Hydrochlorothiazide+Lozartan-Acrichine, 12.5mg+50 mg 84 pcs

Pharmacodynamics:

Combination drug, has hypotensive effect. It contains potassium losartan, an angiotensin II receptor antagonist (ATI subtype), and a hydrochlorothiazide diuretic.

Lozartan is a specific angiotensin II receptor antagonist (ATI subtype). It does not inhibit the bradykinin degrading enzyme kinase II. Reduces total peripheral resistance (TPR), blood concentrations of adrenaline and aldosterone, blood pressure (BP), pressure in the small circle of the circulation: reduces post-load, has a diuretic effect. It prevents the development of myocardial hypertrophy and increases exercise tolerance in patients with chronic heart failure.

Hydrochlorothiazide is a thiazide diuretic. Reduces reabsorption of sodium ions, increases urinary excretion of potassium ions, hydrogen carbonate and phosphate. Lowers BP by reducing the circulating blood volume (RBC). changes the reactivity of the vascular wall, reduces the pressor effect of vasoconstrictors and increases the denresor effect on the ganglia.

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Indications

Active ingredient

Composition

1 film-coated tablet contains:

the active ingredients:

potassium losartan 50 mg,

hydrochlorothiazide 12.5 mg;

excipients:

Lactose 111.55 mg,

Microcrystalline cellulose 37.2 mg,

35 mg pregelatinized starch,

Magnesium stearate 3.75 mg;

coating: green opider [hyprolose, hypromellose, titanium dioxide, quinoline yellow dye] 7.8 mg.

How to take, the dosage

Ingestion, regardless of meals.

The usual starting and maintenance dose of the drug is 1 tablet daily. For those patients in whom adequate control of blood pressure cannot be achieved at this dosage, the dose may be increased to 2 tablets once daily. The maximum dose is 2 tablets once daily. In general, the maximum hypotensive effect is achieved within 3 weeks after the start of treatment. There is no need for special selection of the initial dose in elderly patients.

Interaction

Lozartan enhances the effect of other hypotensive agents. No clinically significant interaction with hydrochlorothiazide, digoxin, indirect anticoagulants, cimetidine, phenobarbital, ketokenazole, erythromycin has been observed. As with other drugs that block angiotensin II or its effects, simultaneous administration of potassium-saving diuretics (e.g., spironolactone, triamterene. amiloride), potassium preparations or substitute salt containing potassium may lead to hyperkalemia.

Hydrochlorothiazide

The following drugs may interact with thiazide diuretics when prescribed concomitantly:

Hypoglycemic agents (oral agents and insulin) may require correction of the dose of hypoglycemic agents.

Other hypotensive agents – possible additive effect.

Colestyramine reduces absorption of hydrochlorothiazide.

Corticosteroids, ACTH increase loss of electrolytes, especially potassium.

Pressor amines – there may be a slight decrease in the effect of pressor amines that does not prevent their use.

Nondepolarizing myorelaxants (e.g., tubocurarine) may increase the effects of myorelaxants.

Lithium-diuretics decrease renal clearance of GH and increase the risk of lithium intoxication, so concomitant use is not recommended.

Non-steroidal anti-inflammatory drugs (NSAIDs) – in some patients, use of NSAIDs may decrease the diuretic, natriuretic and hypotensive effects of diuretics.

Effects on laboratory results

Thiazides may affect parathyroid function test results due to their effect on calcium excretion.

Special Instructions

Cardomin plus – Sanovel can be administered together with other hypotensive agents. There is no need for special selection of the initial dose in elderly patients. The drug may increase plasma concentrations of urea and creatinine in patients with bilateral renal artery stenosis or renal artery stenosis of the only kidney.

Hydrochlorothiazide may exacerbate arterial hypotension and water-electrolyte balance disorders (decreased circulating blood volume, hyponatremia. hypochloremic alkalosis, hypomagnesemia, hypokalemia), impair glucose tolerance, decrease urinary calcium excretion and cause a transient slight increase in plasma calcium concentration, increase cholesterol and triglyceride concentration, provoke the occurrence of hyperuricemia and/or gout. Administration of drugs acting directly on the renin-angiotensin system during the second and third trimesters of pregnancy may lead to fetal death. If pregnancy occurs, withdrawal of the drug is indicated.

The use of diuretics in pregnant women is generally not recommended due to the risk of fetal and neonatal jaundice and maternal thrombocytopenia. Diuretic therapy does not prevent the development of toxemia of pregnancy.

Contraindications

– Hypersensitivity to the components of the drug;

– Anuria;

– Severe arterial hypotension;

– significant hepatic or renal dysfunction (creatinine clearance < 30 ml/s);

– hypovolemia (including with high doses of diuretics.

– pregnancy and lactation;

– age less than 18 years (efficacy and safety have not been established).

– Patients with bilateral renal stenosis or arterial stenosis of the single kidney.

– Patients with diabetes mellitus, hypercalcemia, hyperuricemia and/or gout.

– patients with a history of allergies and bronchial asthma.

– in systemic connective tissue diseases (including systemic lupus erythematosus).

Side effects

The adverse reactions are limited to those previously observed with losartan potassium and/or hydrochlorohiazide.

The most frequent side effects with treatment of essential hypertension include dizziness.

Allergic reactions: angioedema, including swelling of the larynx and/or tongue, resulting in airway obstruction, and/or swelling of the face, lips, pharynx, and/or tongue, occasionally noted when taking losartan. Some of these patients had previously experienced angioedema when using other drugs, including ACE inhibitors. Very rarely, vasculitis, including Schoenlein-Henoch disease, has been reported while taking losartan.

Cardiovascular system: decreased blood pressure.

Gastrointestinal aspects: rare (< 1%) cases of hepatitis, diarrhea have been reported while taking losartan.

Respiratory disorders: cough when taking losartan.

Skin disorders: urticaria.

Laboratory parameters: rare (< 1%) hyperkalemia (serum potassium over

5.5 mmol/l), increased activity of “hepatic” transaminases.

Overdose

Treatment: symptomatic and supportive therapy. If the drug was taken recently, the stomach should be flushed; if necessary, correction of water-electrolytic disorders is carried out.

Lozartan and its active metabolites are not eliminated by hemodialysis.

Similarities