Losagen 50 Heterero tablets treat hypertension (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Losartan

Ingredient

Composition information	Content
Losartan	50mg

Uses

Indications

Losagen 50 drugs are indicated in the following cases:

Treatment of hypertension. This drug can be used separately or combined with other anti -hypertension drugs, including diuretics. New blood pressure. It is a receptor antagonist (type AT1) angiotensin II.

Angiotensin II formed from Angiotensin I in the reaction by enzyme Angiotensin (ACE) catalyzed, is a strong vasoconstrictor: it is the main vascular activation hormone of the Renin - Angiotensin system and is an important component in the pathophysiology of hypertension. Angiotensin II also stimulates the adrenal glands of Aldosteron.

Losartan and the main metabolites have a clogged and aldosteron secretion of angiotensin II by preventing Angiotensin II selectively, not attaching to the AT1 receptor in many tissues (for example, blood vessel muscles, adrenal glands).

In many tissues, there is also AT2 receptor but it is not clear 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 affinity (about 1,000 times) than the AT2 receptor. Losartan is a competitive, reversible inhibitor of 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 the AT1 receptor. The agents of KhaGpngiotensin II also have a hemodynamic effect like ACE inhibitors, but there is no unwanted effect of the common ACE inhibitors are dry cough.

pharmacokinetics

After drinking, Losartan absorbs well and initially metabolized through the liver thanks to the cytochrom P450 enzymes. Losartan's bioavailability is approximately 33%. About 14% of losartan dose taken into active metabolites. This substance is mostly antagonist Angiotensin II.

The half -life of Losartan elimination is about 2 hours, and of the metabolite for about 6 - 9 hours. The average peak concentration of Losartan reaches within 1 hour and of the metabolites with activity within 3-4 hours. Both Losartan and active metabolites are linked to many plasma proteins, mainly albumin and they do not go through blood -brain barriers.

Losartan's distribution volume is about 34 liters and of metabolites with an activity of about 12 liters.

Losartan's total plasma clearance is about 600ml/min. Their clearance in the kidney corresponds to about 75ml/min and 25ml/min. After drinking Losartan marked 14C, collected about 35% of the radioactive in the urine and about 60% in feces.

In patients with mild to medium cirrhosis, the area under the curve (AUC) of Losartan and of the metabolitus has a higher activity, 5 times and 2 times higher than in patients with normal liver.

Before taking Losagen 50 Heterero tablets treat hypertension (3 blisters x 10 tablets)

How to use

oral oral or not with food.

Dosage

Patients with adult hypertension

Can use Losartan Potassium with other anti -hypertension drugs and or not with food. The right dose depends on each patient. The usual starting dose of Losartan potassium is 50mg, once a day, with 25mg for patients may be dehydrated (for example, patients treated with diuretics and patients with a history of hepatic failure).

Losartan Potassium can be used 1 or 2 times daily with a total daily dose of 25mg to 100mg. If the anti -hypertension effect is measured at a minimum when taking the drug once a day, the medication mode twice a day with the same daily dose per day or the increase in the dose can give better results.

Losartan has a significant effect within 1 week, but in some maximum effects appearing in 3-6 weeks. If the blood pressure is not controlled by Losartan Kali used individually, an additional low dose of diuretics. Hydrochorothiazid has been shown to have additional effects. There is no need to adjust the starting dose for elderly patients or for patients with renal impairment, including patients with hemorrhage.

Patients with hypertension children> 6 years old

The recommended usual starting dose is 0.7mg/kg at a time, once a day (to a total of 50mg) used in the form of tablets or hanging fluids. The dosage is corrected according to the response of blood pressure.

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? There is little data overdose.

The most likely manifestations of overdose are reducing blood pressure and tachycardia, slow heart rate that may occur due to sympathetic nervous stimulation (vagus nerves). If symptomatic blood pressure is reduced, supportive treatment. Can not remove Losartan and metabolites that are active by hemolytic.

What to do when forgetting 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 Losagen 50, you may experience unwanted effects (ADR).

Common, ADR> 1/100

Cardiovascular: lower blood pressure.

Central nervous system: insomnia, dizziness.

Endocrine - Metabolism: hyperkalemia.

digestive: diarrhea, indigestion.

Hematology: Light hemoglobin and hematocrit.

Neuropathy - bone: back pain, leg pain, muscle pain.

kidney: lower blood uric acid (when high doses).

Respiratory: cough (less when using ACE inhibitors), nasal congestion, sinusitis.

Uncommon, 1/1000

Cardiovascular: Hypotenary blood pressure, chest pain, A-V degree block II, chest drum, sinus pace, fast heart rate, face edema, blush.

Central nerve: anxiety, loss of air conditioning, confusion, depression, migraine, headache, sleep disorders, fever, dizziness. Skin: hair loss, dermatitis, dry skin, erythema, light sensitivity, itching, urticaria, bruises, foreign rash.
Endocrine - Metabolism: gout.
digestive: anorexia, constipation, flatulence, vomiting, loss of taste, gastritis. genital - urinary: Help, sexual reduction, pee, night piss. liver: slightly increase the tests of liver function and slight increase in bulirubin.
Neurosurgery: Perception, tremor, bone pain, muscle weakness, joint edema, muscle pain.
eyes: blurred vision, conjunctivitis, vision loss, burning and eye aches.
ears: tinnitus. kidney: urinary tract infections, slight increase in creatinine or urea.
Respiratory: Difficulty breathing, bronchitis, nosebleeds, rhinitis, airbornment, discomfort in the throat.

Other effects: sweating.

Instructions on how to handle ADR
Notice to the doctor when having unwanted effects when taking the drug.

Warnings

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

Contraindicated

Losagen 50 contraindications in the following cases:

Hypersensitivity to Losartan or any ingredients of the drug.

Precautions when using

Hypersensitivity:

Tharma.

Liver function decline:

Based on the pharmacokinetic data proves in a meaningful way of increasing the Losartan level in plasma in patients with cirrhosis, it is necessary to consider the use of a lower dose for patients with liver failure.

Renal function decline:

As a result of the inhibition of the Renin-Anotensin-Aldosteron system, the changes in renal function have been reported in sensitive individuals treated with Losartan Kali, in some patients, these changes in renal function can recover when stopping therapy, in patients where kidney function may depend on the activity of the renin-angiotensin-standosterone system (for example, patients with patients with blood failure, patients with patients with blood failure, patients with blood depression severe), therapy with angiotensin conversion enzyme inhibitors combined with reducing urinary and/or nitrogen-developed nitrogen and (in a rare way) with acute and/or death kidney failures.

Similar consequences have been reported to Losartan Kali. In studies with enzyme inhibitors, angiotensin conversion in patients with kidney stenosis on one side or both sides, increased creatinine in serum or blood urea nitrogen (bun) has been reported. Similar effects have been reported to Losartan Kali, in some patients, these effects can recover when stopping treatment.

The ability to drive and operate machinery

Losartan can cause headaches or dizziness. Patients should note when driving or operating machinery.

Pregnancy

Use drugs that work directly on the Renin-Anotensin system in the middle of the middle and the last three months of pregnancy can cause less amniotic fluid, lower blood pressure, anuria, face deformity and death in infants. Although, the use of drugs in the first three months of pregnancy has not been seen related to the risk of the fetus, but after detecting pregnancy, Losartan must be stopped as soon as possible.

Breastfeeding period

It is unknown whether Losartan is secreted into breast milk or not, but there are significant amounts of Losartan and metabolites whether the drug's active in mice milk. Due to harmful potential for breastfeeding, deciding to stop breastfeeding or stopping the drug, taking into account the importance of the drug for the mother.

Drug interactions

There are no significant pharmacokinetic interactions of drugs in interactive studies with hydrochlorothiazid, digoxin, warfarin, cimetidine and phenobarbital. Rifampin, a substance that causes drug metabolism, reduces the level of Losartan and its active metabolites. In humans, two P450 inhibitors have been studied.

Ketoconazole does not affect Losartan's conversion into an active metabolic substance after losartan intravenous injection, and erythromycin have no clinical significance after drinking. Fluconazole, a P450 2C9 inhibitor reduces the concentration of active metabolites and increases the level of Losartan.

No survey of pharmacological consequences of simultaneous use of Losartan and P450 2C9 inhibitors. Demonstrated non -metabolic losartan into active metabolites with a rare, characteristic defect in Cytochrom P450 2C9. These data suggest that the conversion of Losartan into metabolites has an intermediate activity mainly by P450 2C9 and not by P450 3A4.

As with other drugs, Angiotensin II closing effects or its effects, simultaneous use of potassium -saving diocesia (e.g., spironolacton, triamteren, amilorid), potassium supplements, or salt -containing potassium substitutes can lead to hyperiemia.

Lithi: As with other drugs, it affects sodium elimination, lithium elimination may be reduced. Therefore, careful monitoring of serum lithium concentration should be monitored if used simultaneously lithium salts with antagonistic drugs with receptors of angiotensin II.

Non-steroid anti-inflammatory drugs including cyclooxygenase-2 inhibitors. In older patients with dehydration (including patients taking diuretics), or patients with renal impairment, simultaneous use of nonsteroidal anti-inflammatory drugs, including selective COX-2 inhibitors, with antagonistic drugs with receptors of Angiotensin II (including losartan) can impair kidney function, including acute kidney failure.

These effects can often be recovered. Periodic monitoring of kidney function in patients using Losartan combined therapy with nonsteroidal anti -inflammatory drugs. The anti-hypertension effect of antagonistic drugs with the receptor of Angiotensin II (including Losartan) may be impaired by nonsteroidal anti-inflammatory drugs, including selective COX-2 inhibitors.

Storage

Store at temperatures below 30 ° C, avoid moisture. Leave the medicine out of the reach of children.

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