What Is Losartan Potassium Hydrochlorothiazide?

Losartan Potassium Hydrochlorothiazide Tablets, produced by Hangzhou Merck Pharmaceutical Co., Ltd., under the trade name "Hierjea". This medicine is the first compound preparation of angiotensin II receptor (AT1) antagonists and diuretics. Applicable to patients with hypertension in combination therapy. This product is a yellow oval film-coated tablet, which appears white after removing the coating.

Losartan potassium hydrochlorothiazide

Losartan Potassium Hydrochlorothiazide Tablets, produced by Hangzhou Merck Pharmaceutical Co., Ltd., under the trade name "Hierjea". This medicine is the first compound preparation of angiotensin II receptor (AT1) antagonists and diuretics. Applicable to patients with hypertension in combination therapy. This product is a yellow oval film-coated tablet, which appears white after removing the coating.

Chinese name

Losartan potassium hydrochlorothiazide

Foreign name

LosartanPotassiumandHydrochlorothiazideTablets

Product name

Hetiera

Specifications

50mg / 12.5mg

Losartan-hydrochlorothiazide allergic reaction: angioedema. (See Adverse Reactions) Hepatic and renal impairment: This product is not recommended for patients with hepatic insufficiency or severe renal insufficiency (creatinine clearance 3ml / min) (see Dosage and Administration).

Losartan renal insufficiency inhibits the renin-angiotensin system can lead to changes in renal function, and renal failure has been reported in some sensitive patients (especially in some cases where renal function depends on the renin-angiotensin-aldosterone system (In patients with severe cardiac insufficiency or renal dysfunction). In some patients, changes in kidney function can be reversed after stopping treatment.

Patients with bilateral or unilateral renal artery stenosis or unirenal renal artery stenosis, using other drugs that affect the renin-angiotensin system can cause elevated urea and creatinine in the plasma; these changes in renal function can be caused by withdrawal reverse.

Hydrochlorothiazide hypotension and electrolytic imbalance: As with all other antihypertensive treatments, some patients may develop symptomatic hypotension. Patients with diarrhea or vomiting should be observed for clinical signs of water or electrolyte imbalance, such as hypovolemia, hyponaemia, hypochloremia, hypomagnesemia, or hypokalemia. Blood electrolytes should be checked regularly.

Effects on metabolism and endocrine: thiazide treatment reduces glucose tolerance. It may be necessary to adjust the dose of hypoglycemic agents including insulin (see Drug Interactions). Thiazines reduce urinary calcium excretion and cause intermittent mild elevations in blood calcium. Significant hypercalcemia may be a manifestation of recessive hyperparathyroidism. Therefore, thiazide drugs should be discontinued before the measurement of parathyroid function. Elevated cholesterol and triglyceride may be related to thiazide diuretics. Thiazine treatment may trigger hyperuricemia and / or gout in some patients. Because losartan can reduce uric acid, the combined use of potassium losartan and hydrochlorothiazide can reduce the hyperuricemia caused by diuretics.

Other: Whether patients have a history of allergies or bronchial asthma, allergic reactions may occur when taking thiazines. Cases of aggravating or stimulating systemic lupus erythematosus with thiazide have been reported.

Use with caution by athletes.

The usual starting and maintenance doses of this product are once daily, one losartan potassium hydrochlorothiazide tablet (50mg + 12.5mg). For patients with insufficient response, the dose can be increased to once daily, two tablets each time. Losartan potassium hydrochlorothiazide tablets (50mg + 12.5mg) or losartan potassium hydrochlorothiazide tablets (100mg + 25mg), and this dose is the maximum daily dose. Generally, antihypertensive effects are obtained within 3 weeks of starting treatment. This product cannot be used in patients with insufficient blood volume (such as patients taking high-dose diuretics). This product is not recommended for patients with severe renal insufficiency (creatinine clearance 30Ml / min) or liver insufficiency. Elderly patients with hypertension do not need to adjust the starting dose, but losartan potassium hydrochlorothiazide tablets (100mg + 25mg) should not be used as the initial treatment for elderly patients. This product can be taken in combination with other antihypertensive drugs. This product can be taken with food or alone.

[Medication for pregnant and lactating women] In the middle and late stages of pregnancy, the application of drugs that directly affect the renin-angiotensin system can cause damage to the developing embryo and even death. Therefore, this product should be discontinued as soon as possible after pregnancy. Although there is no experience in using this product in pregnant women, animal experiments have confirmed that losartan potassium has damage and lethal effects on fetuses and newborns, and its mechanism is believed to be mediated by drugs to renin-angiotensin effect. In humans, renal perfusion of the fetus begins in the second trimester, and renal perfusion depends on the development of the renin-angiotensin system. Therefore, if this product is taken in the second or third trimester of pregnancy, the risk to the fetus will increase. Thiazines can appear in umbilical cord blood through the placental barrier. It is recommended that pregnant women with high blood pressure without other diseases not routinely use diuretics to avoid unnecessary harm to the mother and fetus, such as fetal or neonatal jaundice, thrombocytopenia, and other adverse reactions that may occur in adults. Diuretics do not prevent the development of toxemia in pregnancy, and there is no satisfactory evidence that it is effective in toxemia. It is unclear whether losartan is excreted through milk, but thiazide drugs can be found in human milk. Due to its potential adverse effects on nursing infants, the importance of the drug to the mother should be weighed against the decision to stop breastfeeding or to stop using the drug.

[Children's medication] Safety and effectiveness in children have not been determined.

[Medication for elderly patients] In clinical studies, there is no clinically significant difference in the efficacy and safety of this product for elderly (65 years) and young (<65 years) patients.

Losartan has not been found in clinical pharmacokinetic tests with hydrochlorothiazide, digoxin, warfarin, cimetidine, phenobarbital (see hydrochlorothiazide: alcohol, barbiturates or anesthetics), Ketoconazole and erythromycin have clinically significant drug interactions. Rifampicin and fluconazole have been reported to reduce levels of active metabolites. The clinical significance of these interactions has not been evaluated. Like other drugs that block angiotensin II and its effects, losartan potassium and potassium-sparing diuretics (such as spironolactone, amphotericin, amiloride), potassium supplements, or potassium-containing salts Combinations of these alternatives may lead to elevated potassium. Like other antihypertensive drugs, the antihypertensive effect of losartan potassium can be attenuated by the nonsteroidal anti-inflammatory drug indomethacin. When hydrochlorothiazide is used concurrently, the following drugs may interact with thiazide diuretics: alcohol, barbiturates, or anesthetics-may cause orthostatic hypotension. Hypoglycemic agents (oral preparations and insulin)-the dose of hypoglycemic agents may need to be adjusted. Other anti-blood pressure drugs-additive effects. The presence of cholestyramine and colestipol, anion exchange resins, hinders the absorption of hydrochlorothiazide. Single-dose administration of biliary limb or colestipol resin will be combined with hydrochlorothiazide, which can reduce the absorption of thiazide drugs from the gastrointestinal tract by up to 85% and 43%, respectively. Corticosteroids, ACTH-exacerbates electrolyte loss, especially resulting in hypokalemia. Pressurized amines (such as epinephrine)-may reduce the response to pressurized amines, but not enough to prevent their use. Skeletal muscle relaxants, non-depolarizing (eg, cylindricin)-may enhance the muscle relaxant response. Lithium-Diuretics reduce the renal clearance of lithium and increase the risk of lithium poisoning. It is not recommended to use them together. Refer to the instructions for the lithium preparation before use. Non-steroidal anti-inflammatory drugs-The use of non-steroidal anti-inflammatory drugs in some patients reduces diuretic diuretic, natriuretic and antihypertensive effects. Drug / Laboratory Interactions-Due to their effect on calcium metabolism, thiazines can interfere with parathyroid function testing (see Precautions).

There is no specific data on the treatment of this product overdose, symptomatic and supportive therapies can be used. Discontinue this product and observe the patient closely. Recommended measures include vomiting (if an overdose has just taken) and appropriate steps to correct dehydration, electrolyte imbalance, liver coma, and hypotension. There is limited data on human overdose of losartan. The most obvious signs of overdose are hypotension and tachycardia; bradycardia may be due to parasympathetic (vagal) excitement. If symptomatic hypotension occurs, supportive therapy should be implemented. Losartan potassium and its active metabolites cannot be removed by hemodialysis. Hydrochlorothiazide is most commonly signs and symptoms caused by electrolyte loss (hypokalemia, hypochloremia, hyponatremia), and dehydration caused by excessive diuresis. If digitalis is used at the same time, hypokalemia may worsen the arrhythmia. The extent to which hydrochlorothiazide is removed by hemodialysis is unknown.

[Efficacy Indication] This product is used for the treatment of hypertension, and is suitable for patients treated by combined medication. [Chemical composition] Losartan potassium hydrochlorothiazide.

[Pharmacological action] Losartan potassium hydrochlorothiazide is the first compound preparation of angiotensin II receptor (AT1 type) antagonist and diuretic combination.

[Drug interactions] Drug interactions may occur if used with other drugs at the same time, please consult your physician or pharmacist for details.

[Adverse reactions] In clinical trials of losartan potassium-hydrochlorothiazide, no special adverse reactions have been found with this compound drug, which are limited to those previously reported for losartan potassium and / or hydrochlorothiazide. The overall incidence of adverse reactions to this combination was similar to placebo, and the percentage of discontinuations was similar to placebo. In general, treatment with losartan potassium-hydrochlorothiazide is well tolerated, and most adverse reactions are mild and transient in nature and do not require interruption of treatment. In a controlled clinical trial of losartan-hydrochlorothiazide in the treatment of essential hypertension, dizziness was the only adverse drug reaction reported to have occurred at a rate of 1% or more above placebo. Other adverse reactions found after marketing: Allergies: Few reports of angioedema (including laryngeal and glottic swelling of the respiratory tract and / or swelling of the face, lips, pharynx and / or tongue) in patients treated with losartan : Some of these patients have experienced angioedema due to taking other drugs (such as ACE inhibitors). Gastrointestinal tract: hepatitis (rarely reported in patients using losartan); diarrhea. Laboratory test results: In clinically controlled trials, clinically significant changes in standard laboratory parameters were rarely associated with taking losartan potassium hydrochlorothiazide, and 0.7% of patients developed hyperkalemia (blood potassium> 5.5mEq / L), but did not require Therefore losartan potassium hydrochlorothiazide was discontinued. Elevated alanine aminotransferases rarely occur, and recovery is usually stopped.

[Contraindications] Patients who are allergic to any of the ingredients in this product; 1. Patients who have no urine; 2. Patients who are allergic to other sulfa drugs. 3. Pregnancy: Losartan potassium hydrochlorothiazide is used in the second or third trimester of pregnancy. The drug directly affects the renin angiotensin system, which can cause fetal damage and even death. Therefore, after confirming pregnancy, the drug should be stopped as soon as possible.