Presart
Generic Name
Losartan Potassium
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| presart 20 mg tablet | ৳ 7.00 | ৳ 70.00 |
Description
Overview of the medicine
Presart 20 mg Tablet contains Losartan Potassium, an Angiotensin Receptor Blocker (ARB) used to treat high blood pressure, protect kidneys in diabetes, and reduce the risk of stroke in patients with high blood pressure and an enlarged heart.
Uses & Indications
Dosage
Adults
The usual starting dose for hypertension is 50 mg once daily. For Presart 20 mg, it may be used as an initial lower dose or for specific patient requirements, adjusted as needed, typically up to 100 mg daily.
Elderly
No initial dosage adjustment is usually required for elderly patients, but a lower starting dose (e.g., 25 mg) may be considered, especially in those over 75 years.
Renal_impairment
No initial dosage adjustment is required for patients with mild to moderate renal impairment. For severe renal impairment or dialysis patients, a lower starting dose (e.g., 25 mg) should be considered.
How to Take
Presart 20 mg Tablet should be taken orally, once daily, with or without food. It is recommended to 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). This blockade prevents the vasoconstricting and aldosterone-secreting effects of angiotensin II, leading to vasodilation and reduced blood pressure.
Pharmacokinetics
Onset
Significant blood pressure reduction typically seen within 6 hours, full effect within 3-6 weeks.
Excretion
Approximately 35% excreted in urine (4% as unchanged Losartan, 6% as active metabolite) and 60% in feces (58% as unchanged Losartan, 13% as active metabolite).
Half life
Losartan: approximately 2 hours; active metabolite (E-3174): 6-9 hours.
Absorption
Rapidly absorbed from the gastrointestinal tract; approximately 33% systemic bioavailability. Peak plasma concentration reached in 1 hour for Losartan and 3-4 hours for its active metabolite.
Metabolism
Undergoes extensive first-pass metabolism by CYP2C9 and CYP3A4 enzymes in the liver to form an active carboxylic acid metabolite (E-3174), which is more potent than Losartan.
Side Effects
Contraindications
- Hypersensitivity to Losartan or any component of the tablet.
- Pregnancy (especially second and third trimesters).
- Concomitant use with Aliskiren in patients with diabetes or moderate to severe renal impairment (eGFR < 60 mL/min/1.73 m²).
- History of angioedema related to previous ACE inhibitor or ARB therapy.
Drug Interactions
Lithium
Increased serum lithium concentrations and lithium toxicity have been reported with ACE inhibitors and ARBs. Monitor serum lithium levels carefully.
Rifampicin, Fluconazole
May reduce the active metabolite levels of Losartan.
Other antihypertensive agents
Additive hypotensive effects. Dose adjustments may be necessary.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs), including selective COX-2 inhibitors
May reduce the antihypertensive effect of Losartan and can lead to deterioration of renal function, including possible acute renal failure, especially in dehydrated or elderly patients. Monitor renal function.
Potassium-sparing diuretics (e.g., Spironolactone, Amiloride, Triamterene) or Potassium supplements
May lead to increased serum potassium levels (hyperkalemia).
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Limited data are available regarding overdose in humans. The most likely manifestations of overdose would be hypotension and tachycardia; bradycardia could occur from parasympathetic (vagal) stimulation. Treatment should be supportive and symptomatic. Gastric lavage may be considered soon after ingestion.
Pregnancy & Lactation
Presart 20 mg Tablet is contraindicated during the second and third trimesters of pregnancy due to the risk of fetal harm or death. It is not recommended during the first trimester. It is not known if Losartan is excreted in human milk; caution should be exercised when administered to a nursing mother. A decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Side Effects
Contraindications
- Hypersensitivity to Losartan or any component of the tablet.
- Pregnancy (especially second and third trimesters).
- Concomitant use with Aliskiren in patients with diabetes or moderate to severe renal impairment (eGFR < 60 mL/min/1.73 m²).
- History of angioedema related to previous ACE inhibitor or ARB therapy.
Drug Interactions
Lithium
Increased serum lithium concentrations and lithium toxicity have been reported with ACE inhibitors and ARBs. Monitor serum lithium levels carefully.
Rifampicin, Fluconazole
May reduce the active metabolite levels of Losartan.
Other antihypertensive agents
Additive hypotensive effects. Dose adjustments may be necessary.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs), including selective COX-2 inhibitors
May reduce the antihypertensive effect of Losartan and can lead to deterioration of renal function, including possible acute renal failure, especially in dehydrated or elderly patients. Monitor renal function.
Potassium-sparing diuretics (e.g., Spironolactone, Amiloride, Triamterene) or Potassium supplements
May lead to increased serum potassium levels (hyperkalemia).
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Limited data are available regarding overdose in humans. The most likely manifestations of overdose would be hypotension and tachycardia; bradycardia could occur from parasympathetic (vagal) stimulation. Treatment should be supportive and symptomatic. Gastric lavage may be considered soon after ingestion.
Pregnancy & Lactation
Presart 20 mg Tablet is contraindicated during the second and third trimesters of pregnancy due to the risk of fetal harm or death. It is not recommended during the first trimester. It is not known if Losartan is excreted in human milk; caution should be exercised when administered to a nursing mother. A decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2 to 3 years from the date of manufacture, depending on storage conditions.
Availability
Pharmacies, hospitals
Approval Status
Approved by FDA/DGDA
Patent Status
Patent expired, generic versions available
WHO Essential Medicine
YesClinical Trials
Losartan's efficacy and safety have been established through large-scale clinical trials such as the LIFE (Losartan Intervention For Endpoint reduction in hypertension) study, which demonstrated its superior ability to reduce cardiovascular morbidity and mortality compared to atenolol in hypertensive patients with left ventricular hypertrophy, and the RENAAL (Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan) study, showing renoprotective effects in type 2 diabetic patients with nephropathy.
Lab Monitoring
- Serum electrolytes (especially potassium) should be monitored periodically, particularly in patients with renal impairment or those taking potassium-sparing diuretics.
- Renal function (serum creatinine, eGFR) should be monitored before and periodically during therapy, especially in patients with pre-existing renal disease or those at risk of renal deterioration.
Doctor Notes
- Regular monitoring of blood pressure, renal function (creatinine, GFR), and serum potassium levels is crucial, especially at the initiation of therapy and after dose adjustments.
- Educate patients on the importance of adherence to therapy and lifestyle modifications.
- Avoid use in pregnant women and women planning to conceive. Ensure appropriate contraception if necessary.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor, usually once daily.
- Do not stop taking Presart 20 mg Tablet abruptly without consulting your doctor, even if you feel well, as blood pressure may rise.
- Inform your doctor or pharmacist 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. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Presart 20 mg Tablet may cause dizziness or lightheadedness, especially when initiating therapy or increasing the dose. Patients should be cautioned about operating machinery or driving until they know how the medication affects them.
Lifestyle Advice
- Adopt a healthy lifestyle, including a balanced diet low in sodium and saturated fats.
- Engage in regular physical activity as advised by your doctor.
- Avoid or limit alcohol consumption and stop smoking.
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