losartan and hydrochlorothiazide (Oral route)

Pronunciation

loe-SAR-tan poe-TAS-ee-um, hye-droe-klor-oh-THYE-a-zide

Oral route(Tablet)

Drugs that act directly on the renin-angiotensin system can cause injury or death to the developing fetus. Stop therapy as soon as possible when pregnancy is detected .

Commonly used brand name(s)

In the U.S.

  • Hyzaar

Available Dosage Forms:

  • Tablet

Therapeutic Class: Angiotensin II Receptor Antagonist/Thiazide Combination

Pharmacologic Class: Losartan

Chemical Class: Thiazide

Uses For losartan and hydrochlorothiazide

Losartan and hydrochlorothiazide combination is used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. Lowering blood pressure may reduce the risk of strokes and heart attacks.

Slideshow: 2014 Update: First Time Brand-to-Generic Switches

Losartan and hydrochlorothiazide combination is also used to reduce the risk of stroke in patients with high blood pressure and enlargement of the heart.

Losartan is an angiotensin II receptor blocker (ARB). It works by blocking a substance in the body that causes the blood vessels to tighten. As a result, losartan relaxes the blood vessels. A lower blood pressure will increase the supply of blood and oxygen to the heart.

Hydrochlorothiazide is a thiazide diuretic (water pill) . It reduces the amount of water in the body by increasing the flow of urine, which helps lower the blood pressure.

losartan and hydrochlorothiazide is available only with your doctor's prescription.

Before Using losartan and hydrochlorothiazide

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For losartan and hydrochlorothiazide, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to losartan and hydrochlorothiazide or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of losartan and hydrochlorothiazide combination in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of losartan and hydrochlorothiazide combination in the elderly. However, elderly patients are more likely to have unwanted side effects, which may require caution in patients receiving losartan and hydrochlorothiazide combination.

Pregnancy

Pregnancy Category Explanation
All Trimesters D Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking losartan and hydrochlorothiazide, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using losartan and hydrochlorothiazide with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Aliskiren
  • Dofetilide

Using losartan and hydrochlorothiazide with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acetyldigoxin
  • Arsenic Trioxide
  • Benazepril
  • Captopril
  • Carbamazepine
  • Crizotinib
  • Cyclophosphamide
  • Dabrafenib
  • Deslanoside
  • Digitalis
  • Digitoxin
  • Digoxin
  • Droperidol
  • Enalapril
  • Enalaprilat
  • Eslicarbazepine Acetate
  • Flecainide
  • Fosinopril
  • Ketanserin
  • Levomethadyl
  • Lisinopril
  • Lithium
  • Methotrexate
  • Metildigoxin
  • Mitotane
  • Moexipril
  • Ouabain
  • Perindopril Erbumine
  • Piperaquine
  • Primidone
  • Proscillaridin
  • Quinapril
  • Ramipril
  • Sotalol
  • Trandolapril

Using losartan and hydrochlorothiazide with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Aceclofenac
  • Acemetacin
  • Alacepril
  • Amtolmetin Guacil
  • Aspirin
  • Benazepril
  • Bepridil
  • Bromfenac
  • Bufexamac
  • Captopril
  • Carbamazepine
  • Celecoxib
  • Chlorpropamide
  • Cholestyramine
  • Choline Salicylate
  • Cilazapril
  • Clonixin
  • Delapril
  • Dexibuprofen
  • Dexketoprofen
  • Diclofenac
  • Diflunisal
  • Dipyrone
  • Enalaprilat
  • Enalapril Maleate
  • Etodolac
  • Etofenamate
  • Etoricoxib
  • Felbinac
  • Fenoprofen
  • Fepradinol
  • Feprazone
  • Floctafenine
  • Fluconazole
  • Flufenamic Acid
  • Flurbiprofen
  • Fosinopril
  • Ginkgo
  • Glipizide
  • Gossypol
  • Ibuprofen
  • Ibuprofen Lysine
  • Imidapril
  • Indomethacin
  • Ketoprofen
  • Ketorolac
  • Licorice
  • Lisinopril
  • Lornoxicam
  • Loxoprofen
  • Lumiracoxib
  • Meclofenamate
  • Mefenamic Acid
  • Meloxicam
  • Moexipril
  • Morniflumate
  • Nabumetone
  • Naproxen
  • Nepafenac
  • Niflumic Acid
  • Nimesulide
  • Oxaprozin
  • Oxyphenbutazone
  • Parecoxib
  • Pentopril
  • Perindopril
  • Phenylbutazone
  • Piketoprofen
  • Piroxicam
  • Pranoprofen
  • Proglumetacin
  • Propyphenazone
  • Proquazone
  • Quinapril
  • Ramipril
  • Rifampin
  • Rofecoxib
  • Salicylic Acid
  • Salsalate
  • Sodium Salicylate
  • Spirapril
  • Sulindac
  • Temocapril
  • Tenoxicam
  • Tiaprofenic Acid
  • Tolfenamic Acid
  • Tolmetin
  • Topiramate
  • Trandolapril
  • Valdecoxib
  • Zofenopril

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Other Medical Problems

The presence of other medical problems may affect the use of losartan and hydrochlorothiazide. Make sure you tell your doctor if you have any other medical problems, especially:

  • Angioedema (an allergic reaction) with other blood pressure medicines (eg, benazepril, enalapril, lisinopril, Lotrel®, Vasotec®, Zestoretic®, Zestril®), history of—Use may cause this condition to reoccur.
  • Anuria (not able to form urine) or
  • Diabetic patients who are also taking aliskiren (Tekturna®) or
  • Patients with kidney disease who are also taking aliskiren (Tekturna®) or
  • Sulfa drug allergy, history of—Should not be used in patients with these conditions.
  • Asthma, or history of—May increase likelihood of having an allergic reaction.
  • Congestive heart failure, severe—Use may lead to kidney problems.
  • Diabetes or
  • Electrolyte imbalances (eg, high or low calcium, magnesium, potassium, or sodium in the body) or
  • Fluid imbalances (caused by dehydration, vomiting, or diarrhea) or
  • Glaucoma, secondary angle closure or
  • Gout or
  • Hypercholesterolemia (high cholesterol in the blood) or
  • Hypertriglyceridemia (high triglycerides or fats in the blood) or
  • Kidney disease or
  • Liver disease (including cirrhosis) or
  • Myopia (changes in the eyeball causing vision problems), acute or
  • Systemic lupus erythematosus (an autoimmune disorder)—Use with caution. May make these conditions worse.
  • Sympathectomy—Blood pressure–lowering effects of losartan and hydrochlorothiazide may be increased.

Proper Use of losartan and hydrochlorothiazide

In addition to the use of the medicine your doctor has prescribed, treatment for your high blood pressure may include weight control and changes in the types of foods you eat, especially foods high in sodium (salt). Your doctor will tell you which of these is most important for you. You should check with your doctor before changing your diet.

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.

Remember that losartan and hydrochlorothiazide will not cure your high blood pressure but it does help control it. You must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

losartan and hydrochlorothiazide may be taken with or without food.

losartan and hydrochlorothiazide comes with a patient information insert. Read and follow the instructions carefully. Ask your doctor if you have any questions.

Dosing

The dose of losartan and hydrochlorothiazide will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of losartan and hydrochlorothiazide. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For high blood pressure:
      • Adults—At first, one tablet once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 100 mg of losartan and 25 mg of hydrochlorothiazide per day.
      • Children—Use and dose must be determined by your doctor.
    • For lowering risk of stroke in patients with high blood pressure and enlargement of the heart:
      • Adults—At first, one tablet once a day. Your doctor may increase your dose as needed.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of losartan and hydrochlorothiazide, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using losartan and hydrochlorothiazide

It is very important that your doctor check your progress at regular visits to make sure that losartan and hydrochlorothiazide is working properly. Blood and urine tests may be needed to check for unwanted effects.

Using losartan and hydrochlorothiazide while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using losartan and hydrochlorothiazide, tell your doctor right away.

losartan and hydrochlorothiazide may cause dizziness, lightheadedness, or fainting, especially when you get up suddenly from a lying or sitting position. Make sure you know how you react to losartan and hydrochlorothiazide before you drive, use machines, or do anything else that could be dangerous if you are dizzy. If you feel dizzy, lie down so you do not faint. Then sit for a few moments before standing to prevent the dizziness from returning.

Check with your doctor right away if you become sick while taking losartan and hydrochlorothiazide, especially if you have severe or continuing nausea or vomiting, or diarrhea that does not stop. These conditions may cause you to lose too much water and may lead to low blood pressure. You can also lose water by sweating, so drink plenty of water during exercise or in hot weather.

Check with your doctor immediately if blurred vision, difficulty reading, eye pain, or any other change in vision occurs during or after treatment. This could be a sign of a serious eye problem. Your doctor may want an eye doctor to check your eyes.

losartan and hydrochlorothiazide may cause serious types of allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using losartan and hydrochlorothiazide.

losartan and hydrochlorothiazide may affect blood sugar levels. Diabetic patients may notice a change in the results of blood or urine glucose tests. Talk to your doctor if you have any questions.

Ask your doctor before you use medicines, supplements, or salt substitutes that contain potassium.

Drinking alcohol or taking narcotic pain relievers or sleeping pills with losartan and hydrochlorothiazide may intensify feeling lightheaded, dizzy, or faint. Tell your doctor if you are drinking alcohol or using pain relievers or sleeping pills.

Do not take other medicines unless they have been discussed with your doctor. This especially includes prescription or nonprescription (over-the-counter [OTC]) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, and herbal or vitamin supplements.

losartan and hydrochlorothiazide Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Symptoms of fluid and electrolyte imbalance
  • Dry mouth
  • increased thirst
  • muscle cramps or pain
  • nausea or vomiting
  • unusual tiredness or weakness
  • weak or irregular heartbeat
Rare
  • Black, tarry stools
  • blood in the urine or stools
  • cough or hoarseness accompanied by chills or fever, lower back or side pain, or painful or difficult urination
  • fainting
  • pinpoint red spots on the skin
  • pounding heartbeat
  • severe stomach pain, nausea, and vomiting
  • skin rash
  • swelling of the feet or lower legs
  • unusual bleeding or bruising
Incidence not known
  • Coma
  • confusion
  • convulsions
  • dark-colored urine
  • decreased urine output
  • fast or irregular heartbeat
  • fever
  • irritability
  • large, flat, blue, or purplish patches in the skin
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • light-colored stools
  • muscle spasms
  • muscle stiffness
  • muscle twitching
  • painful knees and ankles
  • raised red swellings on the skin, the buttocks, legs or ankles
  • restlessness
  • seizures
  • shortness of breath
  • swelling of the face, ankles, or hands
  • upper right abdominal or stomach pain
  • weakness
  • yellow eyes and skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common
  • Cold or flu-like symptoms
  • dizziness
  • headache
  • increased sensitivity of the skin to sunlight
  • sore throat
  • stomach pain
Rare
  • Dry cough
  • sinus problems

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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