Hyzaar Forte (Gizaar) tabs 100mg + 12.5mg #28

Hyzaar Forte instruction for use

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Composition

1 tab. contains losartan potassium 100 mg, hydrochlorothiazide 12.5 mg.
Packaging - 28 pcs.

pharmachologic effect

Hyzaar Forte - the combined drug; has a hypotensive effect. It contains losartan, an angiotensin II receptor antagonist (type AT1) and hydrochlorothiazide, a thiazide diuretic.

Indications

Arterial hypertension. Reducing the risk of cardiovascular morbidity and mortality in patients with arterial hypertension and left ventricular hypertrophy.

Contraindications

Hypersensitivity, anuria, hypovolemia (including on the background of high doses of diuretics), hepatic and / or renal failure, pregnancy, lactation.

Dosage and administration

Hyzaar Forte is taken orally, 1 tablet / day, regardless of the meal. The maximum dose - 2 tablets 1 time / day. The maximum hypotensive effect develops within 3 weeks after the start of treatment.

Use during pregnancy and lactation

Taking medications directly acting on the RAAS in the II-III trimesters of pregnancy can lead to fetal death. In the event of pregnancy, cancellation is indicated (thiazides penetrate through the BBB). In relation to healthy pregnant women, the use of diuretics is usually not recommended due to the risk of fetal and newborn jaundice and mother thrombocytopenia. Diuretic therapy does not prevent the development of toxicosis of pregnancy.

Side effects of Hyzaar Forte

In clinical studies with losartan / hydrochlorothiazide, no adverse events specific to this combination preparation were observed.
Adverse reactions were limited to those already reported with losartan and / or hydrochlorothiazide alone. The cumulative incidence of adverse reactions reported with this combination was comparable to that used with placebo. The frequency of discontinuation of therapy was also comparable to that in patients who received placebo. In most cases, adverse reactions were mild, were transient, and did not require discontinuation of therapy.
In controlled clinical trials, dizziness was the only adverse reaction associated with taking Hyzaar Forte, the frequency of which exceeded that when taking placebo more than 1 percent or more.
Losartan in combination with hydrochlorothiazide is generally well tolerated in patients with arterial hypertension and left ventricular hypertrophy. The most frequent adverse reactions were dizziness, weakness, and fatigue.
During the post-marketing experience using Hyzaar Forte, the following additional adverse reactions have been reported.
Allergic reactions and immunopathological reactions: anaphylactic reactions, angioedema, including laryngeal and glottis edema with the development of airway obstruction and / or swelling of the face, lips, pharynx and / or tongue in patients taking losartan; some of these patients had indications of the development of angioedema in the history of using other drugs, including ACE inhibitors. There are rare reports of vasculitis development (including Schoenlein-Henoch purpura) with losartan.
On the part of the digestive system: rarely - hepatitis, diarrhea (in patients taking losartan).
On the part of the respiratory system: possible cough (in patients taking losartan).
Dermatological reactions: urticaria, increased light and photosensitivity.
From the laboratory indicators: in controlled clinical trials on the background of taking Gizaar®, clinically significant changes in standard laboratory parameters were rarely observed. Hyperkalemia (serum potassium more than 5.5 mEq / l) was observed in 0.7% of patients, which did not require discontinuation of the drug. Increased ALT activity was rarely observed and usually disappeared after discontinuation of therapy.

special instructions

There is no need for a special selection of the initial dose for elderly patients. Perhaps joint appointment with other antihypertensive drugs. May increase urea and creatinine concentrations in plasma in patients with bilateral renal artery stenosis or single renal artery stenosis. Hydrochlorothiazide can increase hypotension and water and electrolyte imbalance (decrease BCC, hyponatremia, hypochloraemic alkalosis, hypomagneemia, hypokalemia), impair glucose tolerance, reduce calcium excretion in the urine and cause a transient slight increase in plasma calcium concentration, increase concentration. provoke the occurrence of hyperuricemia and / or gout. Taking medications directly acting on the RAAS in the II-III trimesters of pregnancy can lead to fetal death. In the event of pregnancy, cancellation is indicated (thiazides penetrate through the BBB). In relation to healthy pregnant women, the use of diuretics is usually not recommended due to the risk of fetal and newborn jaundice and mother thrombocytopenia. Diuretic therapy does not prevent the development of toxicosis of pregnancy.

Interaction

At the same time taking hydrochlorothiazide with ethanol, barbiturates, opioid analgesics increases the risk of orthostatic hypotension; oral hypoglycemic drugs and insulin may require dose adjustment of hypoglycemic agents; with other antihypertensive drugs, an additive effect is possible; with Kolestiramine and Kolestipol - impaired hydrochlorothiazide absorption. A single dose of colestyramine or colestipol may reduce the absorption of hydrochlorothiazide in the gastrointestinal tract by 85% and 43%, respectively. With the simultaneous use of hydrochlorothiazide with GCS, ACTH, it is possible to increase the loss of electrolytes, aggravating hypokalemia; with pressor amines (norepinephrine, epinephrine), a slight decrease in the effect of pressor amines, which does not prevent their use; with non-depolarizing muscle relaxants (tubocurarine) - enhancing their action; with NSAIDs, a decrease in diuretic, natriuretic, and hypotensive action is possible. Do not use simultaneously with lithium preparations, since diuretics reduce renal clearance of lithium and increase the risk of intoxication.

Overdose

Symptoms: Losartan - decreased blood pressure, tachycardia, bradycardia (as a result of vagal stimulation). Hydrochlorothiazide - loss of electrolytes (hypokalemia, hypochloremia, hyponatremia); dehydration (excess diuresis).
Treatment: symptomatic and supportive therapy. If Hyzaar Forte is taken recently, the stomach should be flushed; if necessary, carry out the correction of water and electrolyte disorders. Losartan and its active metabolites are not removed by hemodialysis.

Storage conditions

Shelf life - 2 years.
Hyzaar Forte should be stored in a dry place inaccessible to children at a temperature up to 25 ° C.

Terms of sell

You don't need a prescription to buy Hyzaar Forte.