Hyzaar medicine 50/12.5mg MSD treats hypertension (2 blisters x 15 tablets)

Hypersensitivity to other derivatives of the sulfonamide group.

Caution when using

Losartan - Hydrochlorothiazide

Toxicity for pregnancy

The use of drugs on the Renin - Angiotensin system in the middle and the last three months of pregnancy reduces the kidney function of the fetus, increases disease and death in the fetus and babies. The result of amniotic fluid may be associated with lung reduction and skeletal deformation in fetus. The possible side effects in newborns include reducing skull production, anuria, hypotension, renal failure and death. When detecting pregnancy, Hyzaar must be stopped as soon as possible.

Hypersensitivity

Thich vascular.

Liver failure, kidney failure

Do not use Hyzaar in people with liver failure or severe kidney failure.

losartan

Renal function impairment

In sensitive people, there is a report on renal function changes, including renal failure, as a result of the inhibition of the Renin - Angiotensin system; If the drug is stopped, these changes can recover.

Other drugs that affect the Renin - Angiotensin system may increase urea - blood and creatinine - serum in the narrowing of the kidney artery on both sides or narrow the kidney artery in patients with a single kidney. These effects also meet with Losartan; If the drug is stopped, these kidney function changes can also recover.

hydrochlorothiazide

Hypotension and imbalance of fluid/electrolytes

As for all medications for hypertension, symptomic hypotension may be experienced in some patients. It is necessary to observe in patients with clinical signs of fluid imbalance or electrolytes such as reducing volume, hypoglycet hypoglycet, alkaline chlorine, reducing blood magnesium or hypokalemia may occur during diarrhea or vomiting occurs. Need an electrolyte test in regular serum with time gap suitable for these patients.

Effects on metabolism and endocrine

Using Thiazide can reduce glucose tolerance. Can adjust the dosage of diabetes to treat diabetes, including insulin.

Thiazide can reduce calcium secretion through urine and cause mild and interrupted serum calcium. Calcium - obvious blood can be a result of an increase in the hidden parathyroid gland. Need to stop using thiazid before conducting tests on parathyroid function.

Use diuretic gums may increase cholesterol and triglycerides.

Thiazid may increase blood uric acid and/or cause gout in some people. Because Losartan reduces blood uric acid, Losartan coordinates with hydrochlorothiazide will reduce the increase in uric acid caused by this diuretic.

Other caution

In Thiazid users, there are hypersensitivity reactions whether or not there is no history of allergies or bronchial asthma. There are dramatic or lupus erythematics after using thiazid

The ability to drive and operate machinery

so far, no information has shown that Hyzaar has influenced the ability to drive or operate the user's machines.

Pregnancy

Medicines directly acting on the Renin - Angiotensin system can cause damage and developing pregnancy. When detecting pregnancy, Hyzaar® must be stopped as soon as possible.

Although there is no experience in using Hyzaar® in pregnant women, animal studies with Losartan Kali have shown that drugs that damage fetal and infant animals, sometimes die, the mechanism is considered through impact on the Renin - Angiotensin system. In humans, the excretion of the kidneys of pregnancy depends on the development of the Renin - Angiotensin system starting from the second quarter of pregnancy; Thus, the risk of pregnancy will increase if the mother uses Hyzaar® in the second and third quarter of pregnancy.

The use of drugs on the Renin - Angiotensin system in the middle and the last three months of pregnancy reduces the kidney function of the fetus, increases disease and death in the fetus and babies. The result of amniotic fluid may be associated with lung reduction and skeletal deformation in fetus. The possible side effects in newborns include reducing skull production, anuria, hypotension, renal failure and death. When detecting pregnancy, Hyzaar® must be stopped as soon as possible.

These harmful results are often associated with the use of these drugs in the middle and the last three months of pregnancy. Most epidemiological studies survey abnormalities in fetuses after exposure to anti -hypertension drugs used in the first three months of pregnancy, regardless of drugs that affect the Renin - Angiotensin system with other anti -hypertension drugs.

The appropriate treatment of hypertension in the mother during pregnancy is important to optimize the results for both mother and pregnancy. In special cases when there is no such an appropriate replacement treatment for medication, which affects the Renin - Angiotensin system for a separate patient, must notify the mother about the risk that may occur for the fetus.

It is necessary to conduct a mass ultrasound test to assess the environment in the amniotic fluid. Stop using Hyzaar if observing the lack of amniotic fluid unless this drug is considered a medicine to save life for the mother. Pregnancy tests may be appropriate, based on the week of gestational age. However, doctors and patients should know that the lack of amniotic fluid may not show until the pregnancy has been damaged for a long time. Needs to closely monitor babies with a history of Hyzaar exposure in the uterus on manifestations of hypotension, urinary discharge and hyperkalemia.

Thiazid passes through the placenta and appears in the umbilical cord blood. It is not recommended to use the diuretics for healthy pregnant people and this can bring both mother and pregnancy to unnecessary risks, such as jaundice of fetus and newborn, thrombocytopenia and maybe other harmful reactions that have been encountered in adults, which are not preventing the development of pregnancy toxicity and there is no reliable evidence that the diuretic is useful to treat fetal infections.

The period of breastfeeding

It is unclear whether Losartan will excrete through breast milk or not. Thiazid passes through breast milk. Because of the harmful effect of breastfeeding, it is necessary to decide or stop breastfeeding or stopping the drug, depending on the importance of using the drug with the mother.

Drug interaction

losartan

In clinical pharmacokinetics tests, any clinical interactions have not been determined with hydrochlorothiazid, digoxin, warfarin, cimetidine, phenobarbital (please read the hydrochlorothiazid section: Alcohol, Barbiturates or addictive drugs in the lower part), Ketoconazole and erythromycin. There have been reports on reducing the level of metabolic substances that are active of rifampin and fluconazole. The clinical value of these interactions has not been fully evaluated.

As with other drugs belonging to the Angiotensin II receptor inhibitor group or have the same effect, when used with potassium -keeping (such as Spironolacton, Triamteren, Amiloride), Potassium Supplements, Salt Supplies containing potassium, can lead to increased potassium - serum.

As well as other drugs that affect the excretion of sodium, can also reduce the lithium secretion. Therefore, if lithium salt is used with Angiotensin II receptor inhibitors, the amount of lithium must be monitored in serum.

Non -steroid anti -inflammatory drugs (NSAIDs), including cycloxygenase -2 inhibitors (2 (COX inhibitors - 2), can reduce the effects of diuretic and other high blood pressure medications. Therefore, the lowering effect of the Angiotensin II receptor inhibitors may be impaired by NSAIDs, including the selective inhibitors of COX - 2.

In some patients with renal dysfunction, it has been treated with nonsteroidal anti -inflammatory drugs including cyclooxygenase - 2 inhibitors, simultaneous use of Angiotensin II receptor inhibitors can lead to further impairment of kidney function. These effects can usually be recovered when stopping the drug.

Dual inhibition of the Renin - Angiotensin - Aldosterone (RAAS) system by combining Angiotensin receptor inhibitors, ACE or Aliskiren inhibitors, which comes with an increased risk of hypotension, fainting, hyperkalemia, and changing renal function (including acute renal impairment) compared to the use of a single therapy. Strictly monitor blood pressure, kidney function and electrolyte on patients using Hyzaar and other drugs that affect RAAS. Do not use Aliskiren simultaneously with Hyzaar on diabetes patients. Avoid using Aliskiren with Hyzaar in patients with renal failure (GFR

hydrochlorothiazide

When coordinated, the following drugs may interact with the diuretics:

alcohol, barbiturate or addictive drug

Sacrifice the side effects of hypotension.

Hemodias (insulin and oral medications)

Need to adjust the dose of drugs to lower blood sugar.

Other hypertension medications: Agreement effects.

cholestyramine and Colestipol

Reduce the absorption of hydrochlorothiazide when there is anion exchange plastic. The single dose of cholestyramine or Colestipol plastic combined with hydrochlorothiazide reduces the absorption of thiazid through the gastrointestinal tract in the order of 85% and 43%.

corticosteroids, ACTH

Increases power outages, especially hypokalemia.

Amines as vascular (Adrenaline)

may reduce the response to the amines as a circuit, but there is not enough basis to stop using.

Non -reducing muscle relaxants (such as tuboCurarin)

can increase response to muscle relaxants.

lithium

Digital diuretic reduces kidney clearance to lithium and creates a high risk of lithium toxicity, so it is not advisable to coordinate. Read the lithium manual carefully before using these preparations.

Non -steroid anti -inflammatory drugs (NSAID) including cyclooxygenase inhibitors - 2

In some people, using nonsteroidal anti -inflammatory drugs including cyclooxygenase inhibitors - 2 will reduce the effect of thiazid on diuretic benefits, sodium discharge and hypertension.

Interaction with laboratory tests

Due to the effect of calcium metabolism, thiazid may have interaction with tests on parathyroid function.