Losacar-H 50mg/12.5mg Zydus Cadila tablets for hypertension (10 blisters x 10 tablets)

Severe renal failure (Creatinine clearance

Precautions when using

losartan

Phu Quincke

Patients with a history of Quincke edema (swelling of the face, lips, throat, tongue) should be closely monitored.

Hypotension and reduced volume of circulation

There may be hypotension, especially after the first dose of treatment in patients with reduced volume of circulatory and/or sodium reduction due to strong diuretics, a diet of low salt, diarrhea or vomiting. Need to adjust the condition before using Losacar-H.

Electrolyte imbalance

common in patients with renal failure, with or without diabetes, that phenomenon should be overcome. Therefore, plasma concentrations of potassium, and creatinine clearance need to be monitored, especially in patients with heart failure and creatinine clearance 30 - 50 ml/min. The simultaneous use of potassium diuretics, potassium supplements, salt -replacement substitutes containing potassium with losartan/hydrochlothiad is not recommended.

Hepatic failure

Losartan concentration increases significantly in cirrhosis patients, Losacar-H should be used carefully in patients with a history of mild to moderate liver failure. Losacar-H is contraindicated in patients with severe liver failure.

kidney failure

The consequence of inhibiting the Rennin-Anotensin-Aldosteron system is to change the kidney function, including renal failure (especially in patients with renal function depending on the Rennin-Anotensin-alosteron system, such as severe heart failure patients, previous kidney dysfunction). Losartan should be used cautiously in patients with kidney stenosis on one side or on both sides.

adrenal strength

Patients with primary aldosteron increased will usually not respond to antihypertensive drugs that have mechanisms of action through inhibition of the Rennin-Anotensinaldosteron system. Therefore, the use of Losacar-H is not recommended.

coronary artery disease and cerebral disease

Excessive hypotension in cardiovascular and cerebrovascular patients with ischemia can lead to myocardial infarction or stroke.

heart failure

In patients with heart failure (with or not accompanied by renal failure), there will be a risk of severe arterial hypotension and renal failure (usually acute).

Aortic stenosis and mitral valve stenosis, myocardial obstruction

Be cautious on these objects.

Race difference

Angiotensin, Losartan inhibitors seem to be less effective in reducing blood pressure in black people than other skin colors, due to the higher rate of reducing the Renin disease on high blood pressure.

hydrochlorothiazide

Hypotension, water imbalance and electrolytes

Symptoms of hypotension may occur in some patients. Patients need to monitor the imbalance of water and electrolytes such as: reducing volume, hypoglyc sodium, alkaline infection, chloride, magnesium or blood potassium due to vomiting. Periodically check the concentration of electrolytes in serum. The phenomenon of hypoglycemia can occur in patients with edema or in hot weather.

Effects on metabolism and endocrine

Thiazid may reduce glucose tolerance, may have to adjust the dose of diabetes treatment drugs, including insulin. Potential diabetes can manifest when thiazid treatment.

Thiazid may reduce calcium secretion in urine and may increase slightly in serum calcium levels, signs of hyperpointed hyperthyroidism. Thiazid should be discontinued before checking the parathyroid function. When using thiazid diuretics can increase cholesterol and neutral fat levels. Treatment with thiazid may increase blood uric acid and/or gout in some patients. Because Losartan reduces uric acid, Losartan combines with hydrochlorothiazide, which reduces hyperglycemia due to diuretics.

Hepatic failure

Be cautious in patients with impaired liver function or progressive liver disease, as it can cause cholest liver phenomenon, water changes, electrolytes can cause liver coma. Locasar-H is contraindicated for patients with severe liver failure.

When using thiazid, hypersensitivity reactions may occur on subjects with or without a history of allergies, bronchial asthma, worse or activate systemic lupus erythematosus.

excipients

In the composition containing lactose, patients do not tolerate glucose, deficiency of lactose, malposure of glucose-galactose should not use these drugs.

The ability to drive and operate machinery

Be careful because when starting to use or when increasing the dose to treat hypertension may experience drowsiness or dizziness.

Pregnancy

Do not use Angiotensin II (AIRAS) for pregnant women. When the treatment is with AIRAS, the patient needs to change the plan of pregnancy. If pregnant, it is necessary to stop treating with AIRAS, using appropriate therapy.

Use AIRAS in the middle and late three months of pregnancy can cause fetal poisoning (reduced kidney function, amniotic fluid, underdeveloped skull), neonatal toxicity (kidney failure, hypotension, hypertension, hyperkalemia).

If using AIRAS in the middle 3 months of pregnancy should check the kidney and skull function of the fetus.

Babies whose mothers use AIRAS should be closely monitored.

Hydrochlorothiazide passes through the placenta, when used in the three months between and the end of the pregnancy can be toxic to the fetus and infants: jaundice, electrolyte disorders, platelet reduction.

Do not use hydrochlorothiazide to treat pregnant women, pregnancy hypertension or pre -eclampsia because it only increases the volume of circulatory and reduces the amount of blood to the placenta without reducing the symptoms of the disease.

Hydrochlorothiazide should not be used for hypertension in pregnant women unless there is no replacement. Contraindicated Losacar-H for pregnant women.

Breastfeeding period

Hydrochlorothiazide is excreted through breast milk so the use of losacar-H during breastfeeding is not recommended. Should use safer therapy when breastfeeding, especially for babies or premature births.

Drug interaction

losartan

There is no interaction when using Losartan simultaneously with hydrochlorothiazide, digoxin, warfarin, cimetidine and phenobarbital.

Use with potassium diuretics (Spironolacton, Triamteren, Amirolid), potassium supplements or potassium salts will lead to hyperkalemia.

When using Angiotensin II receptor anti-receptor drugs and nonsteroidal anti-inflammatory (NSAIDs) (NSAIDs) (selective inhibitor or non-selective in COX-2) can reduce the effectiveness of hypotension. When using the Angiotensin II receptor -controlled drug or diuretics with NSAIDs, it may increase the risk of impaired renal function such as acute renal failure, hyperkalemia, especially in impaired renal functional people, elderly people. On these objects, it is necessary to monitor the function at the beginning of treatment and periodically check the kidney function.

Losartan may reduce the effects of sodium and lithium waste. Therefore, lithium lithium concentration must be monitored when using lithium salt along with Angiotensin II receptor drugs. When coordinated with other antihypertensive drugs such as three -round antidepressants, psychotic anti -psychotic drugs, Baclofene, amifostine, can cause excessive hypotension.

hydrochlorothiazide

When used simultaneously, some of the following drugs can cause interaction with thiazid diuretics: alcohol, barbiturate, anesthetic anesthesia or three -round antidepressants that risk hypotension.

Diabetes treatment

Need to adjust the dose for diabetes medications due to thiazid affects the ability to tolerate glucose. Precautions when using metformin because of the risk of lactic acid infection due to renal function impairment caused by hydrochlorothiazide.

Anion exchange resin like Cholestyramin or Colestipol will link with hydrochlorothiazide and reduce the absorption of the drug through the gastrointestinal tract, 85% and 43%.

Other antihypertensive drugs, corticosteroid acthers, supplements for electrolytes, potassium ...

lithium

Diuretics reduce the lithium clearance of the kidneys, causing lithium toxicity, so it should not be coordinated.

Gout treatment (Probenecid, sulfyrazon, allopurinol)

Need to adjust the dose of the drug because hydrochlorothiazide can increase the concentration of uric acid in serum, the dose of probenecid, sulfipyrazon is needed, but when used simultaneously with Allopurinol will increase the hypersensitivity reaction to this drug.

antiviral drugs Acetylcholine (Atropin, biperiden)

Increases the bioavailability of thiazid diuretics due to reducing gastrointestinal motility and stomach void. Thiazid can reduce the excretion of the kidneys of cytotoxic substances such as cyclophosphamide, methotrexate and increase their marrow inhibition.

salicylat

When used with high doses of salicylate may increase the toxicity of salicylate on the central nervous system.

methyldopa

can cause anemia, hemolysis when used simultaneously.

cyclosporin

Increased risk of hyperuricemia and gout complications.