Lopo-Plus
Generic Name
Losartan Potassium + Hydrochlorothiazide
Manufacturer
Incepta Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| lopo plus 50 mg tablet | ৳ 9.00 | ৳ 90.00 |
Description
Overview of the medicine
Lopo-Plus 50 mg Tablet is a combination medicine used to treat high blood pressure (hypertension). It contains Losartan Potassium, an Angiotensin Receptor Blocker (ARB), and Hydrochlorothiazide, a thiazide diuretic. This combination helps to effectively lower blood pressure by relaxing blood vessels and increasing the excretion of excess fluid.
Uses & Indications
Dosage
Adults
The usual starting dose is one Lopo-Plus 50 mg tablet once daily. The dose may be adjusted by the physician based on blood pressure response. Maximum daily dose is generally one Lopo-Plus 100/25 tablet if combination with higher HCTZ is needed.
Elderly
No initial dosage adjustment is typically required, but caution is advised in patients with potential volume depletion or renal impairment.
Renal_impairment
Not recommended in patients with severe renal impairment (creatinine clearance < 30 mL/min). Dose adjustment may be necessary in moderate impairment.
How to Take
Take the tablet orally once daily with or without food. It is recommended to take it at the same time each day to maintain consistent blood levels.
Mechanism of Action
Losartan Potassium selectively blocks the binding of angiotensin II to the AT1 receptor, reducing vasoconstriction and aldosterone secretion. Hydrochlorothiazide inhibits sodium reabsorption in the distal convoluted tubules, increasing the excretion of sodium, chloride, and water, thereby lowering blood pressure and reducing fluid retention.
Pharmacokinetics
Onset
Losartan: Peak blood pressure reduction within 6 hours. Hydrochlorothiazide: Diuretic effect within 2 hours, antihypertensive effect within 3-4 days.
Excretion
Losartan: Excreted via feces (60%) and urine (35-40%). Hydrochlorothiazide: Primarily renal excretion as unchanged drug.
Half life
Losartan: Approximately 2 hours; its active metabolite (E-3174) has a half-life of 6-9 hours. Hydrochlorothiazide: 5.6 to 14.8 hours.
Absorption
Losartan is well absorbed orally, with approximately 33% systemic bioavailability. It undergoes significant first-pass metabolism. Hydrochlorothiazide is rapidly absorbed, with bioavailability ranging from 65-75%.
Metabolism
Losartan is extensively metabolized by CYP2C9 and CYP3A4 to an active carboxylic acid metabolite (E-3174) and inactive metabolites. Hydrochlorothiazide is not metabolized and is excreted unchanged.
Side Effects
Contraindications
- Hypersensitivity to Losartan, Hydrochlorothiazide, or sulfonamide-derived drugs
- Anuria
- Pregnancy (second and third trimesters)
- Severe renal impairment (creatinine clearance < 30 mL/min)
- Severe hepatic impairment
- Concomitant use with aliskiren in patients with diabetes mellitus
Drug Interactions
Lithium
May increase serum lithium levels and lithium toxicity. Careful monitoring is required.
Alcohol, barbiturates, or narcotics
May potentiate orthostatic hypotension (dizziness upon standing).
Antidiabetic drugs (oral agents and insulin)
Dosage adjustment of antidiabetic drugs may be required.
NSAIDs (Nonsteroidal Anti-Inflammatory Drugs)
May reduce the antihypertensive effect and increase the risk of renal impairment, especially in elderly or dehydrated patients.
Potassium-sparing diuretics or potassium supplements
Increased risk of hyperkalemia (high potassium levels).
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 include hypotension (low blood pressure), tachycardia (rapid heartbeat), or bradycardia (slow heartbeat). Management is supportive and symptomatic, including intravenous fluid administration and close monitoring of vital signs.
Pregnancy & Lactation
Contraindicated during the second and third trimesters of pregnancy due to fetal toxicity. Not recommended during breastfeeding, as both Losartan and Hydrochlorothiazide are excreted in breast milk.
Side Effects
Contraindications
- Hypersensitivity to Losartan, Hydrochlorothiazide, or sulfonamide-derived drugs
- Anuria
- Pregnancy (second and third trimesters)
- Severe renal impairment (creatinine clearance < 30 mL/min)
- Severe hepatic impairment
- Concomitant use with aliskiren in patients with diabetes mellitus
Drug Interactions
Lithium
May increase serum lithium levels and lithium toxicity. Careful monitoring is required.
Alcohol, barbiturates, or narcotics
May potentiate orthostatic hypotension (dizziness upon standing).
Antidiabetic drugs (oral agents and insulin)
Dosage adjustment of antidiabetic drugs may be required.
NSAIDs (Nonsteroidal Anti-Inflammatory Drugs)
May reduce the antihypertensive effect and increase the risk of renal impairment, especially in elderly or dehydrated patients.
Potassium-sparing diuretics or potassium supplements
Increased risk of hyperkalemia (high potassium levels).
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 include hypotension (low blood pressure), tachycardia (rapid heartbeat), or bradycardia (slow heartbeat). Management is supportive and symptomatic, including intravenous fluid administration and close monitoring of vital signs.
Pregnancy & Lactation
Contraindicated during the second and third trimesters of pregnancy due to fetal toxicity. Not recommended during breastfeeding, as both Losartan and Hydrochlorothiazide are excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2 to 3 years from the date of manufacture. Refer to the packaging for the exact expiry date.
Availability
Available in pharmacies nationwide
Approval Status
Approved by regulatory bodies (e.g., DGDA)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of Losartan Potassium and Hydrochlorothiazide combination in managing hypertension and reducing associated cardiovascular risks.
Lab Monitoring
- Serum electrolytes (potassium, sodium)
- Renal function (creatinine, BUN)
- Liver function tests
- Blood glucose (especially in diabetic patients)
Doctor Notes
- Emphasize adherence to therapy and lifestyle modifications.
- Monitor blood pressure, renal function, and serum electrolytes periodically.
- Educate patients on potential signs of angioedema or severe electrolyte imbalance.
- Avoid in pregnant patients and those with severe renal/hepatic impairment.
Patient Guidelines
- Take this medicine regularly as prescribed by your doctor, even if you feel well.
- Do not stop taking this medicine suddenly without consulting your doctor.
- Monitor your blood pressure regularly at home if advised by your doctor.
- Inform your doctor about all other medications, supplements, and herbal products you are taking.
Missed Dose Advice
If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to make up for a missed one.
Driving Precautions
This medicine may cause dizziness or lightheadedness, especially at the start of treatment or when the dose is increased. Avoid driving or operating machinery until you know how this medicine affects you.
Lifestyle Advice
- Follow a low-sodium diet and avoid foods high in potassium, unless advised otherwise by your doctor.
- Engage in regular physical activity as recommended by your healthcare provider.
- Limit alcohol consumption and avoid smoking.
- Maintain a healthy weight.
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