sb-losak-plus
Generic Name
Losartan Potassium 50 mg & Hydrochlorothiazide 12.5 mg Tablet
Manufacturer
SB Pharma Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| sb losak plus 50 mg tablet | ৳ 8.00 | N/A |
Description
Overview of the medicine
sb-losak-plus 50 mg Tablet is a combination medicine containing Losartan Potassium, an angiotensin II receptor blocker (ARB), and Hydrochlorothiazide, a thiazide diuretic. It is primarily used to treat high blood pressure (hypertension) by relaxing blood vessels and increasing the excretion of water and sodium from the body.
Uses & Indications
Dosage
Adults
The usual starting dose is one sb-losak-plus 50 mg tablet once daily. The dose may be increased to a maximum of Losartan 100 mg / Hydrochlorothiazide 25 mg if blood pressure is not adequately controlled. It can be taken with or without food.
Elderly
No initial dose adjustment is generally needed for elderly patients with normal renal function, but careful monitoring is advised.
Renal_impairment
Not recommended for patients with severe renal impairment (creatinine clearance < 30 mL/min). Dose adjustment may be necessary for moderate impairment; careful monitoring of renal function and electrolytes is required.
How to Take
Take the tablet orally with a glass of water, with or without food, preferably at the same time each day to maintain consistent blood levels.
Mechanism of Action
Losartan blocks the binding of angiotensin II to the AT1 receptor, inhibiting its vasoconstrictor and aldosterone-secreting effects, thereby lowering blood pressure. Hydrochlorothiazide increases the excretion of sodium and chloride by inhibiting their reabsorption in the distal convoluted tubule, leading to increased diuresis and a reduction in blood volume and blood pressure.
Pharmacokinetics
Onset
Antihypertensive effect typically begins within 1 hour, with peak effect observed within 6-8 hours. Maximum blood pressure reduction may take 3-4 weeks.
Excretion
Losartan and its metabolites are excreted via urine (35%) and feces (60%). Hydrochlorothiazide is primarily excreted unchanged in the urine (over 95%).
Half life
Losartan: approximately 2 hours; its active metabolite (E-3174): 6-9 hours. Hydrochlorothiazide: 5-15 hours.
Absorption
Losartan is well absorbed orally, with an average bioavailability of about 33%. Hydrochlorothiazide is rapidly absorbed from the gastrointestinal tract, with a bioavailability of 65-75%.
Metabolism
Losartan undergoes significant first-pass metabolism by cytochrome P450 enzymes (CYP2C9 and CYP3A4) to its active carboxylic acid metabolite (E-3174) and inactive metabolites. Hydrochlorothiazide is not metabolized.
Side Effects
Contraindications
- Hypersensitivity to Losartan, Hydrochlorothiazide, or any sulfonamide-derived drugs.
- Anuria (absence of urine production) or 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 or renal impairment.
Drug Interactions
Lithium
Increased serum lithium concentrations and toxicity.
Corticosteroids
May enhance electrolyte depletion, particularly hypokalemia.
Other antihypertensive agents
Additive hypotensive effect.
Barbiturates, Narcotics, Alcohol
May potentiate orthostatic hypotension.
Cholestyramine and Colestipol resins
May impair absorption of hydrochlorothiazide.
Antidiabetic drugs (oral agents and insulin)
Dosage adjustment may be required as thiazides may decrease glucose tolerance.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
May reduce the antihypertensive effect and worsen renal function.
Potassium-sparing diuretics (e.g., spironolactone, amiloride, triamterene) or Potassium supplements
Increased risk of hyperkalemia.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe hypotension (low blood pressure), tachycardia (fast heartbeat), bradycardia (slow heartbeat), electrolyte depletion, and dehydration. Treatment is symptomatic and supportive; initiate fluid and electrolyte replacement if necessary. Hemodialysis is not effective for Losartan.
Pregnancy & Lactation
Contraindicated during the second and third trimesters of pregnancy due to risk of fetal injury or death. Not recommended during breastfeeding as both Losartan and Hydrochlorothiazide are excreted in breast milk.
Side Effects
Contraindications
- Hypersensitivity to Losartan, Hydrochlorothiazide, or any sulfonamide-derived drugs.
- Anuria (absence of urine production) or 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 or renal impairment.
Drug Interactions
Lithium
Increased serum lithium concentrations and toxicity.
Corticosteroids
May enhance electrolyte depletion, particularly hypokalemia.
Other antihypertensive agents
Additive hypotensive effect.
Barbiturates, Narcotics, Alcohol
May potentiate orthostatic hypotension.
Cholestyramine and Colestipol resins
May impair absorption of hydrochlorothiazide.
Antidiabetic drugs (oral agents and insulin)
Dosage adjustment may be required as thiazides may decrease glucose tolerance.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
May reduce the antihypertensive effect and worsen renal function.
Potassium-sparing diuretics (e.g., spironolactone, amiloride, triamterene) or Potassium supplements
Increased risk of hyperkalemia.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe hypotension (low blood pressure), tachycardia (fast heartbeat), bradycardia (slow heartbeat), electrolyte depletion, and dehydration. Treatment is symptomatic and supportive; initiate fluid and electrolyte replacement if necessary. Hemodialysis is not effective for Losartan.
Pregnancy & Lactation
Contraindicated during the second and third trimesters of pregnancy due to risk of fetal injury or death. 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 2-3 years from the date of manufacture. Refer to the packaging for the exact expiry date.
Availability
Available in pharmacies and hospitals
Approval Status
Approved
Patent Status
Off-patent (Generic available)
WHO Essential Medicine
YesClinical Trials
Losartan and Hydrochlorothiazide, both individually and in combination, have undergone extensive clinical trials demonstrating their efficacy and safety in the management of hypertension and related cardiovascular risks.
Lab Monitoring
- Regular monitoring of blood pressure.
- Serum electrolytes (potassium, sodium) periodically, especially in elderly, renally impaired, or those on concomitant medications.
- Renal function tests (serum creatinine, BUN) periodically.
- Serum uric acid levels (as hydrochlorothiazide can increase levels).
- Blood glucose levels (especially in diabetic patients).
Doctor Notes
- Educate patients about the importance of consistent medication adherence for blood pressure control.
- Monitor renal function and electrolytes (especially potassium) at baseline and periodically during treatment.
- Advise patients on lifestyle modifications, including diet and exercise, to enhance therapeutic outcomes.
- Caution against the use in pregnant women and women planning pregnancy due to fetal toxicity risk.
Patient Guidelines
- Take the medicine regularly as prescribed by your doctor, even if you feel well.
- Do not stop taking the medicine without consulting your doctor.
- Avoid sudden changes in position to prevent dizziness.
- Report any unusual side effects like swelling of the face, lips, or throat immediately.
- Maintain a low-sodium diet and avoid potassium supplements unless advised by your doctor.
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
This medicine may cause dizziness or lightheadedness, especially when starting treatment or increasing the dose. Exercise caution when driving or operating machinery until you know how it affects you.
Lifestyle Advice
- Adopt a healthy lifestyle including a balanced diet rich in fruits and vegetables, and low in saturated fats and cholesterol.
- Regular physical activity (e.g., brisk walking for at least 30 minutes most days of the week).
- Maintain a healthy weight.
- Limit alcohol consumption.
- Quit smoking.
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