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Losartan and hydrochlorothiazide (Oral route)

Pronunciation:

loe-SAR-tan poe-TAS-ee-um, hye-droe-klor-oh-THYE-a-zide

Brand Names:

  • Hyzaar

Dosage Forms:

  • Tablet

Warnings:

Oral route(Tablet)

Drugs that act directly on the renin-angiotensin system can cause injury or death to the developing fetus when used during the second and third trimesters. Stop therapy as soon as possible when pregnancy is detected .

Classifications:

Therapeutic—

Angiotensin II Receptor Antagonist/Thiazide Combination

Pharmacologic—

Losartan

Chemical—

Thiazide

Uses of This Medicine:

Losartan and hydrochlorothiazide is a combination medicine that belongs to the class of medicines called high blood pressure medicines (antihypertensives). It is used to treat high blood pressure (hypertension).

High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled.

Losartan works by blocking a substance in the body that causes blood vessels to tighten. As a result, losartan relaxes blood vessels. This lowers blood pressure and increases the supply of blood and oxygen to the heart. Hydrochlorothiazide helps reduce the amount of salt and water in the body by acting on the kidneys to increase the flow of urine; this also helps to lower blood pressure.

This combination also may be used for other conditions as determined by your doctor.

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of losartan and hydrochlorothiazide combination in children with use in other age groups.

Older adults—

Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way as they do in younger adults. Although there is no specific information comparing the use of losartan and hydrochlorothiazide combination in the elderly with use in other age groups, this medicine is not expected to cause different side effects or problems in older people than it does in younger adults.

Pregnancy—

Pregnancy CategoryExplanation
1st TrimesterCAnimal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.
2nd TrimesterDStudies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.
3rd TrimesterDStudies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Dofetilide

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acetyldigoxin
  • Arsenic Trioxide
  • Deslanoside
  • Digitalis
  • Digitoxin
  • Digoxin
  • Droperidol
  • Flecainide
  • Ketanserin
  • Levomethadyl
  • Lithium
  • Metildigoxin
  • Ouabain
  • Proscillaridin
  • Sotalol

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Aceclofenac
  • Acemetacin
  • Alacepril
  • Alclofenac
  • Apazone
  • Benazepril
  • Benoxaprofen
  • Bepridil
  • Bromfenac
  • Bufexamac
  • Calcium Carbonate
  • Captopril
  • Carbamazepine
  • Carprofen
  • Celecoxib
  • Chlorpropamide
  • Cholestyramine
  • Cilazapril
  • Clometacin
  • Clonixin
  • Cyclophosphamide
  • Delapril
  • Dexketoprofen
  • Diclofenac
  • Diflunisal
  • Dipyrone
  • Droxicam
  • Enalaprilat
  • Enalapril Maleate
  • Etodolac
  • Etofenamate
  • Felbinac
  • Fenbufen
  • Fenoprofen
  • Fentiazac
  • Floctafenine
  • Fluconazole
  • Flufenamic Acid
  • Flurbiprofen
  • Fosinopril
  • Ginkgo
  • Glipizide
  • Gossypol
  • Ibuprofen
  • Imidapril
  • Indomethacin
  • Indoprofen
  • Isoxicam
  • Ketoprofen
  • Ketorolac
  • Licorice
  • Lisinopril
  • Lornoxicam
  • Meclofenamate
  • Mefenamic Acid
  • Meloxicam
  • Moexipril
  • Nabumetone
  • Naproxen
  • Niflumic Acid
  • Nimesulide
  • Oxaprozin
  • Oxyphenbutazone
  • Pentopril
  • Perindopril
  • Phenylbutazone
  • Pirazolac
  • Piroxicam
  • Pirprofen
  • Propyphenazone
  • Proquazone
  • Quinapril
  • Ramipril
  • Rifampin
  • Rofecoxib
  • Spirapril
  • Sulindac
  • Suprofen
  • Temocapril
  • Tenidap
  • Tenoxicam
  • Tiaprofenic Acid
  • Ticrynafen
  • Tolmetin
  • Topiramate
  • Trandolapril
  • Valdecoxib
  • Zofenopril
  • Zomepirac

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Allergy or
  • Asthma, bronchial—May have an increased risk of allergic reaction to hydrochlorothiazide
  • Fluid or electrolyte (e.g., potassium, chloride, sodium) imbalance (due to excessive perspiration, vomiting, diarrhea, etc.)—The side effects of losartan and hydrochlorothiazide may be increased
  • Heart failure, severe—Lowering of blood pressure by these medicines may make this condition worse
  • Diabetes mellitus (sugar diabetes) or
  • Gout or
  • Hyperglycemia or
  • Hyperuricemia—These conditions may be made worse by hydrochlorothiazide.
  • Kidney disease or
  • Liver disease—These conditions may be aggravated by losartan and hydrochlorothiazide
  • Sympathectomy—Blood pressure–lowering effects may be increased
  • Systemic lupus erythematosus (SLE)—Symptoms of this condition may be made worse with use of hydrochlorothiazide

Proper Use of This Medicine:

This medicine works best if there is a constant amount in the blood. To help keep this amount constant, do not miss any doses and take the medicine at the same time each day.

In addition to the use of the medicine your doctor has prescribed, treatment for your high blood pressure may include weight control and care in the types of foods you eat, especially foods high in sodium. Your doctor will tell you which of these is most important for you. You should check with your doctor before changing your diet.

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.

Remember that this medicine will not cure your high blood pressure but it does help control it. Therefore, you must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life . If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

This medicine may be taken with or without food.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For high blood pressure:
      • Adults—1 tablet once a day. Your doctor may increase your dose if needed.
      • Children—Use and dose must be determined by your doctor.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using This Medicine:

Check with your doctor immediately if you think that you may be pregnant. Losartan and hydrochlorothiazide may cause birth defects or other problems in the baby if taken during pregnancy.

It is important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.

Do not take other medicines unless they have been discussed with your doctor. This especially includes potassium supplements or salt substitutes that contain potassium, since they may change your blood potassium levels, or over-the-counter (nonprescription) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may tend to increase your blood pressure.

Dizziness, lightheadedness, or fainting may occur with this medicine. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you experience these effects.

Check with your doctor right away if you become sick while taking this medicine, especially with severe or continuing nausea and vomiting or diarrhea. These conditions may cause you to lose too much water and lead to low blood pressure.

Dizziness, lightheadedness, or fainting may also occur if you exercise or if the weather is hot. Heavy sweating can cause loss of too much water and result in low blood pressure. Use extra care during exercise or hot weather.

Avoid alcoholic beverages until you have discussed their use with your doctor. Alcohol may make the low blood pressure effect worse and/or increase the possibility of dizziness or fainting.

For diabetic patients:

  • Hydrochlorothiazide may raise blood sugar levels. Check with your doctor if any changes in your blood sugar levels occur.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Rare
Cough or hoarseness accompanied by chills or fever, lower back or side pain, painful or difficult urination
Symptoms of fluid and electrolyte imbalance
Dry mouth
increased thirst
weak and/or irregular heartbeat
muscle cramps or pain
nausea or vomiting
unusual tiredness or weakness
Incidence not known
Coma
confusion
convulsions
dark-colored urine
decreased urine output
fast or irregular heartbeat
fever
high blood pressure
irritability
large, flat, blue or purplish patches in the skin
large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, sex organs
light-colored stools
muscle spasms
muscle stiffness
muscle twitching
painful knees and ankles
raised red swellings on the skin, the buttocks, legs or ankles
restlessness
seizures
shortness of breath
swelling of face, ankles, or hands
upper right abdominal pain
weakness
yellow eyes and skin

Check with your doctor as soon as possible if any of the following side effects occur:

Less common
Cold or flu-like symptoms
dizziness
sore throat
Rare
Black tarry stools
blood in urine or stools
fainting
pinpoint red spots on skin
pounding heartbeat
skin rash
severe stomach pain, nausea, and vomiting
swelling of feet or lower legs
unusual bleeding or bruising

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common
Headache
increased sensitivity of skin to sunlight
stomach pain
Rare
Cough
sinus problems

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 11/4/2010

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