Hyzaar/Hyzaar Plus/Hyzaar Forte

Per Hyzaar FC tab Losartan K 50 mg, hydrochlorothiazide 12.5 mg. Per Hyzaar Plus FC tab Losartan K 100 mg, hydrochlorothiazide 12.5 mg. Per Hyzaar Forte FC tab Losartan K 100 mg, hydrochlorothiazide 25 mg

Treatment of HTN where combination therapy is appropriate. Risk reduction of stroke in hypertensive patients w/ left ventricular hypertrophy.

HTN Initially 1 Hyzaar tab once daily, can be increased after 3 wk to max of 2 Hyzaar tab once daily or 1 Hyzaar Forte tab once daily. Patient whose BP is inadequately controlled w/ losartan 50 mg monotherapy Initiate w/ 1 Hyzaar tab once daily. If BP remains uncontrolled after about 3 wk, dose may be increased to 2 Hyzaar tab once daily or 1 Hyzaar Forte tab once daily. Patient whose BP is inadequately controlled w/ losartan 100 mg monotherapy Initiate w/ 1 Hyzaar Plus tab once daily. If BP remains uncontrolled after about 3 wk, increase dose to 2 Hyzaar tab once daily or 1 Hyzaar Forte tab once daily. Patient whose BP is inadequately controlled w/ hydrochlorothiazide 25 mg once daily or is controlled but experiences hypokalemia Initiate w/ 1 Hyzaar tab once daily. If BP remains uncontrolled after about 3 wk, increase dose to 2 Hyzaar tab once daily or 1 Hyzaar Forte tab once daily. HTN w/ left ventricular hypertrophy Patient whose BP is inadequately controlled on losartan 50 mg Initiate w/ Hyzaar tab. Increase dose to Hyzaar Plus, followed by Hyzaar Forte if additional BP reduction is needed.

May be taken with or without food.

Hypersensitivity. Patients w/ anuria. Concomitant use w/ aliskiren-containing products in patients w/ DM or renal impairment (GFR <60 mL/min/1.73 m²).

Risk of symptomatic hypotension after treatment initiation in patients w/ activated renin-angiotensin system. Correct vol or salt depletion prior to treatment. Do not use as initial therapy in patients w/ intravascular vol depletion. Risk of changes in renal function including acute renal failure. Safety & effectiveness in patients w/ severe renal impairment (CrCl <30 mL/min) have not been established. Not recommended for patients w/ hepatic impairment. Can cause fetal harm when administered to a pregnant woman. When pregnancy is detected, discontinue treatment as soon as possible. Discontinue nursing or discontinue treatment. Safety & effectiveness in ped patients have not been established. Losartan: Dual blockade of the renin-angiotensin-aldosterone system through combined use of ACE inhibitors, ARBs or aliskiren is not recommended. Risk of hyperkalemia. Hydrochlorothiazide: Increased risk of hypersensitivity reaction in patients w/ history of allergy or bronchial asthma. Risk of hypokalemia, hyponatremia & hypomagnesemia; altered glucose tolerance & raised serum levels of cholesterol & triglycerides; hyperuricemia or precipitated frank gout; decreased urinary Ca excretion & elevated serum Ca; idiosyncratic reaction resulting in choroidal effusion, acute transient myopia & acute angle-closure glaucoma; exacerbation or activation of SLE.

Back pain, dizziness, URTI. Anemia, aplastic anemia, hemolytic anemia, leukopenia, agranulocytosis; anorexia, hyperglycemia, hyperuricemia, electrolyte imbalance including hyponatremia & hypokalemia; insomnia, restlessness; dysgeusia, headache, migraine, paraesthesias; xanthopsia, transient blurred vision; palpitation, tachycardia; dose-related orthostatic effects, necrotizing angiitis; nasal congestion; dyspepsia, abdominal pain, gastric irritation, cramping, nausea, vomiting, pancreatitis, sialoadenitis; jaundice; rash, pruritus, purpura, TEN, urticaria, photosensitivity, cutaneous lupus erythematosus; muscle cramps/spasm; glycosuria, renal dysfunction, interstitial nephritis, renal failure; erectile dysfunction/impotence; chest pain, malaise, weakness; liver function abnormalities.

Increased serum conc & toxicity of lithium. Higher frequency of adverse events through combined use of ARBs, ACE inhibitors, or aliskiren. Losartan: Risk of hyperkalemia w/ other drugs that raise serum K levels. Risk of renal function deterioration & attenuated antihypertensive effect w/ NSAIDs including selective COX-2 inhibitors. Hydrochlorothiazide: Reduced diuretic, natriuretic, & antihypertensive effects w/ NSAIDs including selective COX-2 inhibitors. Dose adjustment of antidiabetic drug may be required. Impaired absorption w/ anionic exchange resins (eg, cholestyramine or colestipol resins).

Angiotensin II Antagonists / Diuretics

C09DA01 - losartan and diuretics ; Belongs to the class of angiotensin II receptor blockers (ARBs) in combination with diuretics. Used in the treatment of cardiovascular disease.

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