Lifezar 50mg United tablets treat high blood pressure (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Losartan Potassium

Ingredient

Composition information	Content
Losartan Potassium	50mg

Uses

indications

Lifezar is indicated in the following cases:

High blood pressure treatment:

The drug can be used alone or in combination with other high blood pressure medications. Treatment of hypertension in adults, children and adolescents from 6 to 18 years old. Hypertension in patients with type II diabetes.

Chronic heart failure treatment.

Reduce the risk of stroke in patients with left ventricular hypertrophy.

Pharmacokology

angiotensin II (made up of angiotensin i), is a strong vascular contract, which is the hormone with the onset of the renin -angiotensin system and is an important component in the pathological physiology of hypertension. Angiotensin II also stimulates the adrenal shells of Aldosterone.

Losartan and the main metabolites have the activity of vasodilation and aldosterone secretion of Angiotensin II by selecting the cohesion of Angiotensin II and the AT1 receptor in many tissues (such as blood vessel muscles, adrenal glands). The AT2 receptor is also found in many tissues but it is unclear whether this receptor is related to the cardiovascular air conditioner.

Both Losartan and the main active metabolites do not show the local dominant effect in the AT1 receptor and have a much larger AT1 receptor (about 1000 times) than the AT2 receptor. In vitro combining studies show that Losartan is a reversible competitive inhibitor of the AT1 receptor.

The metabolic substance has the activity of drugs 10 to 40 times stronger than Losartan, calculated by weight and is a non -competitive, reversible inhibitor of receptors.

Both Losartan and its active metabolites do not inhibit ACE (Kininase II, the enzyme that converts angiotensin I into angiotensin II and breaking Bradykinin); As well as not combining or inhibiting other hormone receptors or ionic channels known as important in the cardiovascular regulation.

pharmacokinetics

absorption:

After drinking, Losartan is well absorbed and first metabolized through the liver, forming an active metabolite (E - 3174) and other non -active metabolites. The bioavailability of Losartan tablets is about 33%. The average peak concentration of Losartan and metabolites has the corresponding activity after 1 hour and 3 - 4 hours.

Distribution:

both Losartan and metabolites combined with plasma proteins are more than 99%, mainly with albumin. Losartan's distribution volume is relatively low, 34 liters.

Metabolism:

Plasma concentrations of metabolites are more active than Losartan at all doses, CMAX and AUC of E - 3174 about 2 and 5 - 8 times higher than the corresponding value of Losartan.

After drinking, Losartan's plasma concentrations and metabolites have a rapid decrease in activity, with a half -life of about 2 hours (1.5 - 2.5 hours) and 6 - 9 hours. Due to the short half -life, both Losartan and metabolites have significant accumulation in plasma when using a dose of 100 mg. Exclusion: Once a day.

Losartan's plasma clearance and metabolites have the corresponding activity of about 600 ml/ min and 50 ml/ min. Losartan is metabolized mainly in the liver. About 35% of the dose is excreted in urine in constant form and metabolic form. Only 4% of the dose is excreted in the form of renal.

Losartan's kidney clearance is 74 ml/ min. About 6% of the dose used in urine in the form of metabolism is active with renal clearance of 26 ml/ min. Losartan and metabolic substances are also excreted in bile, with 58% of oral doses found in the feces.

Pharmacokinetics in special patients:

Elderly: Losartan and active in plasma metabolites in the elderly are higher in young people.

Children: Different pharmacokinetic parameters are significant in all age groups.

Hepatitis: Losartan's concentration in plasma increases in patients with cirrhosis and the dosage should be considered in patients with a history of liver disease.

Patients with renal impairment: Losartan concentration in plasma does not change in patients with creatinine clearance above 10 ml/min. The area under the curve (AUC) of Losartan is about 2 times higher than that of patients with dialysis than patients with normal kidney function.

Losartan's active metabolic concentration does not change in patients with renal failure or dialysis.

Before taking Lifezar 50mg United tablets treat high blood pressure (3 blisters x 10 tablets)

How to use

Drugs can be taken or not with food.

Dosage

Hypertension:

Starting dose and maintenance dose are 50 mg/ day/ day for most patients, the maximum effect of lowering blood pressure is achieved after the beginning of treatment is 3-6 weeks, some patients can see more obvious effects with the dose increasing to 100 mg/ time/ day in the morning.

Losartan can be used simultaneously with other antihypertensive drugs, especially thiazide diuretic.

Hypertension in patients with type II diabetes with proteinuria> 0.5 g/ day:

The starting dose is 50 mg/ time/ day.

can increase the dose to 100 mg/ time/ day based on blood pressure response and usually only increase the dose after 1 month of treatment.

Losartan can be used simultaneously with other antihypertensive drugs (diuretic, calcium channel blockers, alpha or beta inhibitors, some central impact drugs) as well as insulin and other hypoglycemic drugs (sulfonylurea, glitazone and glucosidase inhibitors).

heart failure:

The starting dose is 12.5 mg once a day.

The increase in the dose is usually done after a week with a 1 -time dose (12.5 mg, 25 mg, 50 mg, 100 mg until a maximum of 150 mg) and depending on the patient's tolerance.

Reduce the risk of stroke in patients with left ventricular hypertrophy:

The starting dose is 50 times a day.

Can be combined with a low dose and/ or increase the dose of Losartan up to 100 mg once a day depending on the patient's blood pressure response

Special patient:

Patients with dialysis and dialysis:

No need to adjust the dose in these patients.

Patients with liver failure:

Consider using low doses in patients with a history of liver failure.

Old people:

Recommendations at a dose of 25 mg in patients over 75 years old, but often do not need to adjust the dose in the elderly.

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?

Overdose:

Data overdose in people is limited. The most overdose manifestation is probably lower blood pressure and tachycardia; It is also possible to experience a slow heartbeat due to sympathetic stimulation (vagus nerve). If the blood pressure is lowered with symptoms, it must be supported.

How to handle:

Both Losartan and active metabolites cannot be removed by hemolysis.

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. Do not drink twice as prescribed.

Side Effects

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

Most of the undesirable effects are light and lost over time.

Common, ADR ≥ 1/10

Hematology: Anemia

nerve: Dizziness

Urinary tract: Reduce kidney function, kidney failure.

Body: dizziness, fatigue, edema, discomfort.

Endocrine - metabolism: hyperkalemia, hyperurine, blood creatinine, hypoglycemia.

Uncommon, 1/1,000 ≤ ADR

Neurological: headache, sleep disorders.

Cardiovascular: Heart beat fast, angina, hypotension.

Respiratory: Difficulty breathing, cough.

digestive: abdominal pain, constipation, diarrhea, vomiting. skin: urticaria, itching, rash.

Rare, 1/10,000 ≤ ADR

Immune: Hypersensitivity reactions, eagles.

cardiovascular: fainting, arrhythmia.

Endocrine - Metabolism: Increase alanine aminotransferase (ALT).

Instructions on how to handle ADR

Notify the doctor for unwanted effects while taking the drug.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

contraindicated

Lifezar drugs contraindicated in the following cases:

Patients with hypersensitivity to any component of the drug (excipients:?).

Women who are 3 months pregnant between and at the end of pregnancy.

Patients with severe liver failure.

Not coordinated with Aliskiren in people with diabetes or patients with renal failure.

Be cautious when using

allergies:

Thich vascular. Patients with a history of angioedema should be closely monitored.

hypotension and electrolyte disorders:

Special hypotension after initial dose or after increasing the dose, may occur in patients with a decrease in circulatory volume as taking diuretics, diets that limit salt absolute salt, diarrhea or vomiting in patients with signs of lowering blood pressure.

Need to adjust the dose or reduce the initial dose with the above cases.

Electrolyte disorders are quite common in patients with kidney failure or without diabetes and should be closely monitored.

Hepatic failure:

Pharmacological research data shows that Losartan's concentration in plasma increases significantly in cirrhosis patients, the decrease in the dose should be considered for patients with a history of liver function impairment.

kidney failure:

There have been reports on the results of inhibiting the Renin - Angiotensin system that changes the kidney function, including renal failure. This function change can recover when stopped treatment.

Other drugs that affect the Renin - Angiotensin system may increase blood urea, serum creatinine in patients with kidney stenosis on both sides or kidney artery stenosis. These changes can recover when stopping treatment.

kidney transplantation:

No relevant data.

primary Aldosterone:

Patients with primary Aldosterone intense often do not respond to antihypertensive drugs through inhibition of the Renin - Angiotensin system. Therefore, Losartan is not recommended to use in these patients.

Coronary disease :

Like other antihypertensive drugs, excessive hypotension in patients with myocardial ischemia can lead to myocardial infarction or stroke.

heart failure :

Like drugs that affect the Renin - Angiotensin system, the risk of hypotension and acute renal failure may occur in patients with heart failure whether or not kidney failure using Losartan.

Aortic valve stenosis or mitral valve:

Like other vasodilators should pay special attention when prescribing Losartan in patients with aortic valve stenosis or mitral valve.

Renin - Angiotensin - Aldosterone inhibitors:

There is evidence that the use of enzyme inhibitors inhibit Angiotensin II or Aliskiren inhibitors increases the risk of hypotension, hyperkalemia and impaired renal function (including acute renal failure).

Therefore, simultaneous use of the Renin - Angiotensin - Aldosterone inhibitors through a combination of enzyme inhibitors, Angiotensin II or Aliskiren receptor inhibitors are not recommended.

excipients:

Lactose excipients. Patients with rare genetic problems or lactose intolerance, lactase enzyme deficiency should not be used.

The ability to drive and operate machinery

There is no study of Losartan effect on the ability to drive or operate machinery. However, patients must drive or operate machinery to note that occasionally dizziness or drowsiness may occur when taking antihypertensive drugs, especially when starting treatment or when increasing the dose.

Pregnancy

know the risk of pregnancy in the middle and the last 3 months of pregnancy.

Do not use in the first 3 months, contraindicated in the middle 3 months and the last 3 months of pregnancy.

Stop the drug immediately when detected pregnancy.

The period of breastfeeding

whether Losartan is secreted in breast milk or not, Losartan is not recommended for use in breastfeeding women. Recommendation of the use of drugs is well known to be safe when used during breastfeeding.

Interactive drug

Other antihypertensive drugs may increase the hypotension effect of Losartan.

Use copper with drugs that have side effects of lowering blood pressure (such as 3 -round antidepressants, psychotic drugs, Baclofen and amifostine) may increase the risk of hypotension.

Fluconazole (CYP2C9 inhibitors) reduce the effect of metabolites with activity about 50%.

Rifampicin reduces the concentration of active metabolites in plasma by about 40%.

Concomitance Losartan use with potassium drugs (such as potassium diuretics: amiloride, triamterene, spironolactone) or increased blood potassium concentration (such as heparin), supplements or salt containing potassium can lead to hyperpassia blood.

Simultaneous use of lithium with losartan can increase the level of lithium in the blood. The patient should be monitored and regularly checks the blood lithium concentration.

Concentrated AT2 receptor inhibitors with non -anti -inflammatory drugs (NSAIDs) including cyclooxygenase inhibitors - 2 (COX - 2) can reduce the effect of lowering blood pressure. Simultaneous use of AT2 receptor inhibitors or diuretic with NSAIDs can worsen renal failure (including acute renal failure) and hyperkalemia. Need to be careful when combined, especially in the elderly.

Aliskiren: Clinical data shows that compared to the use of drugs on the Renin - Angiotensin - Aldosterone system, using 2 or more drugs in the group on this system through a combination of enzyme inhibitors, Angiotensin II or Aliskiren receptor inhibitors cause more events such as blood pressure drop, hyperkemotic hyperkemia and impaired impairment.

Storage

In a dry place, the temperature does not exceed 30 ° C.

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