Hydrohlorotyazyd, Losartan | Lozap Plus tablets coated.pl.ob. 50 mg + 12.5 mg 90 pcs.
Special Price
$27.60
Regular Price
$39.00
In stock
SKU
BID464790
Release form
film-coated tablets.
film-coated tablets.
Release form
film-coated tablets.
Packing
90 pcs.
Pharmacological action
Lozap - losartan is a specific antagonist of angiotensin II receptors (subtype AT 1). He inhibits kinase II, an enzyme that catalyzes the conversion of angiotensin I to angiotensin II.
Reduces OPSS, blood concentration of adrenaline and aldosterone, blood pressure, pressure in the pulmonary circulation reduces afterload, has a diuretic effect. It interferes with the development of myocardial hypertrophy, increases exercise tolerance in patients with heart failure.
losartan does not inhibit angiotensin converting enzyme (ACE) kininase II and, accordingly, it does not prevent the destruction of bradykinin, therefore side effects indirectly associated with bradykinin (for example, angioedema) are quite rare.
After a single oral administration, the hypotensive effect (systolic and diastolic blood pressure decreases) reaches a maximum after b hours, then gradually decreases within 24 hours.
The maximum hypotensive effect develops after 3 weeks after the start of the drug.
In patients with arterial hypertension without concomitant diabetes mellitus with proteinuria (more than 2 g / day), the use of the drug significantly reduces proteinuria, the excretion of albumin and immunoglobulins G.
Stabilizes the level of urea in blood plasma. Does not affect vegetative reflexes, and does not have a lasting effect on the concentration of norepinephrine in blood plasma. Losartan in a dose of up to 150 mg per day does not affect the level of triglycerides, total cholesterol and cholesterol of high density lipoproteins (HDL) in blood serum in patients with arterial hypertension. At the same dose, losartan does not affect fasting blood glucose levels.
Indications
- Arterial hypertension.
- Chronic heart failure (as part of combination therapy, with intolerance or ineffectiveness of therapy with ACE inhibitors).
- To reduce the risk of developing cardiovascular disease (including stroke) and mortality in patients with arterial hypertension and left ventricular hypertrophy.
- Diabetic nephropathy with hypercreatininemia and proteinuria (ratio of urine albumin and creatinine more than 300 mg / g) in patients with type 2 diabetes and concomitant arterial hypertension (reduced progression of diabetic nephropathy to terminal chronic renal failure).
Contraindications
- Hypersensitivity to the components of the drug.
- Pregnancy.
- Lactation.
- Age under 18 years of age (efficacy and safety not established).
Precautions:
- Arterial hypotension.
- Reduced circulating blood volume.
- Violations of the water-electrolyte balance.
- Bilateral renal artery stenosis.
- Stenosis of a single kidney artery.
- Renal failure.
- Liver failure.
Pregnancy and lactation
There are no data on the use of Lozap during pregnancy. However, it is known that drugs that directly affect the renin-angiotensin system, when used in the second and third trimesters of pregnancy, can cause a developmental defect or even death of the developing fetus. Therefore, if a pregnancy occurs, Lozap should be stopped immediately.
When prescribed during lactation, a decision should be made either to stop breastfeeding or to stop treatment with the drug.
Special instructions
It is necessary to correct dehydration before prescribing Lozap or to begin treatment with a lower dose.
Drugs that affect the renin-angiotensin system can increase blood urea and serum creatinine in patients with bilateral renal stenosis or stenosis of a single kidney artery.
During the treatment period, the concentration of potassium in the blood should be regularly monitored, especially in elderly patients, with impaired renal function.
In patients with cirrhosis of the liver, the concentration of losartan in the blood plasma increases significantly, in connection with which, in the presence of liver diseases in history, it should be prescribed in lower doses.
losartan does not affect the ability to drive or operate machinery.
Composition
In 1 film-coated tablet contains: losartan potassium 50 mg.
Dosage and administration of
The drug is taken orally, regardless of food intake. Multiplicity of admission - 1 time per day.
For arterial hypertension, the average daily dose is 50 mg. In some cases, to achieve a greater therapeutic effect, the dose is increased to 100 mg in two doses or 1 time per day.
In heart failure, the initial dose for patients is 12.5 mg 1 time / day. Typically, the dose increases with a weekly interval (i.e. 12.5 mg / day, 25 mg / day, 50 mg / day) to an average maintenance dose of 50 mg 1 time / day, depending on patient tolerance.
Patients receiving diuretics in high doses, the initial dose should be reduced to 25 mg 1 time / day. It is not necessary to adjust the dose to elderly patients.
To reduce the risk of developing cardiovascular diseases (including stroke) and mortality in patients with arterial hypertension and left ventricular hypertrophy, the initial dose of the drug is 50 mg per day once. In the future, hydrochlorothiazide in low doses can be added and / or the dose of the drug can be increased to 100 mg per day in one or two doses. Patients with concomitant type 2 diabetes mellitus with proteinuria: the drug is prescribed in an initial dose of 50 mg once a day with a further increase in dose to 100 mg / day (taking into account the degree of blood pressure reduction) in one or two doses.
In type 2 diabetes mellitus with proteinuria, the initial dose of the drug is 50 mg 1 time per day with a further increase in dose to 100 mg / day (taking into account the degree of blood pressure reduction) in 1 or 2 doses.
Patients with a history of liver disease, dehydration, during the hemodialysis procedure, as well as patients over 75 years of age, a lower initial dose of the drug is recommended - 25 mg once a day.
Side effects
Allergic reactions: angioedema, including swelling of the larynx and / or tongue, leading to airway obstruction, and / or swelling of the face, lips, pharynx, and / or tongue, occasionally noted with losartan.
In some of the patients with the above allergic reactions, angioedema previously occurred with other drugs, including and ACE inhibitors. It is extremely rare when taking losartan that manifestations of vasculitis, including Shenlein-Genoch disease, were noted.
From the cardiovascular system: lowering blood pressure.
From the digestive tract: when taking losartan, rare (
From the respiratory: when taking losartan - cough.
From the skin: urticaria.
Laboratory parameters: rarely (5.5 mmol / l), increased liver activity transaminase
Drug Interactions
May be prescribed with other antihypertensives. Mutually enhances the effect of beta-blockers and sympatholytics. The combined use of losartan with diuretics has an additive effect.
No pharmacokinetic interactions of losartan with hydrochlorothiazide, digoxin, warfarin, cimetidine, phenobarbital, ketoconazole and erythromycin have been observed. Rifampicin and fluconazole have been reported to lower plasma levels of active metabolite. The clinical significance of these interactions is still unknown. As with other agents that inhibit angiotensin II or its effect, the combined use of losartan with potassium-sparing diuretics (for example, spironolactone, triamteren, amiloride), potassium preparations and salts containing potassium increases the risk of hyperkalemia.
Nonsteroidal anti-inflammatory drugs (NSAIDs), including selective cyclooxygenase-2 inhibitors (C0G-2), can reduce the effect of diuretics and other antihypertensive drugs.
With the combined use of angiotensin II and lithium receptor antagonists, an increase in the concentration of lithium in blood plasma is possible. Given this, it is necessary to weigh the benefits and risks of the combined use of losartan with lithium salts. If it is necessary to use the drugs together, it is necessary to regularly monitor the concentration of lithium in the blood plasma.
Overdose
Symptoms: severe BP, tachycardia due to parasympathetic (vaginal) stimulation, bradycardia may occur.
Treatment: forced diuresis, symptomatic therapy, hemodialysis is not effective.
Storage conditions
Do not store above 30 РC.
Shelf life
3 years.
Deystvuyushtee substance
Gidrohlorotiazid, Losartan
dosage form
tablets
Possible product names
Lozap plus tablets 50 mg + 12.5 mg, 90 pcs.
LOZAP PLUS 0.05 + 0.0125 N90 TABLE P / O
LOZAP PLUS 0.05 + 0.0125 N90 TABLE P / FILM / SHELL
Lozap Plus 50 + 12.5mg Tab. p / pl / rev X90
Lozap plus 50mg + 12.5mg tab. PO No. 90
film-coated tablets.
Packing
90 pcs.
Pharmacological action
Lozap - losartan is a specific antagonist of angiotensin II receptors (subtype AT 1). He inhibits kinase II, an enzyme that catalyzes the conversion of angiotensin I to angiotensin II.
Reduces OPSS, blood concentration of adrenaline and aldosterone, blood pressure, pressure in the pulmonary circulation reduces afterload, has a diuretic effect. It interferes with the development of myocardial hypertrophy, increases exercise tolerance in patients with heart failure.
losartan does not inhibit angiotensin converting enzyme (ACE) kininase II and, accordingly, it does not prevent the destruction of bradykinin, therefore side effects indirectly associated with bradykinin (for example, angioedema) are quite rare.
After a single oral administration, the hypotensive effect (systolic and diastolic blood pressure decreases) reaches a maximum after b hours, then gradually decreases within 24 hours.
The maximum hypotensive effect develops after 3 weeks after the start of the drug.
In patients with arterial hypertension without concomitant diabetes mellitus with proteinuria (more than 2 g / day), the use of the drug significantly reduces proteinuria, the excretion of albumin and immunoglobulins G.
Stabilizes the level of urea in blood plasma. Does not affect vegetative reflexes, and does not have a lasting effect on the concentration of norepinephrine in blood plasma. Losartan in a dose of up to 150 mg per day does not affect the level of triglycerides, total cholesterol and cholesterol of high density lipoproteins (HDL) in blood serum in patients with arterial hypertension. At the same dose, losartan does not affect fasting blood glucose levels.
Indications
- Arterial hypertension.
- Chronic heart failure (as part of combination therapy, with intolerance or ineffectiveness of therapy with ACE inhibitors).
- To reduce the risk of developing cardiovascular disease (including stroke) and mortality in patients with arterial hypertension and left ventricular hypertrophy.
- Diabetic nephropathy with hypercreatininemia and proteinuria (ratio of urine albumin and creatinine more than 300 mg / g) in patients with type 2 diabetes and concomitant arterial hypertension (reduced progression of diabetic nephropathy to terminal chronic renal failure).
Contraindications
- Hypersensitivity to the components of the drug.
- Pregnancy.
- Lactation.
- Age under 18 years of age (efficacy and safety not established).
Precautions:
- Arterial hypotension.
- Reduced circulating blood volume.
- Violations of the water-electrolyte balance.
- Bilateral renal artery stenosis.
- Stenosis of a single kidney artery.
- Renal failure.
- Liver failure.
Pregnancy and lactation
There are no data on the use of Lozap during pregnancy. However, it is known that drugs that directly affect the renin-angiotensin system, when used in the second and third trimesters of pregnancy, can cause a developmental defect or even death of the developing fetus. Therefore, if a pregnancy occurs, Lozap should be stopped immediately.
When prescribed during lactation, a decision should be made either to stop breastfeeding or to stop treatment with the drug.
Special instructions
It is necessary to correct dehydration before prescribing Lozap or to begin treatment with a lower dose.
Drugs that affect the renin-angiotensin system can increase blood urea and serum creatinine in patients with bilateral renal stenosis or stenosis of a single kidney artery.
During the treatment period, the concentration of potassium in the blood should be regularly monitored, especially in elderly patients, with impaired renal function.
In patients with cirrhosis of the liver, the concentration of losartan in the blood plasma increases significantly, in connection with which, in the presence of liver diseases in history, it should be prescribed in lower doses.
losartan does not affect the ability to drive or operate machinery.
Composition
In 1 film-coated tablet contains: losartan potassium 50 mg.
Dosage and administration of
The drug is taken orally, regardless of food intake. Multiplicity of admission - 1 time per day.
For arterial hypertension, the average daily dose is 50 mg. In some cases, to achieve a greater therapeutic effect, the dose is increased to 100 mg in two doses or 1 time per day.
In heart failure, the initial dose for patients is 12.5 mg 1 time / day. Typically, the dose increases with a weekly interval (i.e. 12.5 mg / day, 25 mg / day, 50 mg / day) to an average maintenance dose of 50 mg 1 time / day, depending on patient tolerance.
Patients receiving diuretics in high doses, the initial dose should be reduced to 25 mg 1 time / day. It is not necessary to adjust the dose to elderly patients.
To reduce the risk of developing cardiovascular diseases (including stroke) and mortality in patients with arterial hypertension and left ventricular hypertrophy, the initial dose of the drug is 50 mg per day once. In the future, hydrochlorothiazide in low doses can be added and / or the dose of the drug can be increased to 100 mg per day in one or two doses. Patients with concomitant type 2 diabetes mellitus with proteinuria: the drug is prescribed in an initial dose of 50 mg once a day with a further increase in dose to 100 mg / day (taking into account the degree of blood pressure reduction) in one or two doses.
In type 2 diabetes mellitus with proteinuria, the initial dose of the drug is 50 mg 1 time per day with a further increase in dose to 100 mg / day (taking into account the degree of blood pressure reduction) in 1 or 2 doses.
Patients with a history of liver disease, dehydration, during the hemodialysis procedure, as well as patients over 75 years of age, a lower initial dose of the drug is recommended - 25 mg once a day.
Side effects
Allergic reactions: angioedema, including swelling of the larynx and / or tongue, leading to airway obstruction, and / or swelling of the face, lips, pharynx, and / or tongue, occasionally noted with losartan.
In some of the patients with the above allergic reactions, angioedema previously occurred with other drugs, including and ACE inhibitors. It is extremely rare when taking losartan that manifestations of vasculitis, including Shenlein-Genoch disease, were noted.
From the cardiovascular system: lowering blood pressure.
From the digestive tract: when taking losartan, rare (
From the respiratory: when taking losartan - cough.
From the skin: urticaria.
Laboratory parameters: rarely (5.5 mmol / l), increased liver activity transaminase
Drug Interactions
May be prescribed with other antihypertensives. Mutually enhances the effect of beta-blockers and sympatholytics. The combined use of losartan with diuretics has an additive effect.
No pharmacokinetic interactions of losartan with hydrochlorothiazide, digoxin, warfarin, cimetidine, phenobarbital, ketoconazole and erythromycin have been observed. Rifampicin and fluconazole have been reported to lower plasma levels of active metabolite. The clinical significance of these interactions is still unknown. As with other agents that inhibit angiotensin II or its effect, the combined use of losartan with potassium-sparing diuretics (for example, spironolactone, triamteren, amiloride), potassium preparations and salts containing potassium increases the risk of hyperkalemia.
Nonsteroidal anti-inflammatory drugs (NSAIDs), including selective cyclooxygenase-2 inhibitors (C0G-2), can reduce the effect of diuretics and other antihypertensive drugs.
With the combined use of angiotensin II and lithium receptor antagonists, an increase in the concentration of lithium in blood plasma is possible. Given this, it is necessary to weigh the benefits and risks of the combined use of losartan with lithium salts. If it is necessary to use the drugs together, it is necessary to regularly monitor the concentration of lithium in the blood plasma.
Overdose
Symptoms: severe BP, tachycardia due to parasympathetic (vaginal) stimulation, bradycardia may occur.
Treatment: forced diuresis, symptomatic therapy, hemodialysis is not effective.
Storage conditions
Do not store above 30 РC.
Shelf life
3 years.
Deystvuyushtee substance
Gidrohlorotiazid, Losartan
dosage form
tablets
Possible product names
Lozap plus tablets 50 mg + 12.5 mg, 90 pcs.
LOZAP PLUS 0.05 + 0.0125 N90 TABLE P / O
LOZAP PLUS 0.05 + 0.0125 N90 TABLE P / FILM / SHELL
Lozap Plus 50 + 12.5mg Tab. p / pl / rev X90
Lozap plus 50mg + 12.5mg tab. PO No. 90
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