Lodical Plus
Generic Name
Amlodipine + Losartan
Manufacturer
General Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| lodical plus 5 mg tablet | ৳ 6.50 | ৳ 65.00 |
Description
Overview of the medicine
Lodical Plus 5 mg Tablet is a combination medicine containing Amlodipine (a calcium channel blocker) and Losartan (an angiotensin II receptor blocker). It is primarily used to treat high blood pressure (hypertension) and to reduce the risk of cardiovascular events.
Uses & Indications
Dosage
Adults
The usual recommended dose is one Lodical Plus 5 mg tablet once daily. The dose can be adjusted by the physician based on individual patient response and tolerability.
Elderly
No specific dose adjustment is generally required for elderly patients, but caution should be exercised due to potential age-related decrease in renal and hepatic function.
Renal_impairment
No initial dose adjustment is required for mild to moderate renal impairment. For severe renal impairment or patients on dialysis, caution is advised, and the dose should be determined by a physician.
How to Take
Take the tablet orally with a glass of water, with or without food, preferably at the same time each day. Do not crush, chew, or break the tablet.
Mechanism of Action
Amlodipine is a dihydropyridine calcium antagonist (calcium ion antagonist or slow-channel blocker) that inhibits the transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle. Losartan is an angiotensin II receptor blocker (ARB). It selectively blocks the binding of angiotensin II to the AT1 receptor, found in various tissues, leading to vasodilation, reduction in aldosterone secretion, and decrease in blood pressure.
Pharmacokinetics
Onset
Blood pressure reduction typically starts within 2-4 hours, full effect within 1-2 weeks for Amlodipine, and 3-6 weeks for Losartan.
Excretion
Amlodipine: excreted in urine as inactive metabolites (approx. 60%). Losartan: primarily excreted in feces (approx. 60%) and urine (approx. 35%), mainly as metabolites.
Half life
Amlodipine: 30-50 hours. Losartan: 2 hours (active metabolite: 6-9 hours).
Absorption
Amlodipine is well absorbed orally, bioavailability 64-90%. Losartan is well absorbed orally, bioavailability approx. 33%. Peak plasma concentrations are reached in 6-12 hours for Amlodipine and 1 hour for Losartan (3-4 hours for its active metabolite).
Metabolism
Amlodipine is extensively metabolized in the liver to inactive metabolites. Losartan undergoes significant first-pass metabolism, forming an active carboxylic acid metabolite (E-3174) responsible for most of the ARB activity.
Side Effects
Contraindications
- Hypersensitivity to Amlodipine, Losartan, or any excipients
- Severe hepatic impairment
- Pregnancy (especially 2nd and 3rd trimesters)
- Bilateral renal artery stenosis
- Concomitant use with Aliskiren in patients with diabetes or renal impairment
Drug Interactions
Lithium
Increased serum lithium concentrations and toxicity.
Aliskiren
Contraindicated in diabetic patients or those with renal impairment when combined with ARBs.
Diuretics and other antihypertensives
Additive hypotensive effects.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
May reduce the antihypertensive effect of Losartan and increase the risk of renal impairment.
CYP3A4 inducers (e.g., rifampicin, St. John's Wort)
May decrease Amlodipine exposure.
CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, ritonavir)
May increase Amlodipine exposure.
Potassium-sparing diuretics, potassium supplements, or salt substitutes containing potassium
May lead to hyperkalemia (due to Losartan).
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 may include severe hypotension, dizziness, reflex tachycardia, and peripheral vasodilation with marked and prolonged systemic hypotension. Management involves symptomatic and supportive measures. If recently ingested, gastric lavage or activated charcoal may be considered. Intravenous fluids and vasopressors may be needed to restore blood pressure.
Pregnancy & Lactation
Lodical Plus is contraindicated in the 2nd and 3rd trimesters of pregnancy due to the risk of fetal injury and death associated with ARBs. If pregnancy is detected, discontinue immediately. It is not recommended during lactation as both Amlodipine and Losartan are excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from the date of manufacture.
Availability
Available in pharmacies nationwide
Approval Status
Approved
Patent Status
Off-patent (Generic available)
WHO Essential Medicine
YesClinical Trials
Clinical trials have demonstrated the efficacy and safety of Amlodipine/Losartan combination in reducing blood pressure and improving cardiovascular outcomes in patients with hypertension.
Lab Monitoring
- Blood pressure regularly
- Serum electrolytes (especially potassium and sodium)
- Renal function (BUN, creatinine)
- Liver function tests
Doctor Notes
- Monitor blood pressure and heart rate regularly.
- Assess renal function and serum electrolytes (especially potassium) periodically.
- Counsel patients on adherence to medication and lifestyle modifications.
- Educate patients on symptoms of hyperkalemia or severe hypotension.
Patient Guidelines
- Take medicine exactly as prescribed by your doctor.
- Do not stop taking the medicine abruptly without consulting your doctor.
- Inform your doctor about all other medications you are taking.
- Report any unusual or severe side effects immediately.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
This medicine may cause dizziness or fatigue, especially at the start of treatment or when the dose is increased. Exercise caution when driving or operating machinery until you know how it affects you.
Lifestyle Advice
- Maintain a healthy diet low in sodium and saturated fats.
- Engage in regular physical activity (e.g., brisk walking) as advised by your doctor.
- Limit alcohol consumption.
- Quit smoking.
- Manage stress effectively.
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Global Brand Names
International brand names for this medicine
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