Diastat-L
Generic Name
Losartan Potassium
Manufacturer
Generic Manufacturer (e.g., Square Pharmaceuticals Ltd.)
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| diastat l 25 mg tablet | ৳ 40.00 | ৳ 400.00 |
Description
Overview of the medicine
Diastat-L 25 mg tablet, containing Losartan Potassium, is an angiotensin II receptor blocker (ARB) primarily used to treat high blood pressure (hypertension). It also reduces the risk of stroke in patients with hypertension and left ventricular hypertrophy, and treats kidney disease in patients with type 2 diabetes and a history of hypertension.
Uses & Indications
Dosage
Adults
For hypertension, the usual initial dose is 25-50 mg once daily. The maintenance dose ranges from 25-100 mg once daily. Maximum dose is 100 mg per day.
Elderly
No initial dosage adjustment is typically needed unless severe renal or hepatic impairment is present. A lower starting dose (25 mg once daily) may be considered for volume-depleted or severely impaired elderly patients.
Renal_impairment
No initial dosage adjustment is generally needed for mild to moderate renal impairment. For severe renal impairment (creatinine clearance < 30 mL/min) or dialysis patients, a lower starting dose (25 mg once daily) may be considered.
How to Take
Diastat-L 25 mg tablet is taken orally, usually once daily. It can be taken with or without food. For best results, take it at approximately the same time each day.
Mechanism of Action
Losartan selectively blocks the binding of angiotensin II to the AT1 receptor found in many tissues (e.g., vascular smooth muscle, adrenal gland, kidney), thereby inhibiting the vasoconstrictor and aldosterone-secreting effects of angiotensin II. This leads to vasodilation, reduced blood pressure, and decreased sodium and water retention.
Pharmacokinetics
Onset
Antihypertensive effect begins within 6 hours. Full blood pressure reduction achieved within 3-6 weeks of therapy.
Excretion
Approximately 35% of Losartan is excreted via urine and 60% via feces, as unchanged drug and metabolites.
Half life
Losartan: approximately 2 hours; active metabolite (EXP3174): 6-9 hours.
Absorption
Rapidly absorbed from the GI tract; undergoes extensive first-pass metabolism. Bioavailability is approximately 33%. Peak plasma concentrations of Losartan are reached in about 1 hour and for its active metabolite (EXP3174) in 3-4 hours.
Metabolism
Extensively metabolized by cytochrome P450 enzymes (CYP2C9 and CYP3A4) to an active carboxylic acid metabolite (EXP3174) and several inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to Losartan or any component of the formulation
- Pregnancy (especially during the second and third trimesters)
- Concomitant use with aliskiren in patients with diabetes or renal impairment
Drug Interactions
Lithium
Increased serum lithium concentrations and toxicity have been reported when co-administered with ARBs.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs), including selective COX-2 inhibitors
May reduce the antihypertensive effect of Losartan. Concurrent use may also increase the risk of worsening renal function, especially in elderly, volume-depleted, or renally impaired patients.
Potassium-sparing diuretics (e.g., spironolactone, amiloride, triamterene), potassium supplements, or salt substitutes containing potassium
May lead to hyperkalemia (high potassium levels in the blood).
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose typically include hypotension (low blood pressure) and tachycardia (rapid heartbeat); bradycardia (slow heartbeat) could occur from parasympathetic stimulation. Management involves symptomatic and supportive treatment. If ingestion is recent, gastric lavage may be considered. Administer IV fluids for hypotension. Hemodialysis is unlikely to remove Losartan or its active metabolite effectively.
Pregnancy & Lactation
Pregnancy Category D (second and third trimesters). Diastat-L can cause fetal harm or death when administered to a pregnant woman. It must be discontinued as soon as pregnancy is detected. It is not recommended during breastfeeding due to the potential for adverse effects on the nursing infant.
Side Effects
Contraindications
- Hypersensitivity to Losartan or any component of the formulation
- Pregnancy (especially during the second and third trimesters)
- Concomitant use with aliskiren in patients with diabetes or renal impairment
Drug Interactions
Lithium
Increased serum lithium concentrations and toxicity have been reported when co-administered with ARBs.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs), including selective COX-2 inhibitors
May reduce the antihypertensive effect of Losartan. Concurrent use may also increase the risk of worsening renal function, especially in elderly, volume-depleted, or renally impaired patients.
Potassium-sparing diuretics (e.g., spironolactone, amiloride, triamterene), potassium supplements, or salt substitutes containing potassium
May lead to hyperkalemia (high potassium levels in the blood).
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose typically include hypotension (low blood pressure) and tachycardia (rapid heartbeat); bradycardia (slow heartbeat) could occur from parasympathetic stimulation. Management involves symptomatic and supportive treatment. If ingestion is recent, gastric lavage may be considered. Administer IV fluids for hypotension. Hemodialysis is unlikely to remove Losartan or its active metabolite effectively.
Pregnancy & Lactation
Pregnancy Category D (second and third trimesters). Diastat-L can cause fetal harm or death when administered to a pregnant woman. It must be discontinued as soon as pregnancy is detected. It is not recommended during breastfeeding due to the potential for adverse effects on the nursing infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from the manufacturing date, consult package for exact expiry.
Availability
Pharmacies, Hospitals
Approval Status
Approved
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials, such as the LIFE study (Losartan Intervention For Endpoint reduction in hypertension) and RENAAL study (Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan), have demonstrated the efficacy and safety of Losartan in hypertension, stroke risk reduction, and diabetic nephropathy.
Lab Monitoring
- Serum potassium levels (especially in patients with renal impairment, on potassium-sparing diuretics, or potassium supplements)
- Renal function (BUN, serum creatinine) periodically
- Liver function tests (periodically, especially if liver impairment is suspected)
Doctor Notes
- Periodically monitor serum creatinine and potassium levels, particularly in patients with renal impairment, those on concomitant diuretics, or potassium supplements.
- Advise patients to immediately report any signs of angioedema (swelling of face, lips, tongue, or throat).
- Emphasize the importance of adherence to therapy and lifestyle modifications for optimal blood pressure control.
Patient Guidelines
- Take Diastat-L 25 mg tablet exactly as directed by your doctor, usually once daily.
- Do not stop taking the medication abruptly without consulting your doctor, even if you feel better.
- Inform your doctor about all other medications, supplements, and herbal products you are taking to avoid potential drug interactions.
- Avoid potassium supplements or salt substitutes containing potassium unless specifically advised by your doctor.
Missed Dose Advice
If a dose of Diastat-L is missed, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Diastat-L may cause dizziness or lightheadedness, especially when starting treatment or increasing the dose. Patients should be cautious about operating machinery or driving until they know how Losartan affects them and if these side effects subside.
Lifestyle Advice
- Adopt a healthy lifestyle, including a balanced diet rich in fruits and vegetables, regular physical activity, and limiting sodium intake, to help manage blood pressure.
- Regularly monitor your blood pressure at home if advised by your doctor and keep a record.
- Avoid excessive alcohol consumption as it can further lower blood pressure and interfere with medication.
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