Hypoglycemia 14%; hyperkalemia 7%; weight gain 4%; hyponatremia postmarketing. AHA 2013 heart failure guidelines recommend an initial dose of 25 to 50 mg once daily; target dose: 150 mg once daily Yancy, 2013. 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. buy clavamox tenerife clavamox
Sarilumab: May decrease the serum concentration of CYP3A4 Substrates. Plasma protein binding is constant over the concentration range achieved with recommended doses. Studies in rats indicate that losartan crosses the blood-brain barrier poorly, if at all. Sodium Phosphates: Angiotensin II Receptor Blockers may enhance the nephrotoxic effect of Sodium Phosphates. Specifically, the risk of acute phosphate nephropathy may be enhanced. Management: Consider avoiding this combination by temporarily suspending treatment with ARBs, or seeking alternatives to oral sodium phosphate bowel preparation. If the combination cannot be avoided, maintain adequate hydration and monitor renal function closely.
The mean age was 53 years. Ora-Plus and Ora-Sweet SF and shake for 1 min to disperse ingredients. Trimethoprim: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers.
CYP2C9 Inhibitors Strong: May decrease the metabolism of CYP2C9 Substrates. Losartan Potassium and Hydrochlorothiazide. Monitor renal function periodically in these patients. Your doctor may do blood tests from time to time while you are taking Losartan Potassium and Hydrochlorothiazide tablets. 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. OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional. cyclophosphamide
Yohimbine: May diminish the antihypertensive effect of Antihypertensive Agents. 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. CYP3A4 Inducers Moderate: May decrease the serum concentration of CYP3A4 Substrates. Nervous system disorders: Dysgeusia, headache, migraine, paraesthesias. Amodiaquine: CYP2C8 Inhibitors may increase the serum concentration of Amodiaquine. Keep Losartan Potassium and Hydrochlorothiazide tablets in a tightly closed container, and keep Losartan Potassium and Hydrochlorothiazide tablets out of the light. Plasma losartan concentrations are about twice as high in hypertensive women as hypertensive men, but plasma concentrations of active metabolite are similar. What is the most important information I should know about Losartan Potassium and Hydrochlorothiazide tablets? F. Protect from light. To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position. Plasma concentrations may be increased by losartan, resulting in an increase in the pharmacologic and adverse effects of lithium. Phosphodiesterase 5 Inhibitors: May enhance the hypotensive effect of Blood Pressure Lowering Agents. No clinically significant drug interactions have been found in studies of losartan potassium with hydrochlorothiazide, digoxin, warfarin, cimetidine and phenobarbital. However, rifampin has been shown to decrease the AUC of losartan and its active metabolite by 30% and 40%, respectively. Fluconazole, an inhibitor of cytochrome P450 2C9, decreased the AUC of the active metabolite by approximately 40%, but increased the AUC of losartan by approximately 70% following multiple doses. Conversion of losartan to its active metabolite after intravenous administration is not affected by ketoconazole, an inhibitor of P450 3A4. Tell your doctor about all of the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. 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. Endocarditis prevention. People with Marfan syndrome who have heart or valve involvement or who have had heart surgery may be at increased risk for bacterial endocarditis. This is an infection of the heart valves or tissue which occurs when bacteria enters the blood stream. To prevent this, may be needed prior to dental or surgical procedures.
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. Biliary excretion contributes to the elimination of losartan and metabolite. About 4% is excreted unchanged in the urine and 6% excreted as active metabolite in urine. Musculoskeletal and connective tissue disorders: Muscle cramps, muscle spasm, myalgia, arthralgia. 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. Eye disorders: Xanthopsia, transient blurred vision. Tell your doctor if your condition does not improve or if it worsens for example, your blood pressure readings increase. Closely monitor blood pressure, renal function, and electrolytes in patients on Losartan Potassium and Hydrochlorothiazide and other agents that affect the RAS. Losartan Potassium and Hydrochlorothiazide tablets have not been studied in children less than 18 years old. 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. Educate patient about signs of a significant reaction eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat. Note: This is not a comprehensive list of all side effects. Patients should consult prescriber for additional questions. Investigations: Liver function abnormalities. elavil
Hypotension: Symptomatic hypotension may occur upon initiation in patients who are salt or volume depleted eg, those treated with high-dose diuretics; correct volume depletion prior to administration. This transient hypotensive response is not a contraindication to further treatment with losartan. Hydrochlorothiazide is a thiazide diuretic. Thiazides affect the renal tubular mechanisms of electrolyte reabsorption, directly increasing excretion of sodium and chloride in approximately equivalent amounts. Indirectly, the diuretic action of hydrochlorothiazide reduces plasma volume, with consequent increases in plasma renin activity, increases in aldosterone secretion, increases in urinary potassium loss, and decreases in serum potassium. The renin-aldosterone link is mediated by angiotensin II, so coadministration of an angiotensin II receptor antagonist tends to reverse the potassium loss associated with these diuretics. The mechanism of the antihypertensive effect of thiazides is unknown. Antifungal Agents Azole Derivatives, Systemic: May decrease the metabolism of Losartan. Applicable Isavuconazonium considerations are addressed in separate monographs. Exceptions: Isavuconazonium Sulfate. 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. Medicines are sometimes prescribed for conditions that are not mentioned in patient information leaflets. Do not use Losartan Potassium and Hydrochlorothiazide tablets for a condition for which it was not prescribed. Do not give Losartan Potassium and Hydrochlorothiazide tablets to other people, even if they have the same symptoms that you have. Dizziness or lightheadedness may occur as your body adjusts to the medication. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. Amifostine: Blood Pressure Lowering Agents may enhance the hypotensive effect of Amifostine. Management: When amifostine is used at chemotherapy doses, blood pressure lowering medications should be withheld for 24 hours prior to amifostine administration. If blood pressure lowering therapy cannot be withheld, amifostine should not be administered. 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. Heparin: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. ACE Inhibitors. Angiotensin II Receptor Blockers may increase the serum concentration of ACE Inhibitors. Management: In US labeling, use of telmisartan and ramipril is not recommended. It is not clear if any other combination of an ACE inhibitor and an ARB would be any safer. Consider alternatives to the combination when possible. Cardiac disorders: Palpitation, tachycardia.
Digestive: Hepatitis has been reported rarely in patients treated with losartan. How should I take Losartan Potassium and Hydrochlorothiazide tablets? HER2 in order to develop more targeted treatments for women whose breast cancers are not HER2-positive and therefore do not respond to Herecptin. Advise patient to take daily or bid as prescribed, without regard to meals, but to take with food if stomach upset occurs. 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. This leaflet summarizes the most important information about Losartan Potassium and Hydrochlorothiazide tablets. If you would like more information, talk with your doctor. You can ask your pharmacist or doctor for information that is written for health professionals. Enzalutamide: May decrease the serum concentration of CYP3A4 Substrates. Management: Concurrent use of enzalutamide with CYP3A4 substrates that have a narrow therapeutic index should be avoided. Use of enzalutamide and any other CYP3A4 substrate should be performed with caution and close monitoring. is it safe to buy coreg
Metabolism: Losartan is an orally active agent that undergoes substantial first-pass metabolism by cytochrome P450 enzymes. It is converted, in part, to an active carboxylic acid metabolite that is responsible for most of the angiotensin II receptor antagonism that follows losartan treatment. About 14% of an orally-administered dose of losartan is converted to the active metabolite. In addition to the active carboxylic acid metabolite, several inactive metabolites are formed. In vitro studies indicate that cytochrome P450 2C9 and 3A4 are involved in the biotransformation of losartan to its metabolites. Hepatic impairment: Use with caution in patients with hepatic impairment or a history of hepatic impairment; dose adjustment needed. 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. Potassium Salts: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Rate and magnitude of losartan metabolism to its active metabolite may be decreased, possibly reducing the efficacy; however, based on available data, a clinically important interaction is unlikely. St John's Wort: May decrease the serum concentration of CYP3A4 Substrates. Management: Consider an alternative for one of the interacting drugs. Some combinations may be specifically contraindicated. Consult appropriate manufacturer labeling.
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. Medications are typically not used to treat Marfan syndrome. However, your doctor may prescribe a beta-blocker, which decreases the forcefulness of the heartbeat and the pressure within the arteries, thus preventing or slowing the enlargement of the aorta. Beta-blocker therapy is usually started when the person with Marfan syndrome is young. Persistent dry cough has been associated with ACE-inhibitor use and in practice can be a cause of discontinuation of ACE-inhibitor therapy. Two prospective, parallel-group, double-blind, randomized, controlled trials were conducted to assess the effects of losartan on the incidence of cough in hypertensive patients who had experienced cough while receiving ACE-inhibitor therapy. In efforts to control blood pressure, the patients in both arms of the LIFE study were coadministered hydrochlorothiazide the majority of time they were on study drug 73. Anaphylactic reactions, angioedema including swelling of the larynx and glottis, swelling of the face, lips, pharynx, and tongue vasculitis including Henoch-Schönlein purpura postmarketing. 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. Back pain 12%; muscular weakness 7%; knee pain, leg pain 5%; muscle cramp 1%; rhabdomyolysis postmarketing. Psychiatric disorders: Insomnia, restlessness. Aliskiren: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Aliskiren may enhance the hypotensive effect of Angiotensin II Receptor Blockers. Aliskiren may enhance the nephrotoxic effect of Angiotensin II Receptor Blockers. Management: Aliskiren use with ACEIs or ARBs in patients with diabetes is contraindicated. Respective AUCs for losartan, its active metabolite and hydrochlorothiazide at these dosages in rats were approximately 35, 10 and 10 times greater than those achieved in humans with the administration of 100 mg of losartan in combination with 25 mg hydrochlorothiazide. Distribution: The volume of distribution of losartan and the active metabolite is about 34 liters and 12 liters, respectively. Absorption: Following oral administration, losartan is well absorbed and undergoes substantial first-pass metabolism. The systemic bioavailability of losartan is approximately 33%. Mean peak concentrations of losartan and its active metabolite are reached in 1 hour and in 3 to 4 hours, respectively. While maximum plasma concentrations of losartan and its active metabolite are approximately equal, the AUC area under the curve of the metabolite is about 4 times as great as that of losartan. It also stimulates aldosterone secretion by the adrenal cortex. Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? purchase generic bactrim online store
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. CycloSPORINE Systemic: Angiotensin II Receptor Blockers may enhance the hyperkalemic effect of CycloSPORINE Systemic. Some products may contain potassium. Hydrochlorothiazide may alter glucose tolerance and raise serum levels of cholesterol and triglycerides. 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. Genetic testing alone cannot tell you if you have Marfan syndrome, as there are other connective tissue disorders. Do not consider WebMD User-generated content as medical advice. Never delay or disregard seeking professional medical advice from your doctor or other qualified healthcare provider because of something you have read on WebMD. You should always speak with your doctor before you start, stop, or change any prescribed part of your care plan or treatment. WebMD understands that reading individual, real-life experiences can be a helpful resource but it is never a substitute for professional medical advice, diagnosis, or treatment from a qualified health care provider. If you think you may have a medical emergency, call your doctor or dial 911 immediately. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure JNC. When unstented bilateral renal artery stenosis is present, use is generally avoided due to the elevated risk of deterioration in renal function unless possible benefits outweigh risks. Know the medicines you take. Keep a list of your medicines and show it to your doctor and pharmacist when you get a new medicine. June 1, 2009 -- Researchers at the University of Michigan have identified a gene that may be involved in as many as one in five cancers. And the gene could be blocked by a common drug. 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. If you are using the liquid form of this medication, shake the bottle well before each dose. Low blood pressure hypotension. Low blood pressure may cause you to feel faint or dizzy. Lie down if you feel faint or dizzy. Call your doctor right away.
Diarrhea 15%; gastritis 5%; dyspepsia 4%. Concomitant use of potassium-sparing diuretics, potassium supplements, or salt substitutes containing potassium may lead to increases in serum potassium. Resveratrol: May decrease serum concentrations of the active metabolites of Losartan. Resveratrol may increase the serum concentration of Losartan. What are the possible side effects of Losartan Potassium and Hydrochlorothiazide tablets? Quinagolide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. iressa
Instruct patient to inform health care provider if persistent cough develops while taking this medication. Levodopa: Blood Pressure Lowering Agents may enhance the hypotensive effect of Levodopa. Losartan Potassium and Hydrochlorothiazide is available for oral administration in three tablet combinations of losartan and hydrochlorothiazide. What Are Side Effects Associated with Using Losartan? Of the randomized patients, 4963 54% were female and 533 6% were Black. Hyperuricemia may occur or frank gout may be precipitated in patients receiving thiazide therapy. Because losartan decreases uric acid, losartan in combination with hydrochlorothiazide attenuates the diuretic-induced hyperuricemia.
Hydrochlorothiazide is not metabolized but is eliminated rapidly by the kidney. In these cases, surgery to replace or repair the is necessary. If surgery is performed early, before the valves are damaged, the aortic or mitral valve may be repaired and preserved. If the valves are damaged, they may need to be replaced. Losartan pharmacokinetics have been investigated in the elderly 65 to 75 years and in both genders. Plasma concentrations of losartan and its active metabolite are similar in elderly and young hypertensives. Plasma concentrations of losartan were about twice as high in female hypertensives as male hypertensives, but concentrations of the active metabolite were similar in males and females. How should I store Losartan Potassium and Hydrochlorothiazide tablets? 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. Limited data are available in regard to overdosage in humans. The most likely manifestation of overdosage would be hypotension and tachycardia; bradycardia could occur from parasympathetic vagal stimulation. If symptomatic hypotension should occur, supportive treatment should be instituted. Read the Patient Information Leaflet if available from your pharmacist before you start taking losartan and each time you get a refill. If you have any questions, ask your doctor or pharmacist. Inactive ingredients: colloidal silicon dioxide, hydroxypropyl cellulose, hypromellose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, pregelatinised starch maize and titanium dioxide. What Is Losartan and How Does It Work? online apotheke epoetin-alfa
Vascular disorders: Dose-related orthostatic effects, necrotizing angiitis vasculitis, cutaneous vasculitis. What are Losartan Potassium and Hydrochlorothiazide tablets? Hypersensitivity reactions to hydrochlorothiazide may occur in patients with or without a history of allergy or bronchial asthma, but are more likely in patients with such a history. It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding. Cataract 7%; nasal congestion 2%. LVH can happen from several things. High blood pressure is the most common cause of LVH. Minor increases in BUN or serum creatinine, small decreases in Hgb and Hct, occasional elevations in liver enzymes and serum bilirubin postmarketing.
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. The terminal half-life of losartan is about 2 hours and of the metabolite is about 6 to 9 hours. After single doses of losartan administered orally, about 4% of the dose is excreted unchanged in the urine and about 6% is excreted in urine as active metabolite. Biliary excretion contributes to the elimination of losartan and its metabolites. Following oral 14C-labeled losartan, about 35% of radioactivity is recovered in the urine and about 60% in the feces. Following an intravenous dose of 14C-labeled losartan, about 45% of radioactivity is recovered in the urine and 50% in the feces. Neither losartan nor its metabolite accumulate in plasma upon repeated once-daily dosing. How often did hospital staff describe possible side effects in a way you could understand? The primary endpoint was the first occurrence of cardiovascular death, nonfatal stroke, or nonfatal myocardial infarction. 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. 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. 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. The goal of surgery for Marfan syndrome is to prevent aortic dissection or rupture and to treat problems affecting the heart's valves, which control the flow of blood in and out of the heart and between the heart's chambers. Before having surgery, tell your doctor or dentist about all the products you use including prescription drugs, nonprescription drugs, and herbal products. This information is generalized and not intended as specific medical advice. Do not coadminister aliskiren with Losartan Potassium and Hydrochlorothiazide in patients with diabetes. Pholcodine: Blood Pressure Lowering Agents may enhance the hypotensive effect of Pholcodine. cvs brand zyban for dogs
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Losartan Potassium and Hydrochlorothiazide tablets contain 2 prescription medicines, an angiotensin receptor blocker ARB and a diuretic water pill. 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. cheapest imuran order now usa imuran
Who should not take Losartan Potassium and Hydrochlorothiazide tablets? The double-blind treatment period lasted up to 8 weeks. The incidence of cough is shown in Table 1 below. Scapa E. Effect of grapefruit juice on the pharmacokinetics of losartan and its active metabolite E3174 in healthy volunteers. Dual blockade of the RAS with angiotensin receptor blockers, ACE inhibitors, or aliskiren is associated with increased risks of hypotension, syncope, hyperkalemia, and changes in renal function including acute renal failure compared to monotherapy. AGTR1 shrunk by 30% within eight weeks.
Canadian labeling: Use is not recommended. Other diagnostic tests for Marfan syndrome include a slit lamp in which the doctor will check for dislocated lenses. Hepato-biliary disorders: Jaundice intrahepatic cholestatic jaundice. After 6 weeks of therapy, more patients who received the combination regimen reached target diastolic blood pressure than those who received the monotherapy regimen 29. atinn.info albendazole
Losartan Potassium and Hydrochlorothiazide tablets are not usually the first medicine used to treat high blood pressure. Adults: No dosage adjustment necessary unless the patient is volume depleted; monitor closely. There was no significant effect on heart rate.