Losartan Potassium and Hydrochlorothiazide can pass into your milk and may harm your baby. You and your doctor should decide if you will take Losartan Potassium and Hydrochlorothiazide tablets or breastfeed. You should not do both. Amphetamines: May diminish the antihypertensive effect of Antihypertensive Agents. Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. promethazine shopping
Control of high blood pressure should be part of comprehensive cardiovascular risk management, including, as appropriate, lipid control, diabetes management, antithrombotic therapy, smoking cessation, exercise, and limited sodium intake. Many patients will require more than 1 drug to achieve blood pressure goals. The use of thiazide diuretics is commonly associated with loss of electrolytes, most significantly potassium but also sodium, chloride, bicarbonate, and magnesium. The loss of other electrolytes such as phosphate, bromide and iodide is usually slight. Potassium and magnesium depletion may lead to cardiac arrhythmias and cardiac arrest. Other electrolyte-related complications include metabolic alkalosis and hyponatremia, which are rarely life-threatening. Therapy with thiazide diuretics should be administered cautiously in patients with or predisposed to fluid and electrolyte depletion, including patients with primary or secondary aldosteronism may have low potassium levels; those with severe or prolonged diarrhea or vomiting; and those with poor nutritional status. Fluid and electrolyte abnormalities should be corrected prior to initiating therapy, and blood pressure as well as serum electrolyte concentrations monitored periodically and maintained at normal ranges during therapy. Patients should be advised to immediately report signs and symptoms of fluid or electrolyte imbalance, including dry mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia, arrhythmia, or gastrointestinal disturbances such as nausea and vomiting. Digitalized patients and patients with a history of ventricular arrhythmias should be monitored carefully, since development of hypokalemia may be particularly dangerous in these patients. The risk of hypokalemia may be minimized by slow diuresis, a lower thiazide dosage, potassium supplementation, or combined use with a potassium-sparing diuretic.
Shake suspension well before measuring and administering prescribed dose. Use dosing syringe, dosing spoon, or dosing cup to measure and administer dose. Return suspension to refrigerator immediately after measuring dose. About FAERS: The FDA Adverse Event Reporting System FAERS is used by FDA for activities such as looking for new safety concerns that might be related to a marketed product, evaluating a manufacturer's compliance to reporting regulations and responding to outside requests for information. Reporting of adverse events is a voluntary process, and not every report is sent to FDA and entered into FAERS.
When losartan is taken with grapefruit juice, the grapefruit juice may decrease the ability of your body to activate losartan. This decreased amount of activated losartan may be insufficient to control your blood pressure. It also stimulates aldosterone secretion by the adrenal cortex. Aspergillus nidulans non-disjunction assay at an unspecified concentration. This drug may also be used to treat heart failure. Linear pharmacokinetics. Vd is 34 L losartan and 12 L metabolite. Losartan and active metabolite are highly bound to plasma proteins, primarily albumin. Neither losartan or metabolite accumulates in plasma upon repeated daily dosing.
This information is generalized and not intended as specific medical advice. If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. High Blood Pressure hypertension. Blood pressure is the force in your blood vessels when your heart beats and when your heart rests. You have high blood pressure when the force is too much. The losartan ingredient in Losartan Potassium and Hydrochlorothiazide tablets can help your blood vessels relax so your blood pressure is lower. The hydrochlorothiazide ingredient in Losartan Potassium and Hydrochlorothiazide tablets work by making your kidneys pass more water and salt. Americans. It is found in people of all races and ethnic backgrounds. RxList is part of the WebMD Health Network. The opinions expressed in the WebMD User Reviews are solely those of the User, who may or may not have medical or scientific training, and do not represent the opinions of WebMD. These member reviews have not been reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other purpose except for compliance with our Terms and Conditions. Undergoes substantial first-pass metabolism by CYP-450 2C9 and 3A4 enzymes. Fourteen percent of an oral dose is converted to an active carboxylic acid metabolite that is responsible for most of the angiotensin II receptor antagonist activity. Absorption of hydrochlorothiazide is impaired in the presence of anionic exchange resins. Single doses of either cholestyramine or colestipol resins bind the hydrochlorothiazide and reduce its absorption from the gastrointestinal tract by up to 85 and 43 percent, respectively. Stagger the dosage of hydrochlorothiazide and the resin such that hydrochlorothiazide is administered at least 4 hours before or 4 to 6 hours after the administration of the resin. Gastrointestinal disorders: Dyspepsia, abdominal pain, gastric irritation, cramping, diarrhea, constipation, nausea, vomiting, pancreatitis, sialoadenitis. The administration of a non-steroidal anti-inflammatory agent including a selective COX-2 inhibitor can reduce the diuretic, natriuretic, and antihypertensive effects of loop, potassium-sparing and thiazide diuretics. Therefore, when Losartan Potassium and Hydrochlorothiazide and non-steroidal anti-inflammatory agents including selective COX-2 inhibitors are used concomitantly, observe closely to determine if the desired effect of the diuretic is obtained. Cannabis: CYP2C9 Inhibitors Moderate may increase the serum concentration of Cannabis. More specifically, tetrahydrocannabinol serum concentrations may be increased.
In this study, renal clearance was reduced by 55 to 85% for both losartan and its active metabolite in patients with mild or moderate renal insufficiency. Neither losartan nor its active metabolite can be removed by hemodialysis. Eye problems. One of the medicines in Losartan Potassium and Hydrochlorothiazide tablets can cause eye problems that, if left untreated, may lead to vision loss. Symptoms of eye problems can happen within hours to weeks of starting Losartan Potassium and Hydrochlorothiazide tablets. Drospirenone: Angiotensin II Receptor Blockers may enhance the hyperkalemic effect of Drospirenone. Ceritinib: May increase the serum concentration of CYP2C9 Substrates. American Heart Association with specific antibiotic guidelines. There was no significant effect on heart rate. Store the suspension in the refrigerator between 36-46 degrees F 2-8 degrees C. Do not freeze. Discard any unused suspension after 4 weeks. Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, severe loss of body water and minerals dehydration. Losartan Potassium and Hydrochlorothiazide. Monitor renal function periodically in these patients. Tetrahydrocannabinol: CYP2C9 Inhibitors Moderate may increase the serum concentration of Tetrahydrocannabinol. Tell your doctor if your condition does not improve or if it worsens for example, your blood pressure readings increase. Total plasma Cl of losartan is reduced about 50% and oral bioavailability is increased 2 times. A lower starting dose is recommended. If you take too much Losartan Potassium and Hydrochlorothiazide tablets, call your doctor or Poison Control Center, or go to the nearest hospital emergency room right away. Plasma losartan concentrations are about twice as high in hypertensive women as hypertensive men, but plasma concentrations of active metabolite are similar. Hydrochlorothiazide decreases urinary calcium excretion and may cause elevations of serum calcium. Monitor calcium levels. avana
Grapefruit juice may decrease the amount of active losartan in your blood. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company. Patients on monotherapy were titrated from losartan 50 mg to losartan 100 mg to losartan 150 mg, as needed. The most common signs and symptoms observed are those caused by electrolyte depletion hypokalemia, hypochloremia, hyponatremia and dehydration resulting from excessive diuresis. If digitalis has also been administered, hypokalemia may accentuate cardiac arrhythmias. The degree to which hydrochlorothiazide is removed by hemodialysis has not been established. Pentoxifylline: May enhance the hypotensive effect of Blood Pressure Lowering Agents. What should I tell my doctor before taking Losartan Potassium and Hydrochlorothiazide tablets? Bosentan: May decrease the serum concentration of CYP3A4 Substrates. okuk.info disulfiram
Diazoxide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Thiazides cross the placental barrier and appear in cord blood. There is a risk of fetal or neonatal jaundice, thrombocytopenia, and possibly other adverse reactions that have occurred in adults. Psychiatric disorders: Insomnia, restlessness. Nicorandil: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Enzalutamide: May decrease the serum concentration of CYP2C9 Substrates. Management: Concurrent use of enzalutamide with CYP2C9 substrates that have a narrow therapeutic index should be avoided. Use of enzalutamide and any other CYP2C9 substrate should be performed with caution and close monitoring. LIFE study patients there were 29 primary endpoints among 263 patients on atenolol 11%, 26 per 1000 patient-years and 46 primary endpoints among 270 patients 17%, 42 per 1000 patient-years on losartan. This finding could not be explained on the basis of differences in the populations other than race or on any imbalances between treatment groups. In addition, blood pressure reductions in both treatment groups were consistent between Black and non-Black patients. Given the difficulty in interpreting subset differences in large trials, it cannot be known whether the observed difference is the result of chance. Co, Inc, Whitehouse Station, NJ, 2015. ASH 2015 scientific statement for the treatment of hypertension in patients with coronary artery disease CAD recommends the use of an ARB or ACE inhibitor as part of a regimen in patients with hypertension and chronic stable angina if there is prior MI, LV systolic dysfunction, diabetes mellitus, or CKD. Documentation of allergenic cross-reactivity for angiotensin receptor blockers is limited. It is not known whether losartan is excreted in human milk, but significant levels of losartan and its active metabolite were shown to be present in rat milk. Thiazides appear in human milk. Because of the potential for adverse effects on the nursing infant, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother. The University of Michigan has filed a patent on AGTR1 and is seeking commercial partners. Losartan Potassium and Hydrochlorothiazide tablets can be taken with or without food. Pregnancy: Advise female patients of childbearing age about the consequences of exposure to Losartan Potassium and Hydrochlorothiazide during pregnancy. Discuss treatment options with women planning to become pregnant. Marfan syndrome can rupture the inner layers of the aorta, causing dissection that leads to bleeding in the wall of the vessel. Aortic dissection can be deadly. Surgery may be required to replace the affected part of the aorta. Losartan is used to treat high blood pressure hypertension and to help protect the kidneys from damage due to diabetes. It is also used to lower the risk of strokes in patients with high blood pressure and an enlarged heart. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Losartan belongs to a class of drugs called angiotensin receptor blockers ARBs. It works by relaxing blood vessels so that blood can flow more easily. shop imiquimod manufacturer
At baseline, 1195 13% had diabetes, 1326 14% had isolated systolic hypertension, 1469 16% had coronary heart disease, and 728 8% had cerebrovascular disease. Genetic counseling should be performed prior to pregnancy because Marfan syndrome is an inherited condition. Pregnant women with Marfan syndrome are also considered high-risk cases. If the aorta is normal size, the risk for dissection is lower, but not absent. Those with even slight enlargement are at higher risk and the stress of pregnancy may cause more rapid dilation. Careful follow-up, with frequent blood pressure checks and monthly echocardiograms is required during pregnancy. If there is rapid enlargement or aortic regurgitation, may be required. Your doctor will discuss with you the best method of delivery with you. The following adverse reactions have been identified during post-approval use of Losartan Potassium and Hydrochlorothiazide. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to estimate their frequency reliably or to establish a causal relationship to drug exposure. Hydrochlorothiazide was not genotoxic in vitro in the Ames mutagenicity assay of Salmonella typhimurium strains TA 98, TA 100, TA 1535, TA 1537, and TA 1538 and in the Chinese Hamster Ovary CHO test for chromosomal aberrations, or in vivo in assays using mouse germinal cell chromosomes, Chinese hamster bone marrow chromosomes, and the Drosophila sex-linked recessive lethal trait gene. No carcinogenicity studies have been conducted with the losartan potassium-hydrochlorothiazide combination. Who should not take Losartan Potassium and Hydrochlorothiazide tablets?
Very important. A change in your diet, medicine, or dosage may be necessary. Promptly consult your doctor or pharmacist. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Losartan belongs to a class of drugs called ARBs. It works by relaxing blood vessels so that blood can flow more easily. Methylphenidate: May diminish the antihypertensive effect of Antihypertensive Agents. How often did hospital staff describe possible side effects in a way you could understand? Do not use a household spoon because you may not get the correct dose. Food and Drug Administration. WebMD does not endorse any specific product, service or treatment. Hypertension with left ventricular hypertrophy: Oral: Initial: 50 mg once daily; can be increased to 100 mg once daily based on blood pressure response. Neither losartan nor its active metabolite can be removed by hemodialysis. price epogen work
Oral: Administer without regard to meals; however, administer consistently with respect to food intake at about the same time every day. Keep container tightly closed. Protect from light. Drugs that act on the renin-angiotensin system can cause injury and death to the developing fetus. Discontinue as soon as possible once pregnancy is detected. The use of drugs which act on the renin-angiotensin system are associated with oligohydramnios. Oligohydramnios, due to decreased fetal renal function, may lead to fetal lung hypoplasia and skeletal malformations. Tocilizumab: May decrease the serum concentration of CYP3A4 Substrates. In patients who experience a decline in renal function, discontinuation of AR antagonist therapy is usually not required provided there is symptomatic improvement of the heart failure and renal deterioration is well-tolerated. Transient hypotension is also not a contraindication to further treatment with AR antagonists, since therapy can usually be reinstated without difficulty after blood pressure stabilizes. Use of drugs that act on the renin-angiotensin system during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death. Resulting oligohydramnios can be associated with fetal lung hypoplasia and skeletal deformations. Potential neonatal adverse effects include skull hypoplasia, anuria, hypotension, renal failure, and death. When pregnancy is detected, discontinue losartan as soon as possible. These adverse outcomes are usually associated with use of these drugs in the second and third trimester of pregnancy. Most epidemiologic studies examining fetal abnormalities after exposure to antihypertensive use in the first trimester have not distinguished drugs affecting the renin-angiotensin system from other antihypertensive agents. Appropriate management of maternal hypertension during pregnancy is important to optimize outcomes for both mother and fetus. Nicorandil: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Blood pressure reduction measured at trough was similar for both treatment groups but blood pressure was not measured at any other time of the day. At the end of study or at the last visit before a primary endpoint, the mean blood pressures were 144. If combined, monitor potassium, creatinine, and blood pressure closely. adapalene
Levodopa: Blood Pressure Lowering Agents may enhance the hypotensive effect of Levodopa. While you are taking this medicine, you should avoid eating grapefruit or drinking grapefruit juice. You may choose an alternative citrus beverage such as orange juice. Hypoglycemia 14%; hyperkalemia 7%; weight gain 4%; hyponatremia postmarketing. It may require surgery. Alfuzosin: May enhance the hypotensive effect of Blood Pressure Lowering Agents. For these reasons, FAERS case reports cannot be used to calculate incidence or estimates of risk for a particular product or compare risks between products. Although losartan may be used to prevent kidney problems or treat people who have kidney problems, it may also rarely cause serious kidney problems or make them worse. Your doctor will check your kidney function while you are taking losartan. Tell your doctor right away if you have any signs of kidney problems such as a change in the amount of urine. The opinions expressed in WebMD User-generated content areas like communities, reviews, ratings, or blogs are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. User-generated content areas are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. Marfan syndrome is caused by a change in the gene that controls how the body makes fibrillin, an essential component of connective tissue that contributes to its strength and elasticity. wellbutrin
Losartan Potassium and Hydrochlorothiazide tablets and certain other medicines may interact with each other. In patients who are elderly, volume-depleted including those on diuretic therapy or with compromised renal function, coadministration of NSAIDs, including selective COX-2 inhibitors, with angiotensin II receptor antagonists including losartan may result in deterioration of renal function, including possible acute renal failure. These effects are usually reversible. Monitor renal function periodically in patients receiving losartan and NSAID therapy. To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position. Use caution in treating patients whose renal function may depend on the renin-angiotension-aldosterone system eg, patients with severe CHF. The antihypertensive effects of the drug may be enhanced in the postsympathectomy patient. Hydrochlorothiazide may alter glucose tolerance and raise serum levels of cholesterol and triglycerides. Hydrochlorothiazide, a sulfonamide, can cause an idiosyncratic reaction, resulting in acute transient myopia and acute angle-closure glaucoma. Symptoms include acute onset of decreased visual acuity or ocular pain and typically occur within hours to weeks of drug initiation. Untreated acute angle-closure glaucoma can lead to permanent vision loss. The primary treatment is to discontinue hydrochlorothiazide as rapidly as possible. Prompt medical or surgical treatments may need to be considered if the intraocular pressure remains uncontrolled. Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. There is also an AT 2 receptor found in many tissues but it is not known to be associated with cardiovascular homeostasis. Neither losartan nor its principal active metabolite exhibits any partial agonist activity at the AT 1 receptor, and both have much greater affinity about 1000-fold for the AT 1 receptor than for the AT 2 receptor. In vitro binding studies indicate that losartan is a reversible, competitive inhibitor of the AT 1 receptor. The active metabolite is 10 to 40 times more potent by weight than losartan and appears to be a reversible, non-competitive inhibitor of the AT 1 receptor. Neonates with a history of in utero exposure to Losartan Potassium and Hydrochlorothiazide: If oliguria or hypotension occurs, direct attention toward support of blood pressure and renal perfusion.
Renal and urinary disorders: Glycosuria, renal dysfunction, interstitial nephritis, renal failure. Some products may contain potassium. Chronic kidney disease CKD and hypertension: Regardless of race or diabetes status, the use of an ACE inhibitor ACEI or angiotensin receptor blocker ARB as initial therapy is recommended to improve kidney outcomes. In the general nonblack population without CKD including those with diabetes, initial antihypertensive treatment should consist of a thiazide-type diuretic, calcium channel blocker, ACEI, or ARB. In the general black population without CKD including those with diabetes, initial antihypertensive treatment should consist of a thiazide-type diuretic or a calcium channel blocker instead of an ACEI or ARB. Trimethoprim: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Losartan Potassium and Hydrochlorothiazide tablets. See a complete list of ingredients in Losartan Potassium and Hydrochlorothiazide tablets at the end of this leaflet. The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables. how to purchase chloroquine pharmacy
Cataract 7%; nasal congestion 2%. Lithium: Angiotensin II Receptor Blockers may increase the serum concentration of Lithium. Management: Lithium dosage reductions will likely be needed following the addition of an angiotensin II receptor antagonist. AGTR1 shrunk by 30% within eight weeks. These dosages have been shown to provide respective systemic exposures AUCs for losartan, its active metabolite and hydrochlorothiazide that are approximately 60, 60 and 30 times greater than those achieved in humans with 100 mg of losartan potassium in combination with 25 mg of hydrochlorothiazide. Emotional considerations. Learning you have Marfan syndrome may cause you to feel angry, frightened or sad. You may need to make changes in your lifestyle and adjust to having careful medical follow-up the rest of your life. You may have financial concerns. You also need to consider the risk to your future children. The National Marfan Foundation can provide support. Reduction in the Risk of Stroke: The LIFE study was a multinational, double-blind study comparing losartan and atenolol in 9193 hypertensive patients with ECG-documented left ventricular hypertrophy. Patients with myocardial infarction or stroke within six months prior to randomization were excluded. cheap imuran online canadian pharmacy
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The NTP, however, found equivocal evidence for hepatocarcinogenicity in male mice. The scans can also be used to check the lower back for signs of dural ectasia, a back problem that is common in people with Marfan syndrome. The pharmacokinetics of losartan and its active metabolite are linear with oral losartan doses up to 200 mg and do not change over time. Initiation of Losartan Potassium and Hydrochlorothiazide is not recommended for patients with hepatic impairment because the appropriate starting dose of losartan, 25 mg, is not available. olanzapine
Instruct patient to inform health care provider if persistent cough develops while taking this medication. Brigatinib: May diminish the antihypertensive effect of Antihypertensive Agents. Brigatinib may enhance the bradycardic effect of Antihypertensive Agents. Ciprofloxacin Systemic: Angiotensin II Receptor Blockers may enhance the arrhythmogenic effect of Ciprofloxacin Systemic. What are Losartan Potassium and Hydrochlorothiazide tablets?
Nonsteroidal Anti-Inflammatory Agents. Specifically, the combination may result in a significant decrease in renal function. Nonsteroidal Anti-Inflammatory Agents may diminish the therapeutic effect of Angiotensin II Receptor Blockers. The combination of these two agents may also significantly decrease glomerular filtration and renal function. There are no dosage adjustments provided in the manufacturer's labeling. Cough 11%; bronchitis 10%; upper respiratory tract infection 8%; sinusitis 6%; dry cough postmarketing.
CYP3A4 Inducers Strong: May increase the metabolism of CYP3A4 Substrates. Management: Consider an alternative for one of the interacting drugs. Some combinations may be specifically contraindicated. Consult appropriate manufacturer labeling. Instruct patient in BP and pulse measurement skills. Hg is reasonable for the secondary prevention of cardiovascular events. Dronabinol: CYP2C9 Inhibitors Moderate may increase the serum concentration of Dronabinol.