The pharmaceutical market is rich in drugs for lowering blood pressure. Among them are angiotensin enzyme receptor antagonists.
Kind of drug
The medicine "Lorista" is available in several varieties: in the form of a single-component preparation "Lorista", combined forms of "Lorista N" and "Lorista ND", which differ in the dosage of active substances. Two-component forms of the drug have an antihypertensive effect and have a diuretic effect.
Structure
Lorista tablets of a single-component preparation are available in three dosages containing the active substance of losartan potassium 12.5 mg, 25 mg, 50 mg each. As auxiliary components, corn and pregelatinized starch, microcrystalline cellulose, a mixture of milk sugar with cellulose, aerosil, magnesium stearate are used. The film membrane of dosages of 25 mg or 50 mg of potassium losartan consists of hypromellose, talc, propylene glycol, titanium dioxide, and a yellow quinoline dye is also used for a dose of 12.5 mg.
Lorista N and Lorista ND tablets are composed of a core and a shell. The core includes two active components: potassium losartan 50 mg each (for the N form) and 100 mg (for the N form) and hydrochlorothiazide 12.5 mg (for the "N" form) and 25 mg (for the "N" form). For the formation of the core, additional components are used in the form of pregelatinized starch, microcrystalline cellulose, milk sugar, magnesium stearate.
Lorista N and Lorista ND tablets are coated with a film coating consisting of hypromellose, macrogol 4000, quinoline yellow dye, titanium dioxide and talc.
How does the drug work?
The combined antihypertensive agent (Lorista drug) describes the instructions for the pharmacological action of each active component.
One of the active substances is losartan, which acts as a selective antagonist of the angiotensin type 2 enzyme on non-protein receptors.
In vitro and animal studies have shown that the effects of losartan and its carboxyl metabolite are aimed at blocking the effects of angiotensin on type 1 angiotensin receptors. This activates renin in blood plasma and causes a decrease in the concentration of aldosterone in the blood serum.
Causing an increase in the content of type 2 angiotensin, losartan activates the receptors of this enzyme, at the same time it does not change the activity of the type 2 kininase enzyme involved in the metabolism of bradykinin.
The action of the active component of the drug "Lorista" is aimed at reducing the total peripheral resistance of the vascular bed, blood pressure in the vessels of the pulmonary circulation, afterload, and providing a diuretic effect.
Losartan does not allow the development of a pathological increase in the heart muscle, enhances resistance to the physical work of the human body, in which chronic heart failure is observed.
Daily use of a single dose of losartan causes a steady decrease in upper (systolic) and lower (diastolic) blood pressure. Throughout the day, under the influence of this substance, blood pressure is uniformly controlled, and the antihypertensive effect coincides with the natural circadian rhythm. A decrease in pressure at the end of the dosage of losartan is 80% compared with the peak activity of the active component. With drug treatment, there is no effect on the heart rate, and when you stop taking the drug, there are no signs of drug withdrawal. The effectiveness of losartan extends to the male and female body of all ages.
As part of the combined means, the action of hydrochlorothiazide as a thiazide diuretic is associated with impaired absorption of chlorine, sodium, magnesium, potassium and water ions in primary urine back into the blood plasma of the distal kidney nephron. The substance enhances the retention of calcium and uric acid by the ion. Hydrochlorothiazide exhibits antihypertensive properties due to the expansion of arterioles. The diuretic effect begins after 60-120 minutes, and the maximum diuretic effect lasts from 6 to 12 hours. The optimal antihypertensive effect of treatment with the drug occurs after 1 month.
What is it used for?
The drug "Lorista", tablets, instructions for use recommends the use of:
- for the treatment of arterial hypertension, in which a combination treatment is indicated;
- to reduce the likelihood of diseases of the cardiovascular system and the number of deaths with arterial hypertension and pathological changes in the left ventricle.
Mode of application
This medicine is intended for oral use. Eating food does not affect the effect of the medication. Lorista pressure pills can be combined with antihypertensive drugs. Eating food does not affect the effect of the medication.
On the drug "Lorista" (tablets), the instructions for use have recommendations for dosing a one-component form, "N" and "ND" combinations. For all varieties of the drug, the initial and maintenance dose at elevated pressure is 1 tablet 1 time per day. The maximum effect on reducing pressure is observed after 3 weeks from the start of treatment. To achieve a significant effect, it is allowed to increase the daily dose of the drug "Lorista N" to 2 tablets in 1 dose. Per day, the maximum allowable number of tablets with a dosage of 50 / 12.5 mg is 2 pieces.
If there is no adequate therapeutic effect from taking the medicine "Lorista N", then the drug "Lorista ND", tablets are prescribed. The instruction for this tool includes information on the maximum amount of a larger dosage (100/25 mg) per day, which is no more than 1 tablet.
With a decrease in the volume of blood circulating through the vessels during treatment with high doses of diuretics, the initial daily dose of losartan is used 25 mg at a time. Therefore, therapy with such a hypotensive agent is possible only after the exclusion of diuretics and normalization of blood volume.
The instruction “Lorista” (tablets) does not contain information on the need to adjust the dose for elderly patients and for people who undergo hemodialysis, or for those with renal failure with creatinine clearance from 30 to 50 ml per minute.
To reduce the likelihood of diseases of the cardiovascular system and the number of deaths with arterial hypertension and pathological changes in the left ventricle, a standard initial dose of losartan per day is prescribed at 50 mg per dose. If the results on lowering blood pressure at the initial dosage have not been achieved, an increase to 100 mg of losartan is necessary, which is possible when using 2 tablets of the drug “Lorista N” or 1 tablet “Lorista ND” per day at a time.
Side effects
Some Patients may experience undesirable effects of treatment with this antihypertensive drug. When using the drug "Lorista" (tablets), the instructions for use include a list of side effects associated with various body systems.
The effect on the central nervous system is manifested by headache, systemic and non-systemic dizziness, insomnia, fatigue, migraine.
When it affects the cardiovascular system, the drug causes orthostatic dose-dependent hypotension, palpitations, tachycardia, and vascular inflammation.
The effect on the respiratory system is manifested by cough, infection in the upper respiratory tract, pharyngitis, swelling of the mucous membrane of the nasopharynx.
The digestive system malfunctions in the form of diarrhea, dyspepsia, nausea, vomiting, abdominal pain, hepatitis, liver dysfunction, when the activity of liver enzymes and bilirubin is altered.
The effect on the musculoskeletal system is manifested by myalgia, pain in the back, arthralgia.
The effect on the blood-forming organs is manifested by anemia and purpura.
Laboratory parameters are also characterized, characterized by hyperkalemia, increased levels of hemoglobin, creatinine, hematocrit, and urea in blood plasma.
The action may be accompanied by allergic reactions, manifested by urticaria, pruritus, anaphylactic shock, angioedema of the face, neck, upper trunk and peripheral organs.
Contraindications
Not everyone can be treated with Lorista. Instructions for use does not recommend the use of this tool for anuria, severe impaired renal function, when creatinine clearance is less than 30 ml per minute.
Reception is contraindicated in case of hyperkalemia, refractory hypokalemia, violation of the water balance in the body during therapy with high doses of diuretics, severe impaired liver function, high blood pressure, deficiency of the lactase enzyme, intolerance to glucose and galactose, pregnancy, breast-feeding, children and adolescents under 18 years of age .
The treatment prohibits treatment with Lorista (tablets) for hypersensitivity to the sulfonamide compounds, to the substance losartan, hydrochlorothiazide or auxiliary components of the drug.
Caution is required when using in patients with a disturbed water-electrolyte balance in the blood, when signs of hypochloremic alkalosis, low levels of sodium, potassium, magnesium and high concentrations of calcium ions in the human body are observed.
Bilateral narrowing of the arteries of the kidneys or narrowing of the lumen of the artery to a single kidney, diabetes mellitus, increased uric acid in the blood plasma, deposition of urate in the joints, the presence of allergic reactions to drugs that inhibit angiotensin-converting enzymes, bronchial asthma, and systemic blood diseases cause a cautious the use of antihypertensive medication.
Application features
During treatment with the drug "Lorista" (tablets), the instructions for use allow you to additionally take other antihypertensive drugs. For the elderly, special selection of the initial dosage is not required.
The actions of the drug can lead to an increase in the concentration of creatinine and urea in the blood serum of patients who have bilateral renal artery stenosis or artery stenosis of one kidney.
Under the influence of hydrochlorothiazide, arterial hypotension intensifies, electrolyte balance is disturbed, which is characterized by a decrease in the volume of circulating blood, hyponatremia, hypochloremic alkalosis, hypomagnesemia, hypokalemia. The effect of the diuretic is aimed at increasing the concentration of cholesterol and triglycerides, changing the tolerance of the body to glucose molecules, reducing the excretion of calcium ions in the urine, which leads to their increase in blood serum. Hydrochlorothiazide can cause hyperuricemia and gout.
The combined preparation contains milk sugar, which is contraindicated in patients suffering from a lack of lactase enzyme, with galactosemia or glucose intolerance syndrome and galactose.
At the initial stages of treatment with a hypotensive agent, a decrease in pressure and dizziness attacks are possible, which violates the psychophysical activity of the body. Therefore, patients whose work is associated with increased attention when driving motor vehicles or complex mechanisms should determine their condition before proceeding with their duties.
Analogs
JSC Krka, dd, Novo mesto is a manufacturer of the anti-hypertensive drug Lorista (tablets). Analogues of this tool in their composition have the active substance losartan potassium. For combined forms, similar medicines contain two active components: losartan potassium and hydrochlorothiazide.
For Lorista, the analogue will have the same antihypertensive effect and similar side effects. One such remedy is the Cozaar medication, tablets of 50 or 100 mg of potassium losertan. The manufacturer is the Merck Sharp & Dome B.V. Campaign, The Netherlands.
For combined forms, the analogs are Gizaar and Gizaar forte. The manufacturer is Merck Sharp and Dome B.V., The Netherlands. The smaller dosage tablets are oval-coated with a yellow shell, with the “717” mark on one surface and the mark for dividing on the other side, and the larger dosage oval tablets are coated with a white film coat with the “745” mark on one side.
The composition of the medicine "Gizaar Forte" includes potassium losartan in an amount of 100 mg and hydrochlorothiazide, which contains 12.5 mg. The composition of the drug "Gizaar" includes potassium losartan in an amount of 50 mg and hydrochlorothiazide, which contains 12.5 mg.
Unlike the drug “Lorista ND”, the medicine “Gizaar forte” contains two times less hydrochlorothiazide, and the content of potassium losertan coincides. Both drugs have antihypertensive effect with a slight diuretic effect.
Another combined analogue is the drug "Lozap plus" manufactured by "Zentiva A.S.", Czech Republic. It is available in the form of elongated tablets with a risk on both surfaces coated with a light yellow film. The composition of the medication contains potassium losartan in an amount of 50 mg and hydrochlorothiazide, which contains 12.5 mg.
A similar drug for Lorista N is the drug Vazotens N, manufactured by Actavis group a.o., Iceland. Available in two dosages. Lower dose tablets contain 50 mg of losartan potassium and 12.5 mg of hydrochlorothiazide, while higher dose tablets contain 100 mg of losartan potassium and 25 mg of hydrochlorothiazide.
Reviews
The drug "Lorista" reviews are diverse. Some patients noted an improvement in the initial stages of treatment, when there was a decrease in blood pressure. Others report an increase in blood pressure in the evening or a surge in emotionality. In this case, it is necessary to cancel the treatment with the drug "Lorista" (tablets). The instruction combines the patient reviews in the “Side Effects” section, where all possible adverse events that were recorded when using this antihypertensive agent are indicated.
The drug "Lorista" is taken every day, using the minimum dosage, which over time is increased due to the body getting used to the active substance. The effect of treatment does not appear immediately, but as the medication accumulates in the body.