Losartan/hydrochlorothiazide

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Losartan/hydrochlorothiazide
Combination of
LosartanAngiotensin II receptor antagonist
HydrochlorothiazideThiazide diuretic
Clinical data
Trade namesAnzaplus, Cozaar comp, Hyzaar, Ocsaar Plus
Pregnancy
category
  • US: D (Evidence of risk)
Routes of
administration
By mouth
ATC code
Legal status
Legal status
  • In general: ℞ (Prescription only)
Identifiers
PubChem CID
KEGG
CompTox Dashboard (EPA)

Losartan/hydrochlorothiazide, sold under the trade name Hyzaar among others, is a combination medication used to treat high blood pressure when losartan is not sufficient.[1] It consists of losartan (an angiotensin II receptor antagonist) and hydrochlorothiazide (a diuretic).[1] It is taken by mouth.[1]

Common side effects include dizziness, back pain, and upper respiratory tract infections.[2] Serious side effects may include low blood pressure, kidney problems, allergic reactions, and electrolyte problems.[2] Use in pregnancy and breastfeeding is not recommended.[3] Losartan works by blocking the effects of angiotensin II while hydrochlorothiazide works by decreasing the ability of the kidneys to absorb electrolytes.[2] Interactions include with lithium, agents which increase potassium, and NSAIDs.[2]

The combination was approved for medical use in the United States in 1995.[2] It is available as a generic medication.[1] A month supply in the United Kingdom costs the NHS about 1.50 £ per month as of 2019.[1] In the United States the wholesale cost of this amount is about US$2.50.[4] In 2016 it was the 80th most prescribed medication in the United States with more than 9 million prescriptions.[5]

Medical uses[edit]

It is used for high blood pressure (hypertension) once a day. Based on the initial blood pressure response and/or losartan-hydrochlorothiazide side effects, the dosage may be increased or decreased. With each change in dosage, it may take up to a month to see the full effect.

Side Effects[edit]

Common side effects include dizziness, headache, back pain, rash, fever, diarrhea, cough, and upper respiratory tract infections. [2] Serious side effects may include low blood pressure, kidney problems, allergic reactions, and electrolyte problems.[2]

Drug interactions[edit]

Drug interactions to be aware of include lithium, agents increasing serum levels of potassium, and the use of hydrochlorothiazide with antidiabetic drugs both oral agents and insulin.[2]

Mechanisms[edit]

Losartan works by blocking the effects of angiotensin II by preventing it from binding to the angiotensin I receptor while hydrochlorothiazide works by decreasing the ability of the kidneys to absorb electrolytes. The effects of hydrochlorothiazide indirectly lower the levels of serum potassium. However, with coadministration of losartan which is an angiotensin II receptor antagonist, the low levels of potassium are reversed.[2]

Brand names[edit]

The losartan/hydrochlorothiazide combination preparation is marketed by Merck under the trade name Hyzaar and by Xeno Pharmaceuticals under the name Anzaplus. Merck, Sharp & Dohme market it as Ocsaar Plus in Israel. It is marketed as Cozaar comp in Sweden and South Africa.

References[edit]

  1. ^ a b c d e British national formulary : BNF 76 (76 ed.). Pharmaceutical Press. 2018. p. 176. ISBN 9780857113382.
  2. ^ a b c d e f g h i "Losartan Potassium and Hydrochlorothiazide - FDA prescribing information, side effects and uses". Drugs.com. Retrieved 6 March 2019.
  3. ^ "Hydrochlorothiazide / losartan Pregnancy and Breastfeeding Warnings". Drugs.com. Retrieved 3 March 2019.
  4. ^ "NADAC as of 2019-02-27". Centers for Medicare and Medicaid Services. Retrieved 3 March 2019.
  5. ^ "The Top 300 of 2019". clincalc.com. Retrieved 22 December 2018.