Losar-denk 100 tablets treat hypertension, heart failure (2 blisters x 14 tablets)

Dosage form Box of 2 blisters x 14 tablets
Specifications Losartan

Ingredient

Composition information	Content
Losartan	100mg

Uses

Indication

Losar - Denk 100 is indicated in case:

Treatment of hypertension: can be used alone or in combination with other hypertension medications (for example, thiazid diuretics). Losartan should be used for patients who do not tolerate ACE inhibitors (Angiotensin transfer enzymes). This is a great advantage of Angiotensin receptor antagonists, so it can also be used to treat heart failure as the indications of ACE inhibitors.

Angiotensin II, a potential vasoconstrator, is an initial activity hormone of the Renin - Angiotensin system and is the physiological decision substance of hypertension. Angiotensin II is linked to the AT1 receptor present in many organizations (meaning vascular smooth muscles, adrenal glands, kidneys and heart) and open important biological effects, such as vascular contractions and release aldosteron. Angiotensin II also stimulates smooth muscle cells to proliferate.

Losartan selects the AT1 receptor. Losartan and carboxylic acid metabolites block all the related physiological effects of Angiotensin II In vitro and in vivo regardless of its origin and path.

Losartan has no boot effect and does not select other receptors of hormones or ion channels that play an important role in the cardiovascular regulation. In addition, Losartan does not inhibit ACE (Men Kinase II), Bradykinin decomposition. Therefore, does not increase the undesirable reactions related to Bradykinin.

When using Losartan, the body responds by increasing the activity of the renin system, increasing the production of angiotensin II. However, this does not affect the low voltage effect of the drug. After stopping Losartan, the levels of Renin and Angiotensin II will return to normal within 3 days.

Losartan and main active metabolites have great affinity for the AT1 receptor than the AT2 receptor. The metabolites have an effective activity of 10 to 40 times Losartan.

Pharmacokinetics

absorption

After taking Losartan is well absorbed and into metabolic. An active carboxylic acid metabolites and inactive metabolites are formed. Birth of the whole body of Losartan films is about 33%. The peak concentration of Losartan in plasma is achieved in 01 hour and active metabolites are 3-4 hours.

Distribution

Losartan and active metabolites linked to protein, mainly plasma albumin in plasma ≥ 99%. Losartan's distribution volume is 34 liters.

Metabolism

About 14% of losartan intravenously or convert into active metabolites. After drinking and intravenously Losartan marks C14, the radioactive activity in plasma is Losartan and active metabolites. In addition, it also creates inactive metabolites.

Elimination

Losartan's plasma clearance is about 600 ml/min and active metabolites are 50 ml/min. Kidney clearance is 74 ml/min (Losartan) and 26 ml/min (active metabolites). When taking Losartan, about 4% of the dose is discharged in a constant form in the urine, and 6% discharged into the urine in the form of active metabolites. Pharmacokinetics of Losartan and active metabolites are linear at oral doses of up to 200 mg of Losartan Kali a day.

Before taking Losar-denk 100 tablets treat hypertension, heart failure (2 blisters x 14 tablets)

How to use

can use Losartan when hungry or full.

Dosage

Dosage depending on the patient and must be adjusted according to the blood pressure response.

Losartan's starting dose is usually used for adults of 50 mg daily; The starting dose may be lower as 25 mg/day for patients who are likely to lose fluid in the heart, including people who are taking diuretics, or liver failure.

The usual maintenance dose is 25 - 100 mg/day, divided into 1-2 times. There is no need to change the dose for elderly patients or kidney failure, including people who are hemolysis.

In general, if the blood pressure is not controlled at the dose used, every 1-2 months must adjust the dosage of anti -hypertension drugs.

If using losartan is alone without controlling blood pressure, adding low -dose dosage. Hydrochlorothiazid proves to have a plus effect. Losartan can be used with other anti -hypertension drugs. Do not coordinate Losartan with diuretics to keep potassium, due to the risk of hyperkalemia.

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 do

do when overdose? Depending on the overdose, symptoms are almost excessive hypotension, tachycardia, abnormal slow.

Medication treatment depends on the time of taking the drug, the nature and seriousness of the symptoms. Activated carbon can be used, then monitor the signs of survival and support treatment. Can not exclude Losartan and metabolites that are active in blood via.

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 Losar Denk 100, you may experience unwanted effects (ADR).

Common, ADR> 1/100

Nervous system: dizziness, dizziness, loss of balance.

Metabolic: Hypoglycemia, potassium power.

Uncommon, 1/1000

Nervous system: Sleep, headache, sleep disorders.

Cardiovascular system: suspense, angina, hypertension with symptoms (especially in patients with reduced circulating blood volume such as severe heart failure or treatment with high doses of diuretics), excessive hypotension, including vertical hypotension. skin: rash, urticaria, itching.

Digestive system: abdominal pain, constipation, diarrhea, nausea, vomiting. general disorder: weakness, fatigue, edema.

Respiratory system, chest and mediastinum: Difficulty breathing.

Rare ADR

Cardiovascular system: fainting, atrial fibrillation, stroke.

The immune system: Hypersensitivity, angioedema, laryngeal swelling and subjects related to obstruction of the respiratory tract, face swelling, lips, throat, tongue.

Hepatitis: Hepatitis.

Not determined frequency

Nervous system: migraine.

Respiratory system, chest and mediastinum: cough.

Blood and lymphatic system: Anemia, platelets.

Cardiovascular system: fainting, nervous.

Mechanical - bone and connective tissue system: back pain.

kidney and urinary tract: urinary tract infection.

Liver system: failure liver function.

Common disorders: symptoms like the flu.

Instructions on how to handle ADR

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

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

Contraindicated

Losar Denk 100 contraindicated in the following cases:

Hypersensitivity to active ingredients or any excipients.

Pregnant or lactating women. Severe liver failure.

Be cautious when using

too hypersensitivity

Evaluation: Patients with a history of angioedema, manifested by swelling of the face, lips, throat and/or tongue need to be closely monitored.

Hypotension and an imbalance of electrolytes

Symptomic hypoglycemia, especially after the first dose or after increasing the dose, may occur in patients with reduced blood volume of blood circulation and/or sodium decrease due to compulsory urination or high doses of diuretics, limiting salt, diarrhea or vomiting. These diseases must be treated before using Losar - Denk 100 or the initial dose must be lower. This also applies to children.

Demonstrate imbalance is common in patients with renal failure, with or without diabetes, need to closely monitor the potassium level in plasma and creatinine clearance value, especially patients with heart failure and creatinine clearance about 30-50 ml/min.

Liver function

Losartan concentration in plasma increases significantly in cirrhosis patients, so they must consider lower doses for patients with a history of liver failure. Inexperienced medication for patients with severe liver failure should be contraindicated to use Losartan for patients with severe liver failure

Renal function

There has been a report on the consequences of the inhibition of the Rennin - Angiotensin system, changing the renal function including renal failure, especially in patients with renal function depending on the RENNIN - angiotensin - Aldosteron system, such as patients with severe heart failure or impaired renal function in advance.

As applicable to other drugs that hinder the Rennin - Angiotensin - Aldosteron system, blood urea and creatinine in serum have been observed in patients with kidney stenosis on both sides or one side stenosis in patients with only one kidney. Such renal function changes may be reduced after stopping treatment. Losartan must be used carefully for patients with renal artery stenosis.

For children with impaired renal function

Due to lack of data, not recommended Losartan for children with glomerular filtration ratio below 30 ml/min/1.73m2.

Must monitor kidney function regularly during treatment with Losartan, because the kidneys may be damaged. This is specially applied when Losartan is used in situations that can affect kidney function such as fever, dehydration.

Simultaneous use of losartan with enzyme inhibitors Angiotensin (ACE) has shown that they damage the kidney function. Therefore, do not simultaneously use these drugs.

kidney transplant

There is no experience on patients with kidney transplant.

Initial increase in the concentration of Aldosteron hormones

Patients with an increase in the initial aldosteron concentration generally do not respond to drugs to treat hypertension by inhibiting the Rennin - Angiotensin system. Therefore, do not recommend losartan.

Coronary heart disease and cerebrovascular disease

There may be excessive hypotension in patients with cardiovascular anemia or cerebrovascular disease leading to myocardial infarction and stroke.

heart failure

Losartan can reduce serious arterial blood pressure (usually acute), acute renal failure in patients with heart failure with or without kidney failure.

Be cautious to use Losartan for patients with heart failure associated with severe renal failure, severe heart failure (level IV according to the New York Cardiology Association), symptomatic or life -threatening heart failure.

Precautions when coordinating Losartan and beta blockers.

Aortic stenosis and mitral valve, congested myocardial aneurysm

Be cautious when taking Losartan for patients with aortic stenosis, mitral valve or congested myocardial aneurysm.

Galactose intolerance, lactase enzyme deficiency or poor absorption of glucose, galactose

This drug is contraindicated in patients with rare galactose intolerance due to genetic, lactase deficiency, or poor absorption of glucose, galactose.

Other warnings and special attention

As observed with angiotensin (ACE), Losartan and other Angiotensin II antagonists, it seems less effective in reducing blood pressure in black skin patients than non -black patients.

This may be due to the high popularity of the low renin level in the high blood pressure population.

The ability to drive and operate machinery

The drug can cause dizziness, fatigue, especially at the beginning of treatment or when increasing the dose. Need to be cautious when driving or operating machinery.

Pregnancy

Losartan is contraindicated during pregnancy.

Losartan exposure in the 2nd and third 3 months of pregnancy is known to be toxic to the fetus (the renal function is impaired, less amniotic fluid, slowing down the skull) and toxicity to babies (kidney failure, high blood pressure, potassium power). If Losartan is exposed in the last 6 months of pregnancy, the kidney and head ultrasound must be checked.

Babies whose mothers have used Losartan during pregnancy to closely monitor hypertension.

The period of breastfeeding

While there is no information on the use of Losartan while breastfeeding, it is not recommended that the use of Losartan but must choose other treatment capabilities that have a record of safety when breastfeeding or younger children.

Interactive drug

Losartan's hypotension effect may increase if used simultaneously with other hypertension treatment.

3 -round anti -sensitites, anti -psychotic drugs, Baclofen, amifostin used with losartan can cause excessive hypotension.

Losartan is converted into carboxylic acid metabolites that are active by cytochrom P450 (CYP) 2C9. There was a report that fluconazole (a CYP2C9 inhibitor) reduces the concentration of metabolites that are active in the blood of approximately 50%. Simultaneous treatment of losartan with rifampicin (metabolic enzyme induction) reduces the concentration of metabolites that are active in blood in 40%.

Concentrated use of potassium -saving diuretic (such as amilorid, triamteren, spironolacton) or other drugs may increase potassium concentration in plasma (such as heparin). Potassium supplements and salt -containing salt substitutes when used with Losartan can also cause increased potassium concentration in serum.

Losartan increases lithium concentration in serum. If necessary, coordinated, lithium concentration must be monitored during serum use.

Non -steroid anti -inflammatory drugs reduce the hypotension of Losartan, simultaneously using these two drugs can also cause acute kidney failure, increased serum potassium.

Storage

Store in a cool place, avoid light, temperature below 30⁰C.

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