Losar-denk 50 tablets treat hypertension (2 blisters x 14 tablets)

Dosage form Losartan
Specifications Heart failure, high blood pressure

Ingredient

Composition information	Content
Losartan	50mg

Uses

Indications

Losar-denk 50 indicated in the treatment of hypertension.

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

Pharmacokological

Losartan is an Angiotensin II (AT1) synthesis to drink.

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

Losartan selects 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 does not have the effect of booting nor blocking other receptors of hormones or ions plays an important role in the cardiovascular regulation. In addition, Losartan does not inhibit ACE (Men Kininase 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.

pharmacokinetic

absorption

After taking Losartan is well absorbed and into metabolic. Birth of the whole body of Losartan films is about 33%. The peak concentration of Losartan in plasma is achieved in 01 hour and the metabolites are active as 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 drink into active metabolites. After drinking and intravenously Losartan marks 14C, the radioactive activity in plasma is of Losartan and active metabolites. In addition, Losartan also produces non -active metabolites.

Elimination

Losartan's plasma clearance is about 600 mg/min and the metabolites are active of 50 ml/min.

The kidney clearance is about 74 ml/min (Losartan) and 26 ml/min (active metabolites). Losartan is discharged in urine in the form of an active metabolic form of 6% and in a constant form of 4%. The pharmacokinetics of Losartan and the active metabolites are linear at orally to 200 mg of Losartan Kali a day.

The last half life is about 2 hours (Losartan) and 6-9 hours (active metabolites).

Losartan and metabolites excreted into bile and urine. After taking/intravenously, Losartan is marked with 14C, about 35%/43% of radioactive activity are eliminated through urine and 58%/50% in feces.

Before taking Losar-denk 50 tablets treat hypertension (2 blisters x 14 tablets)

How to use

can drink 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/day. 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.

Normal maintenance dose is 25 - 100 mg/day, divided into 1-2 times. There is no need to adjust the dose for the elderly or kidney failure, including the person who is hemolysis.

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

If using Losartan without controlling blood pressure, extra diuretics may be used. Hydroclorothiazid has been shown to have a plus effect. Losartan can be used with other medications for hypertension. Losartan is not coordinated with potassium diuretics, due to increased 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 to do when using 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

Common, ADR> 1/100

Nervous system: dizziness, dizziness, loss of balance.

Nervous system: Sleep, headache, sleep disorders. Abdominal pain, constipation, diarrhea, nausea, vomiting.

Cardiovascular system: fainting, atrial fibrillation, stroke

Nervous system: migraine. liver energy.

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 50 contraindicated drug in the following cases:

Hypersensitivity to active ingredients or any excipients.

Precautions when using

too hypersensitivity

Evaluation: Patients have 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 hypotension, especially after the first dose or after increasing the dose, may occur in patients with reduced blood volume and/or sodium reduction due to forced diuretic or high doses of diuretics, patients are in the stage of reducing salt, diarrhea or vomiting. These diseases must be treated before using Losar-Denk 50 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.

Hepatic failure

Losartan concentration in plasma increases significantly in cirrhosis patients, so they must consider lower doses for patients with a history of liver failure. There is no experience in taking drugs for patients with severe liver failure should be contraindicated to use losartan for patients with severe liver failure.

kidney failure

Because Losartan inhibits the Rennin-Anotensin-Aldosteron system, causes hyperur with blood urea and serum creatinine in patients with narrowed kidney stenosis on both sides or a kidney stenosis one side of patients with only one kidney. Renal function changes may decrease 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 EGRF

Simultaneous use of Losartan with enzyme inhibitors that damage kidney function. Therefore, do not simultaneously use these drugs.

kidney transplantation: Inexperienced medication on patients with kidney transplant.

Initial increase in the concentration of Aldosteron hormones

Patients increasing the initial aldosteron concentration generally not responding to drugs to treat hypertension by inhibiting the Rennin-Anotensin system. So 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

Patients have rare genetic problems such as galactose intolerance, lactase deficiency or glucose-galactose malabsorption should not be taken.

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

Do not use Losartan for pregnant women because of the risk of teratogenicity. If the diagnosis is pregnant, stop using Losartan immediately and start replacement treatment. Losartan exposure in the last 6 months of pregnancy has been known to cause fetal toxicity (impaired renal function, less amniotic fluid, slowing skull) and toxicity to babies (kidney failure, hypertension, potassium strength). 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.

Breastfeeding period

Do not recommend using Losartan for breastfeeding women.

Medicinal interaction

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 levels 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 dry place, temperatures below 30 ° C.

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