Orbas Plus
Generic Name
Losartan Potassium + Hydrochlorothiazide
Manufacturer
Popular Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| orbas plus 20 mg tablet | ৳ 8.03 | ৳ 80.30 |
Description
Overview of the medicine
Orbas Plus is a combination medicine containing Losartan Potassium, an angiotensin II receptor blocker (ARB), and Hydrochlorothiazide, a thiazide diuretic. It is used to treat high blood pressure (hypertension) to lower the risk of stroke, heart attack, and kidney problems.
Uses & Indications
Dosage
Adults
Typically one tablet of Losartan 50 mg/Hydrochlorothiazide 12.5 mg once daily. May be increased to Losartan 100 mg/Hydrochlorothiazide 12.5 mg once daily if needed.
Elderly
Similar to adults, but dosage adjustment may be needed based on renal function.
Renal_impairment
Not recommended for patients with severe renal impairment (creatinine clearance < 30 mL/min). Lower doses may be considered for moderate impairment.
How to Take
Take orally, once daily with or without food. It is recommended to take it at the same time each day.
Mechanism of Action
Losartan blocks the vasoconstricting and aldosterone-secreting effects of angiotensin II, leading to vasodilation and reduced blood pressure. Hydrochlorothiazide increases the excretion of sodium and chloride by inhibiting their reabsorption in the distal convoluted tubule, leading to fluid loss and lowered blood pressure.
Pharmacokinetics
Onset
Losartan: Antihypertensive effect within 6 hours. Hydrochlorothiazide: Diuretic effect within 2 hours.
Excretion
Losartan: Both renal (35%) and biliary/fecal (60%) excretion. Hydrochlorothiazide: Primarily renal excretion (95% unchanged).
Half life
Losartan: ~2 hours (parent drug), ~6-9 hours (active metabolite). Hydrochlorothiazide: 5.6-14.8 hours.
Absorption
Losartan: Well absorbed orally, undergoes first-pass metabolism. Bioavailability ~33%. Hydrochlorothiazide: Well absorbed, bioavailability ~65-75%.
Metabolism
Losartan: Extensively metabolized by CYP2C9 and CYP3A4 to an active carboxylic acid metabolite. Hydrochlorothiazide: Not metabolized.
Side Effects
Contraindications
- Anuria
- Hypersensitivity to losartan, hydrochlorothiazide, or sulfonamide-derived drugs
- Pregnancy (second and third trimesters)
- Severe hepatic impairment
- Refractory hypokalemia, hyponatremia, hypercalcemia, and symptomatic hyperuricemia
Drug Interactions
Lithium
Increased serum lithium concentrations and toxicity.
Corticosteroids, ACTH
Intensified electrolyte depletion, particularly hypokalemia.
ACE inhibitors or Aliskiren
Increased risk of hyperkalemia, renal impairment, and hypotension (especially in diabetics).
Alcohol, barbiturates, or narcotics
Potentiation of orthostatic hypotension.
NSAIDs (Nonsteroidal anti-inflammatory drugs)
May reduce the antihypertensive effect and increase the risk of renal impairment.
Potassium-sparing diuretics (e.g., spironolactone, amiloride), potassium supplements, or salt substitutes containing potassium
Increased risk of hyperkalemia.
Storage
Store below 30°C, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe hypotension, tachycardia, bradycardia (less common), and electrolyte depletion (e.g., hypokalemia, hyponatremia). Management is supportive and symptomatic; correct electrolyte abnormalities and maintain hydration. Hemodialysis is not effective.
Pregnancy & Lactation
Pregnancy: Category D. Contraindicated in the second and third trimesters due to fetal toxicity. Discontinue as soon as pregnancy is detected. Lactation: Not recommended. Losartan and hydrochlorothiazide are excreted in breast milk.
Side Effects
Contraindications
- Anuria
- Hypersensitivity to losartan, hydrochlorothiazide, or sulfonamide-derived drugs
- Pregnancy (second and third trimesters)
- Severe hepatic impairment
- Refractory hypokalemia, hyponatremia, hypercalcemia, and symptomatic hyperuricemia
Drug Interactions
Lithium
Increased serum lithium concentrations and toxicity.
Corticosteroids, ACTH
Intensified electrolyte depletion, particularly hypokalemia.
ACE inhibitors or Aliskiren
Increased risk of hyperkalemia, renal impairment, and hypotension (especially in diabetics).
Alcohol, barbiturates, or narcotics
Potentiation of orthostatic hypotension.
NSAIDs (Nonsteroidal anti-inflammatory drugs)
May reduce the antihypertensive effect and increase the risk of renal impairment.
Potassium-sparing diuretics (e.g., spironolactone, amiloride), potassium supplements, or salt substitutes containing potassium
Increased risk of hyperkalemia.
Storage
Store below 30°C, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe hypotension, tachycardia, bradycardia (less common), and electrolyte depletion (e.g., hypokalemia, hyponatremia). Management is supportive and symptomatic; correct electrolyte abnormalities and maintain hydration. Hemodialysis is not effective.
Pregnancy & Lactation
Pregnancy: Category D. Contraindicated in the second and third trimesters due to fetal toxicity. Discontinue as soon as pregnancy is detected. Lactation: Not recommended. Losartan and hydrochlorothiazide are excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24-36 months (check product specific label)
Availability
Available in pharmacies nationwide
Approval Status
Approved by DGDA (Bangladesh)
Patent Status
Generic available
Clinical Trials
Clinical trials have shown the efficacy and safety of Losartan/Hydrochlorothiazide combination in reducing blood pressure and cardiovascular events in hypertensive patients.
Lab Monitoring
- Serum electrolytes (potassium, sodium)
- Renal function (creatinine, BUN)
- Liver function tests
- Uric acid levels
- Blood glucose (especially in diabetics)
Doctor Notes
- Monitor serum electrolytes and renal function periodically.
- Educate patients on symptoms of hypotension and electrolyte imbalance.
- Avoid in pregnant patients and those with severe renal impairment.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor.
- Do not stop taking it without consulting your doctor, even if you feel well.
- Monitor your blood pressure regularly as advised by your doctor.
- Report any unusual side effects, especially dizziness or fainting.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose.
Driving Precautions
May cause dizziness or fatigue, especially at the start of treatment or when the dose is increased. Avoid driving or operating machinery until you know how the medicine affects you.
Lifestyle Advice
- Adopt a healthy diet low in sodium and saturated fats.
- Engage in regular physical activity.
- Maintain a healthy weight.
- Limit alcohol consumption.
- Quit smoking.
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