Cozaar medicine 50mg MSD treats hypertension (2 blisters x 15 tablets)

Dosage form Box of 2 blisters x 15 tablets
Specifications Losartan
Ingredient Myocardial infarction, psoriasis, high blood pressure

Ingredient

Composition information	Content
Losartan	50mg

Uses

Indications

Cozaar drug is indicated in the following cases:

Hypertension:

Treatment of hypertension. Type 2 diabetes and diabetes, with proteinuria greater than 0.5g/day

slow down the process of renal disease progression, determined by reducing the incidence of coordination events doubling blood creatinine levels, the end stage of kidney disease (hemolysis or kidney transplantation), or death and lower proteinuria.

Pharmacy

angiotensin II is attached to the AT1 receptor, in many types of tissue (for example, blood vessel, adrenal, kidney, heart) and create important biological effects, including vasoconstriction and aldosterone secretion. Angiotensin II also stimulates smooth muscle cell proliferation.

Through in vito and in vivo results, both Losartan and carboxylic acid metabolites with pharmacological activity (E-3174) will seal all the above physiological effects of Angiotensin II, regardless of the origin or synthetic path of Angiotensin II.

When using Losartan, the negative response of Angiotensin II for renin secretion will no longer exist, leading to increased renin activity in plasma and eventually increasing the angiotensin II in plasma. Despite increased concentration of these substances, the effect of lowering blood pressure and keeping the level of Aldosterone is not high in plasma is still maintained, proving the effective inhibiting the Angiotensin II receptor.

Losartan is selectively attached to the AT1 receptor, which is not attached or sealed with other hormone receptors or important ion channels in the cardiovascular regulation. Moreover, Losartan does not inhibit Angiotensin (ACE) (Kininase II), which is Bradykinin decomposition. Therefore, what effects are not related to the AT1 receptor closing, such as increasing the effect of Bradykinin intermediaries or the effect of edema does not occur when using Losartan.

Losartan inhibits response to angiotensin I and II response without affecting the response to Bradykinin, this finding is suitable for the specific mechanism of action of Losartan. In contrast, the ACE enzyme inhibitors are blocked with angiotensin I response and increases the response to Bradykinin without inhibiting response to angiotensin II. This is the difference in pharmacological resources between Losartan and ACE transfer inhibitors.

In a specially designed study to evaluate the cough ratio in patients with cozaar compared to patients with ACE enzyme inhibitors, the cough ratio in cozaar users or the Hydrochlorothiazide group is equal and significantly lower than in the ACE enzyme inhibitor group.

In patients with hypertension without diabetes and proteinuria, Losartan significantly reduces proteinuria, reduces albumin and IgG. Losartan maintains glomerular filtration and reduces the filter volume. In general, Losartan reduces uric acid in serum (usually

For patients with left ventricular failure, dose of 25mg and 50mg Losartan causes positive effects on hemodynamics and nerves, characterized by an increase in the heart index and decreased pulmonary capillary pressure, body blood vessels, average body blood pressure, heart rate and decrease in respectively aldosterone and norepinephrine in blood. Hypotension in people with heart failure depends on the dose.

pharmacokinetic

absorption

Birth of the body of Losartan tablets is about 33%. The average peak concentration of Losartan and of the metabolites is activity achieved after one hour (with Losartan) and 3-4 hours (with metabolites).

Distribution

Both Losartan and metabolites have an activity attaching ≥ 99% to plasma proteins, mainly on albumin. Losartan's VD distribution volume is 34L.

Metabolism

About 14% of the intravenous or oral dose of Losartan is converted into biological metabolites. After drinking and intravenously Losartan Kali, which marks 14C, the cycle marks in plasma are mainly losartan and active metabolites. The minimum metabolism of Losartan into an active metabolite is about 1% of researchers.

In addition to active metabolites, there are also non-active metabolites formed, including two main substances created by the Butyl branch hydroxylation and auxiliary metabolic substance, N-2 Tetrazole Glucuronide.

Elimination

Losartan's plasma purification is 600ml/min, of the active metabolite is 50ml/minute. Losartan's kidney purification is about 74ml/minute and of an active metabolite of 26ml/minute. When using Losartan by oral, about 4% of the dose will be excreted intact through the urine and about 6% of the dose will be through urine in the form of active metabolites.

Losartan and metabolites are discharged through bile and urine. After taking a dose of Losartan marked with 14C, about 35% of the markers found in the urine, 58% found in feces.

Before taking Cozaar medicine 50mg MSD treats hypertension (2 blisters x 15 tablets)

How to use

can drink cozaar when hungry or full.

Can take cozaar along with other hypertension medications.

Dosage

Hypertension

Initial and maintained dose for most patients is 50mg, taken once a day. The maximum effect of treating hypertension reaches 3-6 weeks after starting the medication. Increasing dose to 100mg, once a day can be helpful for some patients.

For patients with reduced circulatory volume (for example, high -dose dosage medical treatment), should consider the starting dose of 25mg, once a day.

No need to adjust the starting dose for elderly patients or kidney failure even if you are hemolysis. Need to consider lower doses for you with a history of liver failure.

Reduce the risk of cardiovascular disease and cardiovascular death for adult patients with hypertension with left ventricular hypertrophy.

Normally, the starting dose is 50mg of cozaar, drink once a day. Low -dose Hydrochlorothiazide can be added or increased by cozaar dose to 100mg, once a day depending on the response on blood pressure.

Treatment of kidney disease in adult patients with hypertension and type 2 diabetes, with proteinuria greater than 0.5g/day

Normally, the starting dose is 50mg of cozaar, drink once a day. Cozaar dose can be increased to 100mg, once a day depending on the response on blood pressure. Cozaar can be used with other hypertension drugs (for example: diuretics, calcium channel blockers, alpha or beta blockers, and central acting drugs) as well as insulin and other common hypoglycemic drugs (such as sulfonylurea, glitazone and glucosidase inhibitors).

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

What to do when overdose? The most common manifestation of overdose is hypotension and fast heartbeat, which can also have a slow heartbeat due to sympathetic nerve stimulation (vagus nerves). If symptomatic hypotension occurs, it is necessary to take supportive treatments.

Cannot remove Losartan or metabolites that are still active of Losartan by blood decentralization.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

When using Cozaar, you may experience unwanted effects (ADR).

Common, ADR> 1/100

Body: weakness, fatigue, chest pain, swelling/swelling. Sore throat, sinus disorders, upper respiratory infections.

Rare, ADR

The immune system: Ban Henoch-Schoenlein.

The digestive system: Hepatitis.

The immune system: Anaphylactic reactions, angiography, including laryngeal edema and drum jams or face edema, lips, throat or tongue.

Nervous/mental system: migraine (migraine), taste buds.

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Contraindicated

Cozaar drugs are contraindicated in the following cases: Hypersensitivity to active ingredients or any excipients listed in the ingredients.

Precautions when using

sensitive

Tharma.

Hypotension and water/electrolyte imbalance

In patients, the patient reduces the volume of circulatory (such as a high -dose diuretic treatmenter) may occur symptomatic hypotension. These conditions must be adjusted before using cozaar, or a lower starting dose.

Common electrolyte imbalance on kidney failure patients, with or without diabetes and this is a problem to be solved. In a clinical study conducted in patients with type 2 diabetes, proteinuria, hyperkalemia rate in the cozaar treatment group higher than the control group; However, only few patients have to stop treating due to hyperkalemia.

Liver function

Based on the pharmacokinetics data on Losartan concentration in plasma significantly increasing in patients with cirrhosis, it is necessary to consider lower doses for patients with a history of liver failure.

Renal function

As a result of the inhibition of the Renin-Anotensin system, there have been reports on renal function changes, including kidney failure in sensitive people, these kidney function changes can recover when stopping the drug.

Other drugs that act on the renin-analiotensin system can cause hyperurine and serum creatinine in patients with narrowed kidney stenosis on both sides or kidney stenosis in humans with only one kidney. There have been reports on these side effects in patients using Cozaar, these renal function changes can recover when stopping the drug.

Use for children

Cozaar's hypotension effect in children from> 1 month to 16 years old with hypertension has been proven. Using Cozaar in these age groups has been strengthened by evidence from good and appropriate control studies in children and adults using Cozaar as well as the literature of the use of drugs in children.

For children who can swallow the pills, the recommended dose is 25mg/time/day in patients with severe patients> 20kg to 50kg, the starting dose is 50mg, once a day. Can increase the dose to up to 100mg, 1 time.

On patients with a decrease in the volume of circulating, this condition should be adjusted before using Cozaar.

Harmful reactions occur in children when using the drug is similar to the observed reactions in adults.

Do not recommend the use of cozaar in pediatric patients with glomerular filtration

Used for the elderly

In clinical studies, there is no difference in effectiveness and safety of Losartan related to age.

The ability to drive and operate machinery

has not conducted any research of Cozaar about the image towards driving and operating machinery. However, some of Cozaar's adverse effects have been reported that can affect the ability of patients to drive and operate machinery. The response of each individual with cozaar is different.

Pregnancy

When used in the middle and the last three months of pregnancy, the drug has a direct use of the renin-angiotensin system that can cause damage even death for the developing fetus. When detected, pregnant, should stop cozaar as soon as possible.

Although there is no experience in using cozaar for pregnant women, studies with Losartan Kali have shown that the injury in the fetus, babies and death, the mechanism of this influence is thought to be due to the intermediate pharmacological properties acting on the renin-anidensin system. In humans, the fetal kidney perfusion depends on the development of the renin-angiotensin system, starting in the middle of the middle of pregnancy. Therefore, the risk for the fetus increases if used cozaar for the three months or the last three months of pregnancy.

Breastfeeding period

It is unclear whether Losartan will be secreted into the mother's milk. Because many drugs are secreted into the mother's milk and due to the potential for adultery effects, they should decide or stop the drug or stop breastfeeding, consider the importance of the drug for the mother.

Medicinal interaction

as well as other drugs belonging to Angiotensin II blockers or inhibiting the effects of angiotensin II, if used with potassium diuretics (such as spironolactone, triamterene, amiloride), potassium supplements or salt replacement substances containing Kali, can lead to kolioma in the rod.

As well as other drugs that affect sodium elimination, lithium elimination may be reduced. Therefore, it is necessary to carefully monitor serum lithium concentration if used simultaneously containing lithium salt with Angiotensin II receptor antagonists.

NSAID anti-inflammatory drugs (NSAIDs) include cyclooxygenase-2 (COX-2) antagonists that can reduce the effects of diuretics and other hypertension drugs. Therefore, the lowering effects of Angiotensin II receptor antagonists or enzyme inhibitors may be reduced by NSAIDs including COX-2-selected antagonists.

In some patients with kidney function damage (for example, the elderly, or patients with a decrease in the volume of circulatory, including those who are taking diuretics) are being treated with nonsteroidal anti-inflammatory drugs, including COX-2 selective counterparts, simultaneous use of angiotensin II receptor anti-receptor drugs can increase impaired renal impairment. These effects are often recovered. Therefore, be careful when using combined drugs in patients with damaged kidney function.

The literature has been recorded in patients who have atherosclerosis, heart failure, or diabetes with the target organs, the double-glocated drugs that the renin-angiotensin-aldosterone system comes with a higher frequency of lowering blood pressure, fainting, hyperkalemia and changes in renal function (including acute renal failure) compared to the use of the lenin-angiotensin-aldosterone system. Double blockade (for example: ACE supplementation with an angiotensin II receptor inhibitor) should be used for limited cases that need to closely monitor kidney function.

Storage

Store less than 30 ° C (86 ° F). Store in the original packaging. Avoid light.

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