Losartan Boston 50mg treatment of hypertension from mild to severe (4 blisters x 15 tablets)

Digestive system: abdominal pain, constipation, diarrhea, nausea, vomiting.

Skin and subcutaneous tissue: urticaria, itching, rash. Other: edema.

Rare, ADR

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

Be cautious when using

Ingredients containing lactose may not be suitable for patients with lactose intolerance, galactosemia disease or absorbent glucose/galactose.

Hypersensitivity reactions, eagles

It is not recommended for patients with a history of angioedema or not related to ACE inhibitors or Angiotensin II receptor objects.

Lagging blood pressure and electrolyte disorders

Symptomic hypotension, especially after the first dose and after increasing the dose, may occur in patients with reduced intravascular volume and/or sodium lowering due to the treatment of high doses, salt diet, diarrhea or vomiting. Therefore, this condition must be adjusted before starting the drug or the starting dose lower.

Electrolyte imbalance

Common in patients with renal failure, suffering from or without diabetes and needs treatment. With type II diabetes, kidney disease is hyperactive, need to closely monitor the concentration of potassium potassium and creatinine clearance, especially patients with heart failure and creatinine clearance (30 - 50 ml/min).

Do not simultaneously use potassium -saving, potassium supplements, replace salt containing potassium with losartan.

Patients with liver failure

Use low doses for patients with a history of liver failure. Do not use losartan for patients with severe liver failure, drugs are not recommended for children with liver failure.

Patients with renal failure

Due to the inhibition of the Renin - Angiotensin system, it can cause kidney failure (especially in patients with renal function depending on the Renin - Angiotensin - Aldosteron system, such as people with pre -severe kidney dysfunction or severe heart failure), which can increase blood urea and creatinine (patients with nephrotic stenosis of one or either side).

Kidney function can recover when discontinued. Caution should be careful in patients with one or both sides of the kidney artery.

Children kidney failure

Losartan is not recommended in children with glomerular filtration

Need to monitor kidney function regularly, especially when fever, dehydration can reduce kidney function.

Not used simultaneously inhibits ACE and Losartan.

Patients with kidney transplant

No experience.

primary Aldosteron

Not responding to Losartan.

Calm and cerebrovascular disease

Excessive hypothermia due to lack of oxygen can lead to myocardial infarction or stroke

heart failure

In patients with heart failure, with or without renal failure, there is a risk of severe arterial hypotension and kidney failure (usually acute).

Caution in patients with heart failure and severe renal failure, in patients with severe heart failure (4 -degree heart failure according to NYHA) as well as in patients with heart failure and symptoms of life -threatening arrhythmia.

Be cautious when combining Losartan with beta blockers.

Caution in patients with aortic valve stenosis and mitral valve, hypertrophic myocardial obstruction.

Patients planning pregnancy/pregnancy

Losartan is not selected when starting pregnancy unless necessary. Patients planning pregnancy need to be exchanged for safe hypertension. When you know pregnancy, it is necessary to stop Losartan immediately, and start appropriate alternative therapy.

Coordinate with the Renin Angiotensin Aldosteron inhibitors

Concomitance of ACE inhibitors, Angiotensin II or Aliskiren inhibitors increases the risk of hypotension, hyperkalemia and impaired kidney function (including acute renal failure).

If combined with the Renin Angiotensin Aldosteron inhibitors are absolutely necessary, regular monitoring regularly, electrolyte and blood pressure.

ACE inhibitors and Angiotensin II receptor antagonists should not be used simultaneously in patients with diabetes kidney disease.

The ability to drive and operate machinery

There has been no research on the influence of Losartan on the ability to drive and operate machinery. However, unwanted effects such as dizziness, fatigue can occur, especially when increasing the dose. Be careful in these cases.

Pregnancy

Use drugs directly on the Renin-Anotensin system in the three months between or the last 3 months of pregnancy may cause damage and death for the fetus. When detecting pregnancy, it is necessary to stop using Losartan as soon as possible.

Whether Losartan is excreted in breast milk. Due to the possibility of harming breastfeeding, deciding to stop breastfeeding, or taking drugs to take into account the importance of the drug for the mother.

Interaction

used with other drugs may increase the risk of hypotension: other blood pressure drugs, three -ring antidepressants, anti -psychotic drugs, Baclofen and amifostine.

Losartan metabolizes through CYP 2C9, so when used with fluconazole (CYP 2C9 inhibitor), it reduces the formation of an activity of about 50%, and is used with Fluvastatin (CYP2C9 weak inhibitor) is not affected.

Sharing losartan with rifampicin reduced 40% of the concentration of active metabolites in plasma.

Do not share losartan with the following drugs because it can lead to increased serum potassium: Angiotensin II receptor resistant drugs, potassium -keeping drugs (potassium -saving, amilorid, triamteren, spironolacton) or increases potassium levels (heparin), potassium supplements or salt replacement substances containing potassium.

It is necessary to carefully monitor the lithium content in serum if used in combination with lithium salts with Angiotensin II receptor antagonistic drugs.

Anti-blood pressure effects of Angiotensin II receptor antagonists or ACE inhibitors can be reduced by NSAIDs, including selective inhibitors of COX-2, acetylsalicylic acid with anti-inflammatory doses.

Concomitance Angiotensin II receptor antagonists or diuretics and NSAID drugs can lead to an increase in the risk of kidney function (acute renal failure), and serum hyperpassia, especially in patients with impaired kidney function. The combination needs to be cautious, especially in the elderly. Always keep the body in a state of water equilibrium and monitor kidney function at the beginning of treatment simultaneously, and periodically later.

Clinical test data has shown that combining with the Renin Angiotensin Aldosteron (RAAS) inhibitors through the use of a combination of ACE, ARB or Aliskiren inhibitors associated with a higher frequency than side effects such as hypotension, hyperkalemia and impaired kidney function (including acute renal failure) compared to RAAS.