High Cholesterol? Learn about treatments

Losartan/ hydrochlorothiazide

Generic Name: losartan/hydrochlorothiazide (loe-SAR-tan/HYE-droe-KLOR-oh-THYE-a-zide)
Brand Name: Hyzaar

Losartan/hydrochlorothiazide can cause injury or even death to a developing fetus when used during pregnancy. Contact your doctor immediately if you suspect that you are pregnant. If you are planning to become pregnant, talk with your doctor about other treatment options.


Losartan/ hydrochlorothiazide is used for:

Treating high blood pressure. It is also used to decrease the risk of stroke in certain patients with high blood pressure. It may also be used for other conditions as determined by your doctor.

Losartan/hydrochlorothiazide is a combination angiotensin II receptor blocker and diuretic. The angiotensin II receptor blocker works by relaxing the blood vessels. Exactly how the diuretic works to decrease blood pressure is unknown, but it helps the kidneys to eliminate fluid and sodium from the body.

Do NOT use losartan/ hydrochlorothiazide if:

  • you are allergic to any ingredient in losartan/hydrochlorothiazide or to any other sulfonamide medicine (eg, sulfamethoxazole)
  • you are pregnant
  • you have severe kidney problems or are unable to urinate
  • you are taking a medicine that contains aliskiren and you also have diabetes or kidney problems. Check with your doctor or pharmacist if you are not sure if a medicine you take contains aliskiren
  • you are taking dofetilide or ketanserin

Contact your doctor or health care provider right away if any of these apply to you.

Slideshow: Grapefruit and Medicines: A Possible Deadly Mix?

Grapefruit and grapefruit juice can react adversely with over 85 prescription medications.

Before using losartan/ hydrochlorothiazide:

Some medical conditions may interact with losartan/hydrochlorothiazide. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are able to become pregnant
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have had a severe reaction (eg, swelling of the hands, face, lips, eyes, throat, or tongue; trouble swallowing or breathing; hoarseness) after taking any other angiotensin II receptor blocker (eg, valsartan) or an angiotensin-converting enzyme (ACE) inhibitor (eg, captopril)
  • if you are dehydrated; have low blood volume; have low blood sodium, chloride, or magnesium levels; have high or low blood potassium levels; or have high blood calcium levels
  • if you have asthma; gout; heart problems (eg, congestive heart failure); liver, gallbladder, or kidney problems; high blood cholesterol or lipid levels; diabetes; or systemic lupus erythematosus
  • if you have recently had a certain type of nerve surgery (sympathectomy)

Some MEDICINES MAY INTERACT with losartan/hydrochlorothiazide. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Potassium-sparing diuretics (eg, spironolactone) or potassium supplements because the risk of high blood potassium levels may be increased
  • Dofetilide or ketanserin because the risk of irregular heartbeat may be increased
  • Adrenocorticotropic hormone (ACTH), barbiturates (eg, phenobarbital), corticosteroids (eg, prednisone), diuretics (eg, furosemide), narcotic pain medicines (eg, morphine), or other medicines for high blood pressure because they may increase the risk of losartan/hydrochlorothiazide's side effects
  • Cholestyramine or colestipol because they may decrease losartan/hydrochlorothiazide's effectiveness
  • ACE inhibitors (eg, enalapril) or aliskiren because the risk of certain side effects (eg, kidney problems, high blood potassium levels, low blood pressure) may be increased
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, celecoxib, ibuprofen) because they may decrease losartan/hydrochlorothiazide's effectiveness and the risk of serious kidney problems may be increased
  • Diazoxide, digoxin, or lithium because the risk of their side effects and toxic effects may be increased by losartan/hydrochlorothiazide
  • Insulin or other diabetes medicine (eg, glipizide, metformin) because their effectiveness may be decreased by losartan/hydrochlorothiazide

This may not be a complete list of all interactions that may occur. Ask your health care provider if losartan/hydrochlorothiazide may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use losartan/ hydrochlorothiazide:

Use losartan/hydrochlorothiazide as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • An extra patient leaflet is available with losartan/hydrochlorothiazide. Talk to your pharmacist if you have questions about this information.
  • Take losartan/hydrochlorothiazide by mouth with or without food.
  • Drinking extra fluids while you are taking losartan/hydrochlorothiazide is recommended. Check with your doctor for instructions.
  • Losartan/hydrochlorothiazide may increase the amount of urine or cause you to urinate more often when you first start taking it. To keep this from disturbing your sleep, try to take your dose before 6 pm.
  • If you take cholestyramine or colestipol, ask your doctor or pharmacist how to take it with losartan/hydrochlorothiazide.
  • Continue to take losartan/hydrochlorothiazide even if you feel well. Do not miss any doses.
  • If you miss a dose of losartan/hydrochlorothiazide, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use losartan/hydrochlorothiazide.

Important safety information:

  • Losartan/hydrochlorothiazide may cause drowsiness, dizziness, or light-headedness. These effects may be worse if you take it with alcohol or certain medicines. Use losartan/hydrochlorothiazide with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Losartan/hydrochlorothiazide may cause dizziness, light-headedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
  • Report any light-headedness or fainting to your doctor immediately. Your risk of light-headedness or fainting may be increased if you experience diarrhea, vomiting, excessive sweating, if you do not drink enough fluids, or if you are on a low-salt (sodium) diet.
  • It may take 2 to 4 weeks to get the full benefit from losartan/hydrochlorothiazide. Do not stop using losartan/hydrochlorothiazide or change your dose of losartan/hydrochlorothiazide without checking with your doctor.
  • Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms.
  • Losartan/hydrochlorothiazide contains a sulfonamide called hydrochlorothiazide, which can cause certain eye problems (myopia, angle-closure glaucoma). Your risk may be increased if you are allergic to sulfonamide medicines (eg, sulfamethoxazole) or penicillin antibiotics (eg, amoxicillin). Untreated angle-closure glaucoma can lead to permanent vision loss. If these eye problems occur, symptoms usually occur within hours to weeks of starting losartan/hydrochlorothiazide. Contact your doctor right away if you experience symptoms such as vision changes (eg, decreased vision clearness) or eye pain.
  • Losartan/hydrochlorothiazide may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to losartan/hydrochlorothiazide. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
  • Tell your doctor or dentist that you take losartan/hydrochlorothiazide before you receive any medical or dental care, emergency care, or surgery.
  • If you have high blood pressure, do not use nonprescription products that contain stimulants. These products may include diet pills or cold medicines. Contact your doctor if you have any questions or concerns.
  • Your doctor may have also prescribed a potassium supplement for you. If so, follow the dosing carefully. Do not start taking additional potassium on your own or change your diet to include more potassium without first checking with your doctor.
  • Check with your doctor before you use a salt substitute or a product that has potassium in it.
  • Diabetes patients - Losartan/hydrochlorothiazide may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
  • Losartan/hydrochlorothiazide may raise your blood sugar. High blood sugar may make you feel confused, drowsy, or thirsty. It can also make you flush, breathe faster, or have a fruit-like breath odor. If these symptoms occur, tell your doctor right away.
  • Losartan/hydrochlorothiazide may not be effective in reducing the risk of stroke in black patients who have high blood pressure and a certain heart problem (enlarged ventricle).
  • Losartan/hydrochlorothiazide may interfere with certain lab tests, including parathyroid function tests. Be sure your doctor and lab personnel know you are taking losartan/hydrochlorothiazide.
  • Lab tests, including kidney function, blood pressure, and blood electrolytes, may be performed while you use losartan/hydrochlorothiazide. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Use losartan/hydrochlorothiazide with caution in the ELDERLY; they may be more sensitive to its effects.
  • Losartan/hydrochlorothiazide should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: Losartan/hydrochlorothiazide may cause birth defects or fetal death if you take it while you are pregnant. If you think you may be pregnant, contact your doctor right away. Losartan/hydrochlorothiazide is found in breast milk. Do not breast-feed while taking losartan/hydrochlorothiazide.

Possible side effects of losartan/ hydrochlorothiazide:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Back pain; cold symptoms; diarrhea; dizziness; light-headedness, especially when sitting up or standing; stuffy nose.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, throat, or tongue; unusual hoarseness); burning, numbness, or tingling; chest pain; confusion; dark urine; decrease in sexual ability; decreased urination; drowsiness; eye pain; fainting; fast, slow, or irregular heartbeat; fever, chills, or persistent sore throat; mental or mood changes (eg, depression); muscle pain, tenderness, or cramps; numbness of an arm or leg; one-sided weakness; red, swollen, blistered, or peeling skin; restlessness; seizures; severe or persistent dizziness or light-headedness; severe or persistent dry mouth, nausea, or stomach pain; shortness of breath; sluggishness; slurred speech; sudden, severe headache; swelling of the arms or legs; unusual bruising or bleeding; unusual thirst; unusual tiredness or weakness; unusually pale skin; vision changes (eg, decreased vision clearness); vomiting; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include fainting; fast or slow heartbeat; severe or unusual dizziness or light-headedness; symptoms of blood electrolyte problems (eg, confusion; irregular heartbeat; mental or mood changes; muscle pain, weakness, or cramping; seizures; sluggishness); symptoms of dehydration (eg, decreased urination; dry mouth or eyes; fast heartbeat; unusual thirst, tiredness, or weakness).

Proper storage of losartan/hydrochlorothiazide:

Store losartan/hydrochlorothiazide at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep losartan/hydrochlorothiazide out of the reach of children and away from pets.

General information:

  • If you have any questions about losartan/hydrochlorothiazide, please talk with your doctor, pharmacist, or other health care provider.
  • Losartan/hydrochlorothiazide is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take losartan/hydrochlorothiazide or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about losartan/hydrochlorothiazide. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to losartan/hydrochlorothiazide. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using losartan/hydrochlorothiazide.

Issue Date: September 3, 2014
Database Edition 14.3.1.003
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

Hide
(web2)