Lorista HD tabs 100mg + 25mg #30

Lorista HD instruction for use

You can buy Lorista HD her

Composition

1 tablet contains: losartan potassium 100 mg, hydrochlorothiazide 25 mg,
excipients: pregelatinized starch, microcrystalline cellulose, lactose monohydrate, magnesium stearate, hypromellose, macrogol 4000, quinoline yellow dye (E104), titanium dioxide (E171), talc.
Packaging
Pack of 14, 30, 60 or 90 pcs.

pharmachologic effect

Lorista HD - combination drug; has a hypotensive effect. Losartan is a selective antagonist of angiotensin II receptors (type AT1) for oral administration, non-protein nature. In vivo and in vitro losartan and its biologically active carboxyl metabolite (EXP-3174) block all physiologically significant effects of angiotensin II on AT1 receptors, regardless of the route of its synthesis: leads to an increase in plasma renin activity, decreases plasma aldosterone concentration, etc. Losartan indirectly induces activation of the AT2 receptor by increasing the level of angiotensin II. Losartan does not inhibit the activity of kininase II, an enzyme that is involved in the metabolism of bradykinin. Reduces total peripheral vascular resistance (OPSS), pressure in the "small" circle of blood circulation; reduces afterload, has a diuretic effect. Interferes with the development of myocardial hypertrophy, increases exercise tolerance in patients with chronic heart failure (CHF). Taking losartan once a day results in a statistically significant reduction in systolic and diastolic blood pressure (BP). Losartan evenly controls the pressure throughout the day, with the antihypertensive effect consistent with the natural circadian rhythm. The decrease in blood pressure (BP) at the end of the dose of Lorista HD was approximately 70-80% of the effect at the peak of the drug, 5-6 hours after administration. The syndrome of "cancellation" is not observed; losartan also has no clinically significant effect on heart rate (HR). Losartan is effective in men and women, as well as in the elderly (&> 65 years) and younger patients (& <65 years). Hydrochlorothiazide. Thiazide diuretic, the diuretic effect of which is associated with impaired reabsorption of sodium, chlorine, potassium, magnesium ions, and water in the distal nephron; delays the excretion of calcium ions, uric acid. It has antihypertensive properties; hypotensive effect develops due to the expansion of arterioles. Virtually no effect on normal blood pressure (BP). The diuretic effect occurs after 1-2 hours, reaches a maximum after 4 hours and lasts 6-12 hours. The antihypertensive effect occurs after 3-4 days, but it may take 3-4 weeks to achieve the optimum therapeutic effect.

Lorista HD, indications for use

    Arterial hypertension (for patients who are recommended combination therapy).
    Reducing the risk of cardiovascular morbidity and mortality in patients with arterial hypertension and left ventricular hypertrophy.

Contraindications

Hypersensitivity to losartan, to agents derived from sulfonamides and other components of Lorista HD, anuria, marked renal dysfunction (creatinine clearance (CK) less than 30 ml / min.), Hyperkalemia, dehydration (including during the administration of high doses of diuretics) , severe liver dysfunction, refractory hypokalemia, pregnancy, lactation, hypotension, age up to 18 years (efficacy and safety not established), lactase deficiency, galactosemia or glucose / gal malabsorption syndrome acytosis.

Dosage and administration

Inside, regardless of the meal. Loristu HD can be combined with other antihypertensive agents. Arterial hypertension The initial and maintenance dose is 1 tablet Loristy HD (100/25 mg) 1 time per day. As a rule, the drug is prescribed in the absence of an adequate therapeutic effect Loristy N (50 / 12.5 mg). Maximum antihypertensive effect is achieved within three weeks of therapy. The maximum daily dose is 1 tablet of Lorista HD. In patients with a reduced volume of circulating blood (for example, while receiving large doses of diuretics), the recommended initial dose of losartan in patients with hypovolemia is 25 mg once a day. In this regard, Lorista HD therapy should be started after discontinuation of diuretics and correction of hypovolemia. Elderly patients and patients with moderate renal insufficiency (creatinine clearance 30-50 ml / min), including those on dialysis, do not require correction of the initial dose. Reducing the risk of cardiovascular morbidity and mortality in patients with arterial hypertension and left ventricular hypertrophy. The standard initial dose of losartan is 50 mg 1 time per day. Patients who failed to achieve target blood pressure levels while receiving losartan 50 mg / day require therapy by combining losartan with low doses of hydrochlorothiazide (12.5 mg), and, if necessary, increase the dose of losartan to 100 mg per combination with hydrochlorothiazide in a dose of 12.5 mg / day, in the future - to increase to 1 tablet Loristy HD 100/25 mg total (100 mg of losartan and 25 mg of hydrochlorothiazide once a day).

Use during pregnancy and lactation

Data on the use of losartan during pregnancy is not. Renal perfusion of the fetus, which depends on the development of the renin-angiotensin system, begins to function in the third trimester of pregnancy. The risk to the fetus increases when taking losartan in the second and third trimesters. At establishment of pregnancy therapy Lorista HD has to be immediately stopped. If necessary, the appointment of Lorista HD during lactation is necessary to stop breastfeeding.

Side effects

From the side of blood and lymphatic system: infrequently - anemia, Schönlein-Genoch disease.
On the part of the immune system: rarely - anaphylactic reactions, angioedema (including laryngeal and tongue edema, causing airway obstruction and / or swelling of the face, lips, pharynx).
On the part of the central nervous system and peripheral nervous system: often - headache, systemic and non-systemic dizziness, insomnia, fatigue; infrequently - migraine.
Since the cardiovascular system: often - orthostatic hypotension (dose-dependent), palpitations, tachycardia; rarely - vasculitis.
On the part of the respiratory system: often - cough, infections of the upper respiratory tract, pharyngitis, swelling of the nasal mucosa.
On the part of the digestive tract: often - diarrhea, dyspepsia, nausea, vomiting, abdominal pain.
On the part of the hepatobiliary system: rarely - hepatitis, abnormal liver function.
On the part of the skin and subcutaneous fat: infrequently - urticaria, pruritus.
On the part of the musculoskeletal system and connective tissue: often - myalgia, back pain; infrequently - arthralgia.
Other: often - asthenia, weakness, peripheral edema, chest pain.
Laboratory indicators: often - hyperkalemia, increased hemoglobin and hematocrit concentrations (clinically insignificant); sometimes a moderate increase in the level of urea and serum creatinine; very rarely - increased activity of liver enzymes and bilirubin.

special instructions for Lorista HD

You can designate with other antihypertensives. There is no need for a special selection of the initial dose for elderly patients. Lorista HD can increase the concentration of urea and creatinine in the blood plasma of patients with bilateral renal artery stenosis or renal artery stenosis of a single kidney. Hydrochlorothiazide can increase arterial hypotension and disturbances of water and electrolyte balance (decrease in circulating blood volume, hyponatremia, hypochloraemic alkalosis, hypomagnesaemia, hypokalemia), impair glucose tolerance, reduce urinary calcium excretion and cause transient, slight elevation of calcium concentration in the plasma, reduce blood glucose, decrease urinary calcium excretion and cause transient calcium levels. the concentration of cholesterol and triglycerides, provoke the occurrence of hyperuricemia and / or gout. Taking medications directly acting on the renin-angiotensin system during the II and III trimesters of pregnancy can lead to fetal death. In the event of pregnancy shows the abolition of the drug. Diuretics are usually not recommended for pregnant women due to the risk of jaundice in the fetus and newborn, and thrombocytopenia in the mother. Diuretic therapy does not prevent the development of toxicosis of pregnancy.

Interaction

Losartan In clinical studies, interactions of pharmacokinetics revealed no clinically significant drug interactions with hydrochlorothiazide, digoxin, warfarin, cimetidine, phenobarbital, ketoconazole and erythromycin. Rifampicin and fluconazole reduce the level of the active metabolite (this interaction has not been studied clinically). The combination of losartan with potassium-sparing diuretics (spironolactone, triamterene, amiloride), potassium-sparing additives or potassium salts can lead to hyperkalemia. NSAIDs, including selective cyclooxygenase-2 inhibitors, may reduce the effect of diuretics and other antihypertensive drugs, including losartan. In patients with impaired renal function who received NSAID therapy (including cyclooxygenase-2 inhibitors), therapy with angiotensin II receptor antagonists can lead to a further deterioration in renal function, including acute renal failure, which is usually reversible. The hypotensive effect of losartan, like other antihypertensive drugs, can be reduced by taking indomethacin.
Hydrochlorothiazide With thiazide diuretics, drugs such as ethanol, barbiturates, and narcotics can potentiate the risk of orthostatic hypotension. Hypoglycemic agents (for oral administration and insulin) - may require dose adjustment of hypoglycemic agents. Other antihypertensives - additive effect. Kolestiramin and colestipol - in the presence of anionic exchange resins the absorption of hydrochlorothiazide is disturbed. Corticosteroids, ACTH (adrenocorticotropic hormone) - a pronounced decrease in electrolyte levels, in particular hypokalemia. Pressory amines (for example, epinephrine, norepinephrine) - reducing the severity of the response to the reception of pressor amines. Muscle relaxants of non-depolarizing type of action (for example, tubocurarine) - increased effect of muscle relaxants. Lithium - diuretics reduce the renal clearance of lithium and increase the risk of developing the toxic effect of lithium; simultaneous use is not recommended. NSAIDs (including cyclooxygenase-2 inhibitors) can reduce the diuretic, natriuretic and hypotensive effects of diuretics. Due to the effect on calcium metabolism, their intake may distort the results of the study of the function of the parathyroid glands.

Overdose

Losartan

Symptoms: marked decrease in blood pressure, tachycardia; bradycardia due to parasympathetic (vagal) stimulation.
Treatment: forced diuresis, symptomatic therapy, hemodialysis is ineffective.

Hydrochlorothiazide

Symptoms: the most frequent symptoms are due to electrolyte deficiency (hypokalemia, hypochloremia, hyponatremia) and dehydration due to excessive diuresis. With simultaneous intake of cardiac glycosides, hypokalemia can aggravate the course of arrhythmias.
Treatment: symptomatic.

Storage conditions

Shelf life - 3 years.
Store in a dry place at a temperature not exceeding 30 ° C.

Terms of sell

You can buy Lorista HD without a prescription.