Sastan-H Treatment of Hypertension (3 blisters x 10 tablets)

hydrochlorothiazid has the effect of lowering blood pressure, according to the mechanism of reducing plasma volume and extracellular fluid due to increased sodium secretion through the urinary tract, then the hypotension effect depends on peripheral resistance.

Dynamic pharmacokinetics

losartan

absorption

After drinking, Losartan absorbs well. Losartan's bioavailability is approximately 33%.

Distribution

both Losartan and active metabolites are highly linked to plasma proteins, mainly albumin and they do not pass the bloodstream barrier. Losartan's distribution volume is about 34 l and metabolites are active about 12 l.

Metabolism

Losartan has initially metabolized through the liver thanks to the cytocrom P450 enzymes. About 14% of Losartan dose is metabolized into active metabolites, this substance is mostly anti -receptor antagonism Angiotesin II.

Elimination

Losartan is eliminated through urine. The clearance of the drug through the kidney corresponds to about 75 ml/minute and with metabolic substances about 25 ml/min.

hydrochlorothiazid

absorption

After drinking, hydrochlorothiazide absorbs relatively fast, about 65–75% of the dose of use, but this ratio may decrease in people with heart failure.

Distribution

hydrochlorothiazid linked to serum protein (40-70%), mainly serum albumin. Hydroclorothiazid also accumulates in red blood cells with a 3 -time stomach level in plasma.

Metabolism

hydrochlorothiazid is not metabolized.

Elimination

hydrochlorothiazide except mainly through the kidneys, largely in the form of non -metabolic. The sale time of hydrochlorothiazid is about 9.5 - 13 hours, but may last in the case of renal failure so the dose should be adjusted.

Be cautious when using

Caution when used for patients with liver and kidney diseases.

Absolute compliance with the prescribed dosage, not arbitrarily increasing or stopping the drug.

The drug can cause headaches, dizziness should be careful when the patient is driving or operating machines.

The ability to drive and operate machinery

drugs that cause headaches, dizziness will affect the ability to drive and operate machinery. Therefore, these objects when using the drug must be very careful.

Pregnancy

The drug directly works on the Renin - Angiotensin system; In the middle and the last three months of pregnancy can cause less amniotic fluid, hypotension, anuria, urinary discharge, face deformation and death in infants. Although the use of drugs in the first three months of pregnancy has not seen the risk of the fetus, but after detecting pregnancy, Losartan must be stopped as soon as possible.

The period of breastfeeding

currently has many clinical research reports on the safety of the drug on nursing women. Therefore, it is necessary to consider carefully before using the drug.

Drug interaction

Losartan does not affect the pharmacokinetics of Digoxin oral or intravenously. Drinking losartan along with cimetidine increases the area under the curve (AUC) of Losartan by about 18%, but does not affect the pharmacokinetics of the active metabolites of Losartan. Drinking Losartan along with Phenobarbital reduces about 20% of Losartan and of active metabolites.

Hyperbysical hyperka when used simultaneously with potassium diuretics, potassium supplements, salt replacement substitutes containing potassium. Rifampicin, aminoglutethimid, carbamazepin, nafcilin, nevirapin, phenytoin, reducing losartan concentration and metabolites in plasma when used simultaneously. Losartan increases the effects of drugs: amifostin, hypotension drugs, carvedilol, hypoglycemic drugs, lithiums, potassium diuretics, rituximab.

There is no pharmacokinetic interaction between losartan and hydrochlorothiazide.

Anti-inflammatory and pain relievers (NSAID) especially COX-2 used in combination with Losartan can cause kidney failure, so kidney function should be monitored.