Trade Names:Hyzaar- Tablets 12.5 mg hydrochlorothiazide/50 mg losartan potassium- Tablets 12.5 mg hydrochlorothiazide/100 mg losartan potassium- Tablets 25 mg hydrochlorothiazide/100 mg losartan potassiumHyzaar DS (Canada)
Losartan antagonizes the effect of angiotensin II (vasoconstriction and aldosterone secretion) by blocking the angiotensin II receptor (AT1 receptor) in vascular smooth muscle and the adrenal gland, producing decreased BP; hydrochlorothiazide inhibits reabsorption of sodium and chloride in ascending loop of Henle and early distal tubules.
Anuria; hypersensitivity to other sulfonamide-derivatives or any component of product.
PO 50 mg losartan/12.5 mg hydrochlorothiazide once daily is usual dose (max, 100 mg losartan/25 mg hydrochlorothiazide daily).
Administer once daily in the morning, with or without food. Administer with food if GI upset occurs.
Store tablets at controlled room temperature (59° to 86°F). Keep container tightly closed. Protect from light.
Losartan plasma levels may be elevated, increasing the antihypertensive and adverse effects.Lithium
Plasma levels of lithium may be elevated, increasing the pharmacologic and adverse effects.Rifamycins (eg, rifampin)
Losartan plasma levels may be reduced, decreasing the antihypertensive effects.Potassium-sparing diuretics (eg, spironolactone), potassium supplements, salt substitutes containing potassium
May lead to increased serum potassium.Hydrochlorothiazide Alcohol, barbiturates, narcotics
Increased risk of orthostatic hypotension.Antidiabetic agents
Dose adjustments of antidiabetic agent may be needed.Antihypertensives
Actions of other antihypertensive agents may be potentiated.Cholestyramine, colestipol resins
Absorption of hydrochlorothiazide may be impaired.ACTH, corticosteroids
Increased risk of electrolyte depletion (eg, hypokalemia).Pressor amines (eg, norepinephrine)
Decreased response to pressor amine.Nondepolarizing skeletal muscle relaxants (eg, turbocurarine)
Responsiveness to muscle relaxant may be increased.Lithium
Plasma levels of lithium may be elevated, increasing the risk of toxicity.NSAIDs
Antihypertensive, diuretic, and natriuretic effects of hydrochlorothiazide may be reduced.
Serum levels of protein-bound iodine may be decreased without signs of thyroid dysfunction.
Palpitations; orthostatic effects, angina pectoris, arrhythmias (eg, atrial fibrillation, sinus bradycardia, tachycardia, ventricular tachycardia, ventricular fibrillation), CVA, hypotension, MI, second-degree AV block (losartan); orthostatic hypotension (hydrochlorothiazide).
Dizziness; syncope, anxiety, ataxia, confusion, depression, dream abnormality, hyperesthesia, insomnia, decreased libido, memory impairment, migraine, nervousness, panic disorder, paresthesia, peripheral neuropathy, sleep disorder, somnolence, tremor, vertigo (losartan); restlessness (hydrochlorothiazide).
Rash; alopecia, dermatitis, dry skin, ecchymosis, erythema, flushing, photosensitivity, pruritus, sweating, urticaria (losartan); photosensitivity, urticaria, necrotizing angiitis (vasculitis and cutaneous vasculitis), erythema multiforme (eg, Stevens-Johnson syndrome), exfoliative dermatitis (eg, toxic epidermal necrolysis), purpura (hydrochlorothiazide).
Sinusitis; cough; nasal congestion, angioedema, pharyngeal discomfort, rhinitis, blurred vision, burning/stinging in the eyes, conjunctivitis, decreased visual acuity, taste perversion, tinnitus (losartan); transient blurred vision, xanthopsia (hydrochlorothiazide).
Abdominal pain; anorexia, constipation, dental pain, dry mouth, dyspepsia, flatulence, gastritis, vomiting (losartan); pancreatitis, sialadenitis, cramping, gastric irritation (hydrochlorothiazide).
Impotence, nocturia, urinary frequency, UTI (losartan); glucosuria, renal failure, renal dysfunction, interstitial nephritis (hydrochlorothiazide).
Anemia (losartan); aplastic anemia, agranulocytosis, leukopenia, hemolytic anemia, thrombocytopenia (hydrochlorothiazide).
Jaundice (intrahepatic cholestatic jaundice) (hydrochlorothiazide).
Edema; gout (losartan); hyperglycemia, hyperuricemia (hydrochlorothiazide).
Upper respiratory tract infection; dyspnea, epistaxis, respiratory congestion (losartan); respiratory distress (eg, pneumonitis, pulmonary edema) (hydrochlorothiazide).
Back pain; chest pain, facial edema, arm pain, arthralgia, arthritis, fibromyalgia, hip pain, joint swelling, knee pain, leg pain, muscle cramps, muscle weakness, musculoskeletal pain, myalgia, shoulder pain, stiffness (losartan); weakness, fever, muscle spasm (hydrochlorothiazide).
When used in pregnancy during the second and third trimesters, drugs that act directly on the renin-angiotensin system can cause injury and even death to the developing fetus. When pregnancy is detected, discontinue therapy as soon as possible.
Monitor blood sugar in diabetic patient when drug is started or dose is changed.
Category C (first trimester); Category D (second and third trimester).
Undetermined (losartan); excreted in breast milk (hydrochlorothiazide).
Safety and efficacy not established.
May occur in patients with or without history of allergy or bronchial asthma; cross-sensitivity with sulfonamides may also occur.
Use with caution.
Do not use.
Correct condition before using drug.
Exacerbation or activation may occur with thiazide diuretics.
Hypotension, tachycardia, bradycardia, electrolyte depletion (eg, hypokalemia), dehydration.
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