop.info renova
Surgical patients: In patients on chronic angiotensin receptor blocker ARB therapy, intraoperative hypotension may occur with induction and maintenance of general anesthesia; however, discontinuation of therapy prior to surgery is controversial. If continued preoperatively, avoidance of hypotensive agents during surgery is prudent Hillis, 2011. Losartan Potassium and Hydrochlorothiazide. As a result, a greater proportion of the patients on Losartan Potassium and Hydrochlorothiazide reached the target diastolic blood pressure 17. Renal impairment: Use with caution with preexisting renal insufficiency. Chronic kidney disease CKD and hypertension: Regardless of race or diabetes status, the use of an ACE inhibitor ACEI or angiotensin receptor blocker ARB as initial therapy is recommended to improve kidney outcomes. In the general nonblack population without CKD including those with diabetes, initial antihypertensive treatment should consist of a thiazide-type diuretic, calcium channel blocker, ACEI, or ARB. In the general black population without CKD including those with diabetes, initial antihypertensive treatment should consist of a thiazide-type diuretic or a calcium channel blocker instead of an ACEI or ARB. Side Effects List Losartan POTASSIUM side effects by likelihood and severity. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company. Check your blood pressure regularly while taking this medication. Learn how to monitor your own blood pressure, and share the results with your doctor. Deferasirox: May decrease the serum concentration of CYP3A4 Substrates. buy brand telmisartan online australia
Plasma losartan concentrations are twice as high in hypertensive women as hypertensive men, but plasma concentrations of active metabolite are similar. No dosage adjustment is necessary. Pholcodine: Blood Pressure Lowering Agents may enhance the hypotensive effect of Pholcodine. Losartan plasma levels may be reduced, decreasing the antihypertensive effects. Instruct patient in BP and pulse measurement skills. Although losartan may be used to prevent kidney problems or treat people who have kidney problems, it may also rarely cause serious kidney problems or make them worse. Your doctor will check your kidney function while you are taking losartan. Tell your doctor right away if you have any signs of kidney problems such as a change in the amount of urine. CYP2C9 Inhibitors Moderate: May decrease the metabolism of CYP2C9 Substrates. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Losartan belongs to a class of drugs called ARBs. It works by relaxing blood vessels so that blood can flow more easily. Losartan potassium and hydrochlorothiazide has been evaluated for safety in 858 patients treated for essential hypertension and 3889 patients treated for hypertension and left ventricular hypertrophy. Most adverse reactions have been mild and transient in nature and have not required discontinuation of therapy. Marfan syndrome requires a treatment plan that is individualized to the patient's needs. These dosages have been shown to provide respective systemic exposures AUCs for losartan, its active metabolite and hydrochlorothiazide that are approximately 60, 60 and 30 times greater than those achieved in humans with 100 mg of losartan potassium in combination with 25 mg of hydrochlorothiazide. Resveratrol: May decrease serum concentrations of the active metabolites of Losartan. Resveratrol may increase the serum concentration of Losartan. Plasma protein binding is constant over the concentration range achieved with recommended doses. Studies in rats indicate that losartan crosses the blood-brain barrier poorly, if at all. buy keftab eu
Treatment of hypertension; nephropathy in type 2 diabetic patients; reduce risk of stroke in patients with hypertension and left ventricular hypertrophy. Administer without regard to meals. Administer with food if GI upset occurs. Lithium: Angiotensin II Receptor Blockers may increase the serum concentration of Lithium. Management: Lithium dosage reductions will likely be needed following the addition of an angiotensin II receptor antagonist. Hypertension with left ventricular hypertrophy: Oral: Initial: 50 mg once daily; can be increased to 100 mg once daily based on blood pressure response. 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 coadministration of an angiotensin II receptor antagonist tends to reverse the potassium loss associated with these diuretics. The mechanism of the antihypertensive effect of thiazides is unknown. There was no difference in response for men and women or in patients over or under 65 years of age. Tocilizumab: May decrease the serum concentration of CYP3A4 Substrates. Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients. seroflo
Losartan plasma levels may be elevated, increasing the antihypertensive and adverse effects. Renal and urinary disorders: Glycosuria, renal dysfunction, interstitial nephritis, renal failure. Angioedema: Angioedema has been reported rarely with some angiotensin II receptor antagonists ARBs and may occur at any time during treatment especially following first dose. It may involve the head and neck potentially compromising airway or the intestine presenting with abdominal pain. Patients with idiopathic or hereditary angioedema or previous angioedema associated with angiotensin-converting enzyme ACE inhibitor therapy may be at an increased risk. Prolonged frequent monitoring may be required, especially if tongue, glottis, or larynx are involved, as they are associated with airway obstruction. Patients with a history of airway surgery may have a higher risk of airway obstruction. Discontinue therapy immediately if angioedema occurs. Aggressive early management is critical. Intramuscular IM administration of epinephrine may be necessary. Do not readminister to patients who have had angioedema with ARBs. Musculoskeletal and connective tissue disorders: Muscle cramps, muscle spasm, myalgia, arthralgia. Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. Dabrafenib: May decrease the serum concentration of CYP3A4 Substrates. Management: Seek alternatives to the CYP3A4 substrate when possible. If concomitant therapy cannot be avoided, monitor clinical effects of the substrate closely particularly therapeutic effects. Talk to your doctor about other ways to lower your blood pressure if you plan to become pregnant.
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In this study, renal clearance was reduced by 55 to 85% for both losartan and its active metabolite in patients with mild or moderate renal insufficiency. Neither losartan nor its active metabolite can be removed by hemodialysis. High Blood Pressure hypertension. Blood pressure is the force in your blood vessels when your heart beats and when your heart rests. You have high blood pressure when the force is too much. The losartan ingredient in Losartan Potassium and Hydrochlorothiazide tablets can help your blood vessels relax so your blood pressure is lower. The hydrochlorothiazide ingredient in Losartan Potassium and Hydrochlorothiazide tablets work by making your kidneys pass more water and salt. buy sominex in queensland
After oral administration of hydrochlorothiazide, diuresis begins within 2 hours, peaks in about 4 hours, and lasts about 6 to 12 hours. DULoxetine: Blood Pressure Lowering Agents may enhance the hypotensive effect of DULoxetine. Undergoes substantial first-pass metabolism by CYP-450 2C9 and 3A4 enzymes. Fourteen percent of an oral dose is converted to an active carboxylic acid metabolite that is responsible for most of the angiotensin II receptor antagonist activity. The double-blind treatment period lasted up to 8 weeks. The incidence of cough is shown in Table 1 below.
This leaflet summarizes the most important information about Losartan Potassium and Hydrochlorothiazide tablets. If you would like more information, talk with your doctor. You can ask your pharmacist or doctor for information that is written for health professionals. Skin and subcutaneous tissue disorders: Rash, pruritus, purpura, toxic epidermal necrolysis, urticaria, photosensitivity, cutaneous lupus erythematosus. This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects. No clinically significant drug interactions have been found in studies of losartan potassium with hydrochlorothiazide, digoxin, warfarin, cimetidine and phenobarbital. However, rifampin has been shown to decrease the AUC of losartan and its active metabolite by 30% and 40%, respectively. Fluconazole, an inhibitor of cytochrome P450 2C9, decreased the AUC of the active metabolite by approximately 40%, but increased the AUC of losartan by approximately 70% following multiple doses. Conversion of losartan to its active metabolite after intravenous administration is not affected by ketoconazole, an inhibitor of P450 3A4.
Ora-Plus and Ora-Sweet SF and shake for 1 min to disperse ingredients. Losartan Potassium and Hydrochlorothiazide. Correct volume or salt depletion prior to administration of Losartan Potassium and Hydrochlorothiazide. Do not use Losartan Potassium and Hydrochlorothiazide as initial therapy in patients with intravascular volume depletion. Drospirenone: Angiotensin II Receptor Blockers may enhance the hyperkalemic effect of Drospirenone. Those with dilation of the aorta will be asked to avoid high intensity team sports, contact sports, and isometric exercises such as . Ask your cardiologist about activity guidelines for you.