Lostad T50

Losartan K

Treatment of essential HTN in adults & childn & adolescents 6-18 yr; renal disease in adults w/ HTN & type 2 DM w/ proteinuria ≥0.5 g/day as part of an antihypertensive treatment; chronic heart failure in adults when treatment w/ ACE inhibitors is not considered suitable due to incompatibility, especially cough, or contraindication. Reduction in the risk of stroke in adult hypertensive patients w/ left ventricular hypertrophy documented by ECG.

HTN Usual starting & maintenance dose: 50 mg once daily. Some patients may receive additional benefit by increasing to 100 mg once daily (in the morning). Hypertensive type II diabetic patients w/ proteinuria ≥0.5 g/day Usual starting dose: 50 mg once daily. May be increased to 100 mg once daily based on BP response from 1 mth onwards after treatment initiation. Heart failure Usual initial dose: 12.5 mg once daily. Titrate at wkly intervals as tolerated by patient (ie, 12.5 mg daily, 25 mg daily, 50 mg daily, 100 mg daily). Max dose: 150 mg once daily. Reduction in the risk of stroke in hypertensive patients w/ left ventricular hypertrophy documented by ECG Usual starting dose: 50 mg once daily. Add low dose hydrochlorothiazide &/or increase losartan dose to 100 mg once daily based on BP response. Childn 6-18 yr weighing >50 kg 50 mg once daily; in exceptional cases, can be increased to 100 mg once daily, weighing 20-50 kg 25 mg once daily; in exceptional cases, can be increased to 50 mg once daily. Elderly >75 yr Consider initiating therapy w/ 25 mg. Patient w/ intravascular vol depletion Starting dose: 25 mg once daily.

May be taken with or without food.

Hypersensitivity. Concomitant use w/ aliskiren-containing products in patients w/ DM or renal impairment (GFR <60 mL/min/1.73 m²). Severe hepatic impairment. Pregnancy (2nd & 3rd trimester).

Hypersensitivity (angioedema). Symptomatic hypotension may occur in patients who are vol- &/or Na-depleted, especially after the 1st dose & after dose increase. Closely monitor plasma K conc & CrCl values, especially patients w/ heart failure & CrCl 30-50 mL/min. Consider lower dose for patients w/ history of hepatic impairment. Increases in blood urea & serum creatinine in patients w/ bilateral renal artery stenosis or stenosis of the artery to a solitary kidney. Regularly monitor renal function during treatment. Excessive BP decrease in patients w/ ischaemic CV & cerebrovascular disease could result in MI or stroke. Risk of severe arterial hypotension & acute renal impairment in patients w/ heart failure w/ or w/o renal impairment. Caution in combination w/ a β-blocker. Not recommended to co-administer w/ K-sparing diuretics, K supplements & K-containing salt substitutes. Dual blockade of renin angiotensin-aldosterone system (RAAS) through the combined use of ACE-inhibitors, angiotensin II receptor blockers or aliskiren is not recommended. Patients w/ recent kidney transplantation; aortic or mitral stenosis or obstructive hypertrophic cardiomyopathy; rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption. Not recommended in patients w/ primary aldosteronism. May impair ability to drive or operate machinery. Not recommended during 1st trimester of pregnancy & breastfeeding. Infants whose mothers have taken losartan should be closely observed for hypotension. Not recommended in childn w/ hepatic impairment or in childn w/ GFR <30 mL/min/1.73 m².

Dizziness; vertigo; hyperkalaemia, hypoglycaemia; asthenia, fatigue; anaemia; orthostatic hypotension; renal impairment/failure; increased blood urea, serum creatinine, serum K.

Increased hypotensive action w/ other antihypertensive agents, TCAs, antipsychotics, baclofen & amifostine. Decreased exposure to losartan active metabolite w/ fluconazole (CYP2C9 inhibitor). Reduced plasma conc of the active metabolite w/ rifampicin (enzyme inducer). Increased serum K w/ other medicinal products which retain K (eg, K-sparing diuretics: amiloride, triamterene, spironolactone) or may increase K levels (eg, heparin), K supplements or salt substitutes containing K. Potential increase in serum lithium conc & toxicity. Attenuation of antihypertensive effect w/ NSAIDs (ie, selective COX-2 inhibitors, acetylsalicylic acid at anti-inflammatory doses & non-selective NSAIDs). Increased risk of worsening of renal function & increased serum K w/ concomitant use of angiotensin II antagonists or diuretics & NSAIDs. Higher frequency of adverse events w/ combined use of ACE inhibitors, angiotensin II receptor blockers or aliskiren.

Angiotensin II Antagonists

C09CA01 - losartan ; Belongs to the class of angiotensin II receptor blockers (ARBs). Used in the treatment of cardiovascular disease.

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