Losert Plus (50/12.5mg) 20 Tablets

It contains; Losartan and hydrochlorothiazide as its active components. Losartan: Angiotensin II Receptor Blocker. Losartan selectively and competitively blocks angiotensin II receptors at the AT1 receptor site, this mechanism results in a compensatory increase in levels of renin and angiotensin. This drug binds with AT1 receptors with high affinity and is more than 10000 fold selective for the AT1 receptor than the AT2 receptor. It works by inhibiting angiotensin II-induced vasopressin release, release of adrenal catecholamine, inhibits rapid and slow pressor response, thirst, hyperplasia and cellular hypertrophy, noradrenergic neurotransmission, and increase in sympathetic tone. Losartan also inhibits angiotensin II-induced action of aldosterone and vasoconstriction, which results in lowering of blood pressure. Losartan increases the urinary flow, and excretion of; sodium, potassium, chloride, magnesium, calcium, uric acid and phosphate. In comparison to ACE inhibitors, angiotensin II-receptor blockers effectively inhibit the renin-angiotensin system, while not affecting the response to bradykinin. Hydrochlorothiazide is a thiazide-type diuretic drug that is to treat hypertension globally and is comparatively safe. Hydrochlorothiazide performs its action by acting on the distal convoluted tubules of kidneys and inhibiting the sodium chloride cotransporter system. This mechanism results in a diuretic action that decreases blood pressure, but it could also result in a potassium loss in the urine.

Hydrochlorothiazide, Losartan

Tablet

Hypertension (High Blood Pressure)

Dose must be taken according to the doctor’s advice only; doses given below are suggested as supportive literature for better understanding in some areas of requirements. Adult dose: For hypertension; Initial dose is 50mg Losartan/12.5mg Hydrochlorothiazide orally a day. Dose must be adjusted according to the patient's condition. Do not exceed a dose up 100mg losartan/25mg hydrochlorothiazide orally a day or 50mg losartan/12.5mg hydrochlorothiazide orally after 12 hours.

Overdose of this drug will show you the signs of hypotension, nausea, muscle weakness, extreme dry mouth and thirst and dizziness. Consult your doctor immediately in case of overdose.

In case you missed any dose, take the next dose as soon as you remember, but don't double your next dose to compensate for the missed one.

Take it orally according to your doctor’s advice.

When pregnancy is detected, discontinue losartan as soon as possible. Do not use hydrochlorothiazide in case of increasing azotemia and oliguria during treatment of severe progressive renal disease. Avoid use of this drug during breastfeeding. Avoid use of diuretics like; hydrochlorothiazide for treatment of increased blood pressure in patients with primary adrenal insufficiency.

Hyperkalemia Edema Hypotension Renal Artery Stenosis or Volume Depletion. Myopia Acute angle-closure glaucoma(reversible) Urticaria Muscle spasm Hypomagnesemia Hypercalcemia Hyponatremia Hyperuricemia Hypersensitivity reactions

It may cause headache or dizziness after the first dose. Caution is required in gout or gouty arthritis patients as Hydrochlorothiazide may cause hyperuricemia and precipitate gout or gouty arthritis in susceptible patients. Hydrochlorothiazide must be used with extreme caution or avoid hydrochlorothiazide in the management of ascites due to cirrhosis; because hydrochlorothiazide may lead to rapid progression of hyponatremia when used in combination with spironolactone and furosemide. Caution is required while using hydrochlorothiazide in patients with moderate or high cholesterol concentrations; it may increase cholesterol and triglyceride levels. As hydrochlorothiazide reduces calcium excretions so long term use of hydrochlorothiazide may affect normal functioning of parathyroid gland due to development of hypercalcemia and hypophosphatemia. May cause azotemia in patients with impaired renal function. Use with caution in patients with severe liver dysfunction; avoid electrolyte and acid/base imbalances that might lead to liver encephalopathy or coma. May cause changes in glucose control so use with caution in patients with prediabetes or diabetes mellitus. Avoid the use of diuretics like; hydrochlorothiazide in the immediate postoperative period after bariatric surgery because it could lead to electrolyte disturbances and dehydration. Once oral fluid intake becomes normal then this medicine could be resumed after indication. Some preparation of hydrochlorothiazide may contain propylene glycol; in neonates if large amounts of propylene glycol are given orally, intravenously (e.g., >3,000 mg per day), or topically then it may result in fatal toxicities like; metabolic acidosis, seizures, renal failure, and CNS depression; these toxicities could occur in children and adults including hyperosmolality, lactic acidosis, seizures, and respiratory depression; so use with caution. Development of electrolyte disturbances may be minimized when used in combination with other electrolyte-sparing antihypertensive medicines (e.g., angiotensin-converting enzyme, angiotensin receptor blockers, or aldosterone inhibitors).

Go for monitoring heart rate