Losardil
Generic Name
Losartan Potassium 100 mg & Hydrochlorothiazide 25 mg
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| losardil 10025 100 mg tablet | ৳ 12.05 | ৳ 120.50 |
Description
Overview of the medicine
Losardil 100/25 is a combination medication containing Losartan, an Angiotensin II Receptor Blocker, and Hydrochlorothiazide, a thiazide diuretic. It is primarily used to treat high blood pressure (hypertension) and to reduce the risk of stroke in patients with hypertension and left ventricular hypertrophy.
Uses & Indications
Dosage
Adults
The usual starting and maintenance dose is one Losardil 100/25 tablet once daily. The maximum effect is generally achieved within 3-4 weeks of starting treatment.
Elderly
No initial dosage adjustment is generally needed for elderly patients with normal renal function. However, caution should be exercised in very elderly patients.
Renal_impairment
Use with caution. Not recommended for patients with severe renal impairment (creatinine clearance <30 mL/min). Regular monitoring of renal function and potassium levels is advised.
How to Take
Losardil 100/25 tablets are for oral administration and can be taken with or without food. It is recommended to take the tablet at approximately the same time each day to maintain consistent blood levels.
Mechanism of Action
Losartan selectively blocks the angiotensin II type 1 (AT1) receptor, preventing angiotensin II from binding and causing vasoconstriction and aldosterone release. This leads to vasodilation and reduced blood pressure. Hydrochlorothiazide inhibits sodium and chloride reabsorption in the distal convoluted tubule of the kidney, leading to increased excretion of sodium, chloride, and water, thus reducing blood volume and blood pressure.
Pharmacokinetics
Onset
Antihypertensive effect of Losartan generally begins within 1 hour, with peak effect in about 6 hours. Hydrochlorothiazide's diuretic effect begins within 2 hours.
Excretion
Losartan is excreted in both urine (~35%) and feces (~60%) as unchanged drug and metabolites. Hydrochlorothiazide is primarily excreted unchanged in the urine, with approximately 95% of the oral dose eliminated renally.
Half life
Losartan has a terminal half-life of about 2 hours, and its active metabolite (E-3174) has a half-life of 6-9 hours. Hydrochlorothiazide has a half-life of 5.6-14.8 hours.
Absorption
Losartan is well absorbed orally, with approximately 33% bioavailability. It undergoes extensive first-pass metabolism. Hydrochlorothiazide is rapidly absorbed from the gastrointestinal tract, with bioavailability ranging from 65-75%.
Metabolism
Losartan undergoes extensive hepatic metabolism, primarily by CYP2C9 and CYP3A4, to an active carboxylic acid metabolite (E-3174) and several inactive metabolites. Hydrochlorothiazide is not metabolized and is excreted unchanged.
Side Effects
Contraindications
- Hypersensitivity to Losartan, Hydrochlorothiazide, or sulfonamide-derived drugs.
- Anuria.
- Severe renal impairment (creatinine clearance <30 mL/min).
- Severe hepatic impairment.
- Pregnancy (especially second and third trimesters).
- Concomitant use with aliskiren in patients with diabetes mellitus or renal impairment.
Drug Interactions
NSAIDs
Non-steroidal anti-inflammatory drugs (NSAIDs), including selective COX-2 inhibitors, may reduce the antihypertensive effect of ARBs and diuretics, and may increase the risk of renal impairment, especially in dehydrated or elderly patients.
Lithium
Concurrent use with lithium may increase serum lithium concentrations and lead to lithium toxicity. Regular monitoring of serum lithium levels is recommended.
Other antihypertensive agents
Concomitant use with other antihypertensives may result in an additive hypotensive effect.
Alcohol, barbiturates, narcotics
May potentiate orthostatic hypotension (a sudden drop in blood pressure upon standing).
Potassium-sparing diuretics/Potassium supplements
May increase the risk of hyperkalemia. Close monitoring of serum potassium is necessary.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children. Do not freeze.
Overdose
Symptoms of overdose include hypotension (low blood pressure), tachycardia (rapid heartbeat), and possibly bradycardia (slow heartbeat). Due to hydrochlorothiazide, electrolyte depletion (hypokalemia, hyponatremia) and dehydration may also occur. Treatment is symptomatic and supportive. If ingestion is recent, gastric lavage may be considered. Administer activated charcoal to reduce absorption.
Pregnancy & Lactation
Losardil 100/25 is contraindicated during pregnancy, especially in the second and third trimesters, due to the risk of fetal harm and death. If pregnancy is detected, the medication should be stopped immediately. It is not recommended during lactation due to the potential for adverse effects on the nursing infant.
Side Effects
Contraindications
- Hypersensitivity to Losartan, Hydrochlorothiazide, or sulfonamide-derived drugs.
- Anuria.
- Severe renal impairment (creatinine clearance <30 mL/min).
- Severe hepatic impairment.
- Pregnancy (especially second and third trimesters).
- Concomitant use with aliskiren in patients with diabetes mellitus or renal impairment.
Drug Interactions
NSAIDs
Non-steroidal anti-inflammatory drugs (NSAIDs), including selective COX-2 inhibitors, may reduce the antihypertensive effect of ARBs and diuretics, and may increase the risk of renal impairment, especially in dehydrated or elderly patients.
Lithium
Concurrent use with lithium may increase serum lithium concentrations and lead to lithium toxicity. Regular monitoring of serum lithium levels is recommended.
Other antihypertensive agents
Concomitant use with other antihypertensives may result in an additive hypotensive effect.
Alcohol, barbiturates, narcotics
May potentiate orthostatic hypotension (a sudden drop in blood pressure upon standing).
Potassium-sparing diuretics/Potassium supplements
May increase the risk of hyperkalemia. Close monitoring of serum potassium is necessary.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children. Do not freeze.
Overdose
Symptoms of overdose include hypotension (low blood pressure), tachycardia (rapid heartbeat), and possibly bradycardia (slow heartbeat). Due to hydrochlorothiazide, electrolyte depletion (hypokalemia, hyponatremia) and dehydration may also occur. Treatment is symptomatic and supportive. If ingestion is recent, gastric lavage may be considered. Administer activated charcoal to reduce absorption.
Pregnancy & Lactation
Losardil 100/25 is contraindicated during pregnancy, especially in the second and third trimesters, due to the risk of fetal harm and death. If pregnancy is detected, the medication should be stopped immediately. It is not recommended during lactation due to the potential for adverse effects on the nursing infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months from the date of manufacture when stored under recommended conditions.
Availability
Pharmacies, Hospitals
Approval Status
Approved
Patent Status
Generic Available (Patent Expired for components)
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of Losartan/Hydrochlorothiazide combinations in treating essential hypertension and reducing cardiovascular risks, including stroke, in appropriate patient populations.
Lab Monitoring
- Serum electrolytes (especially potassium, sodium, magnesium, calcium) regularly, as hydrochlorothiazide can cause imbalances.
- Renal function (BUN, creatinine) before starting therapy and periodically thereafter.
- Liver function tests.
- Uric acid levels, as hydrochlorothiazide can increase them.
- Blood glucose levels, especially in diabetic patients.
Doctor Notes
- Emphasize the importance of consistent medication adherence for optimal blood pressure control.
- Regularly monitor renal function, serum electrolytes (especially potassium), and uric acid levels, particularly in elderly patients or those with pre-existing renal impairment.
- Advise patients about potential symptoms of orthostatic hypotension and how to mitigate them.
- Counsel female patients of childbearing potential about the fetal toxicity risk and the need for effective contraception.
- Consider potential drug-drug interactions, especially with NSAIDs, potassium supplements, and lithium.
Patient Guidelines
- Take Losardil 100/25 exactly as prescribed by your doctor.
- Do not stop taking the medication abruptly without consulting your doctor, even if you feel better.
- Regularly monitor your blood pressure at home as advised by your physician.
- Inform your doctor about all other medications you are taking, including over-the-counter drugs and herbal supplements.
- Report any unusual symptoms or side effects immediately to your doctor.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. However, 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
Losardil 100/25 may cause dizziness or lightheadedness, especially when initiating treatment or increasing the dose. Patients should be cautious when driving or operating machinery until they know how the medication affects them.
Lifestyle Advice
- Maintain a healthy and balanced diet, low in sodium and saturated fats.
- Engage in regular physical activity as recommended by your doctor.
- Avoid smoking and limit alcohol consumption.
- Manage stress through relaxation techniques or hobbies.
- Achieve and maintain a healthy weight.
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