The drug "Lorista N" belongs to the class of funds for normalizing the functioning of the heart and blood vessels. The medication is based on two components: losartan and hydrochlorothiazide. For one package in pharmacies, they are currently asking for an average of 350 rubles or more. The efficacy and safety of the combination agent have been tested in clinical trials. It was succeeded to reveal that separate reception of these two compounds and simultaneous give identical kinetics. "Lorista N" belongs to the category of antihypertensive drugs, is prescribed for high blood pressure. True, you should not take the medicine yourself, without the advice of a doctor: there are contraindications and side effects.
Technical points
Losartan is one of the main components of Lorista N tablets. This compound is rapidly and efficiently absorbed through the gastrointestinal tract. Already in the process of primary processing, metabolism occurs in the liver cells, the result of which is the formation of the active component and several products that do not show pharmacological activity. The bioavailability of losartan is estimated at 33%. Studies have shown that the use of a medication during a meal does not affect the concentration of a substance in the circulatory system. The highest parameters are achievable for losartan within an hour after ingestion, and for the active product of the transformation reaction, on average after 3-4 hours.
In the instructions to Lorista N, the manufacturer mentions that losartan and the active product of its metabolism mainly enter into strong bonds with plasma proteins - up to 99% of the total volume of these substances. The bulk of the reactions are in albumin. The volume of distribution is estimated to be close to 34 liters. As shown by special studies of the activity of the drug "Lorista N", a small amount of losartan is able to penetrate the blood-brain barrier, but such a substance is rated as very low.
Plasma clearance for losartan is estimated at 600 ml per minute, and for the product of its processing in the liver - 50 ml per minute. The clearance in the kidneys is approximately 74 and 26 ml per minute, respectively. The half-life of the compound reaches two hours, and up to nine for the active processing product. The main route of elimination is with bile (about 58%), other volumes are excreted by the kidneys.
Hydrochlorothiazide
In the instructions for Lorista N, the tablet manufacturer indicates that this substance is able to be absorbed into the circulatory system by 60-80%. The maximum concentration of this compound in the blood is observed already an hour after taking the medication, but in some cases you can expect up to five hours. Up to 64% of the substance binds to plasma proteins. Hydrochlorothiazide cannot enter into metabolic reactions. Elimination is carried out by the kidneys. The elimination half-life is estimated at 5-15 hours.
Dynamics
To use Lorista N as useful as possible, you must follow the recommendations of the doctor and manufacturer. In the instructions, the manufacturer gives a description of the logic of the tool, thereby arguing the importance of observing the rules for the use of this combined drug, designed to lower the pressure.
The losartan present in each tablet is a substance selectively capable of inhibiting angiotensin-type AT1 receptors. This is a non-protein substance. Both the starting compound and the product of its transformation in the body are able to stop the effectiveness of the second angiotensin, which means that there is no physiological effect on the AT1 receptors.
Studies have shown that the use of "Lorista N" indirectly allows you to activate the AT2 receptors, as the concentration of the second angiotensin in the body increases. At the same time, there is no effect on the activity of the second kininase, that is, the enzyme indispensable for the transformation of bradykinin.
In the instructions for use with "Lorista N", the manufacturer indicates that due to losartan, the pressure in the small circle of blood flow decreases. The residual load on the system is reduced, while the substance activates urination.
The instructions for use of “Lorista N” declare that under the influence of losartan myocardial hypertrophy is prevented, resistance to physical activity is growing, which is especially important for people suffering from chronic heart failure. The use of the medication only once a day can significantly reduce the parameters of CAD, dAD. Lorista N tablets control pressure indicators throughout the day, providing a uniform effect that advises circadian rhythm.
The decrease in blood pressure by the end of the period of action of the composition is 70-80% relative to the peak of efficiency. This is observed on average 5-6 hours after ingestion of the tablets. Both the reviews and the instruction “Lorista N” confirm that the drug is not addictive, and the rejection of it does not provoke withdrawal. Under the influence of losartan, there is no correction of the heart rate.
You can use tablets for people of all ages, since losartan has proven effective in the study of groups of patients older and younger than 65 years - information about this is mentioned in the instructions for use. Reviews about "Lorista N" also mention that the drug is effective in both sexes.
Hydrochlorothiazide: dynamics
The instruction “Lorista N” (12.5 mg + 50 mg) explains how hydrochlorothiazide works. This substance is primarily a diuretic, belongs to the thiazide group, shows a pronounced effect, since it prevents the reabsorption of sodium, potassium, magnesium ions and elements of water, chlorine in the nephron. Under the influence of hydrochlorothiazide, the elimination of uric acid and calcium ions slows down.
Hydrochlorothiazide is not only a diuretic, but also an antihypertensive compound. A distinctive feature is the almost complete absence of influence if blood pressure indicators are normal.
The instructions for use "Lorista N" (12.5 + 50 mg) indicate that the diuretic effect when using tablets is observed within an hour after administration. Sometimes it takes twice as much time, and the peak is reachable by about the fourth hour after the composition enters the body. The action of hydrochlorothiazide lasts for 6-12 hours. The antihypertensive effect can be observed on average on the third day, sometimes on the fourth. To achieve a stable pronounced result, you will have to use the composition for at least a month.
When will it help?
In reviews of "Lorista N", patients taking the drug noted that the drug is really effective at high blood pressure. True, it is not suitable for everyone. Tablets are used only if the patient is recommended combination treatment.
With high blood pressure, and also if an excessively large volume of the heart ventricle is installed on the left, Lorista N according to the instructions (12.5 mg of hydrochlorothiazide in one tablet) can be used to reduce the risks of heart disease, blood vessels, and also reduce the danger death due to these pathologies.
Strongly impossible!
The manufacturer indicates that in some individuals, increased sensitivity to the active components of the drug is possible. If this fact is detected, you can not use Lorista N tablets. Reviews indicate that the drug is prohibited for people suffering from high sensitivity to sulfonamides.
Contraindications to the use of tablets are:
- anuria
- creatinine clearance less than 30 ml per minute;
- increased potassium in the body;
- dehydration, including triggered by a high dosage of diuretics;
- Alleged and confirmed impaired liver function;
- potassium deficiency refractory type.
In the instructions for Lorista N (50 mg and other dosage options), the manufacturer indicates that the drug is not suitable for pregnant women and breast-feeding mothers.
Currently, there is no official information about the possibility of using the drug by minors. It is not known how effective they are, what negative consequences the medication can lead to.
The instructions for use "Lorista N" 50 mg (and other options) mention the impossibility of using tablets for hypotension, lack of lactase in the body, malabsorption syndrome and galactosemia.
Special occasion
The instructions for use "Lorista N" 12.5 mg + 50/100 mg indicate that the drug is allowed to certain groups of people only under the condition of monitoring their condition. Patients require such an attitude if disturbances in the balance of electrolytes and water in the circulatory system are found for their organisms. A specific approach should be to patients with gout, diabetes and asthma. The possibility of using tablets for renal artery stenosis is limited: bilateral, if there are two kidneys, if only one, then the artery responsible for its nutrition.
Taking the drug requires special care if the patient has already experienced angioedema in the past, provoked by any medication, including ACE inhibitors. The instructions for use "Lorista N" 50 mg (and other forms of release) indicate the need to monitor the condition of the patient’s body if the tablets are taken by people suffering from systemic diseases that affect the circulatory system, including lupus erythematosus.
A combination of the described drug and ICOG-2, as well as other medications for stopping inflammatory processes from the class of non-steroidal ones, should be cautious.
"Interesting" position
The instructions for use "Lorista N" (100 mg or 50 mg and 12.5 mg) indicate that currently there is no information about the effects of taking losartan tablets in pregnant women.
Renal perfusion activity dates were established for the human embryo: third trimester of maturation. Perfusion is determined by the work of the renin-angiotensin system. Therefore, risks for the child are possible when losartan enters the mother's body in the second and third trimesters.
The manufacturer recommends abandoning the tablets if pregnancy is detected.
If a woman who is breastfeeding a child needs treatment, she will have to transfer the baby to artificial nutrition.
Negative consequences
Observations of patients taking the drug allow us to say with confidence that the following side effects from taking the medication are possible:
- anemia;
- anaphylactic reaction;
- Shenlein-Genoch disease;
- angioedema;
- sleep disturbances;
- fatigue
- vasculitis;
- violation of the rhythm and heart rate;
- pressure reduction;
- cough;
- swelling of the mucous membranes of the nasal cavity;
- violation of the stool;
- hepatitis;
- dyspepsia;
- malfunctioning kidneys;
- nausea and vomiting;
- allergic skin reactions;
- myalgia;
- arthralgia;
- weakness;
- soreness in the sternum;
- tendency to edema;
- asthenia.
Some patients noted that against the background of the use of pills, they were sick and dizzy, migraine disturbed. The risk of infectious diseases of the upper respiratory tract, throat infection increases. A fairly high percentage of patients taking pills for pressure patients noted that their back hurt.
Laboratory studies may show an increased concentration of potassium in the circulatory system, hematocrit, hemoglobin. Much less often, an increase in the amount of urea, creatinine is established. In a small percentage of cases against the background of drug use in patients, an increase in the activity of liver enzymes was noted. Activation of bilirubin is possible.
Mutual influence: losartan
It was not possible to detect a clinically significant result of the interaction of this component of the tablets with the second active substance included in the drug "Lorista N", and with:
- warfarin;
- cimetidine;
- digoxin.
Conducted trials with losartan and erythromycin, ketoconazole gave the same results.
A decrease in the concentration of the active product of transformation of losartan is possible with a combination of tablets from pressure and fluconazole, rifampicin. It was not possible to identify how clinically significant this fact is.
While receiving medications with losartan and diuretics, which provoke the accumulation of potassium, additives that contribute to its preservation in the tissues of the body, as well as potassium salts, redundancy of this element in the patient's body is possible.
It is possible to decrease the effectiveness of losartan and other drugs to normalize blood pressure and activate urination if the patient uses anti-inflammatory non-steroidal drugs, including drugs that selectively inhibit COX-2. The use of such combination therapy against a background of renal impairment can cause deterioration. In some cases, this caused acute kidney failure. The problem in the predominant percentage of cases is reversible.
Indomethacin, entering the body at the same time as losartan, can lower its ability to adjust the patient's pressure indicators.
Mutual effect: hydrochlorothiazide
The simultaneous use of this medication, barbiturates, ethanol in food is associated with an increased risk of orthostatic reduced pressure. A combination of Lorista N and various types of drugs can lead to this.
Hypoglycemic medications intended for oral use, as well as insulin, may have a weaker effect on the background of the use of hydrochlorothiazide. In some cases, according to the results of the tests, the doctor makes a decision on the dosage adjustment.
The combination of hydrochlorothiazide and other means to reduce pressure gives an additional effect, the drugs reinforce each other.
The absorption of hydrochlorothiazide is inhibited if the patient takes colestipol, colestyramine. This is due to the appearance of anionic resins in the body.
A decrease in the concentration of electrolytes is detected by combining the described tablets and ACTH, corticosteroids. There is a risk of potassium deficiency in the patient's body.
Epinephrine, norepinephrine, and other pressor amine compounds provoke a weaker response of the body, if used simultaneously with hydrochlorothiazide.
The combination of this substance and muscle relaxants of a non-depolarizing class leads to an increase in the effectiveness of the second group of drugs.
With the simultaneous ingestion of lithium and diuretic diuretics into the body, a reduced clearance of this element in the kidneys is provoked, which means that the risk of a toxic effect increases. Whenever possible, it is reasonable to avoid such combination therapy.
Anti-inflammatory drugs from the non-steroidal group can inhibit the effectiveness of diuretics, medications to reduce blood pressure. These agents act on the calcium transformation chain, which means that analyzes of the functioning of the parathyroid glands can give false results.
Too much!
Since the drug is combined, the manufacturers of Lorista N tablets separately indicate the symptoms of excess in the body of losartan and hydrochlorothiazide. The first manifests itself:
- persistent decrease in pressure;
- tachy, bradycardia.
The patient is shown therapy for the relief of disturbing symptoms, forced diuresis. Blood dialysis, studies have shown, does not show a pronounced result.
An excess of hydrochlorothiazide can be seen in the manifestations:
- lack of electrolytes in the circulatory system;
- dehydration.
If hydrochlorothiazide is combined with cardiac glycosides, there is a risk of a lack of potassium, worsening the condition of a patient suffering from arrhythmia.
With an excess of hydrochlorothiazide, therapy is indicated for the relief of disturbing symptoms.
Analogs
Lorista N belongs to the same group of medicines as the drugs:
- "Iruzid."
- "Walz".
- Egipress.
The possibility of replacing the medication prescribed by the doctor with alternative ones must be clarified at the doctor's appointment. With an independent choice, there is a risk of ineffective therapy and a variety of side effects.
Terms of use
Lorista N tablets are intended for oral use. You can eat them at a convenient time, without reference to meals. A combined dose with other drugs is allowed to stabilize the pressure indicators. The doctor selects specific volumes, focusing on the patient’s condition, diagnosis and related health problems.
In case of arterial hypertension, Lorista N tablets are taken once a day. The best option for a start is 12.5 mg + 50 mg. The most pronounced effect on pressure can be observed in the third or fourth week of the course. If the results are not strong enough, it is reasonable to double the dosage, using the entire volume at a time. Greater than 100 mg + 12.5 mg per day is strictly not recommended.
If the BCC is below average, losartan at the beginning of the course is shown in an amount of 25 mg. Since the condition most often occurs against the background of the use of diuretics in a large dosage, it is reasonable first to cancel diuretics, adjust hypovolemia, only then prescribe Lorista N tablets.
The initial dosage for people with moderate renal failure, as well as for patients in old age, coincides with other groups of patients. No specialized correction is required, based only on these features of the condition.
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Under the influence of hydrochlorothiazide, there is a risk of glucose tolerance failures, potassium accumulation, imbalance of water and electrolytes in the body. Under the influence of this component, there is a possibility of a slight increase in the concentration of calcium in the plasma component of the blood, but the phenomenon is transient. There is a risk of increasing the amount of triglycerides, total cholesterol.
During the bearing of a child, the drug “Lorista N” is not indicated, since there is a risk of thrombocytopenia in a woman, jaundice in a child (during gestation and after birth). It must be borne in mind that diuretics do not prevent general poisoning of the body due to pregnancy.
Clinical observations showed that in a small percentage of cases, Lorista N tablets provoked a decrease in pressure, which made my head spin. This can have an indirect effect on the mental state, emotional stability of the patient. If a person is forced to drive vehicles, work in conditions of increased concentration of attention, it is reasonable to first assess the body's response to the medication in order to ensure the highest possible level of safety.
High blood pressure: what is this trouble?
Hypertension, high blood pressure, hypertension — all these terms are used to denote a condition when a person’s pressure is steadily maintained above normal: the tonometer shows 140/90 or more.
Arterial pressure is the pressure inside the blood vessels, due to which the fluid moves throughout the body.
Medical statistics claim that it is precisely high blood pressure - the most common disease in the world among those affecting the heart and blood vessels. In combination, she is one of the most dangerous. On average, every fifth inhabitant of the planet suffers from increased pressure. Against the background of arterial hypertension, the risk of ischemia, heart attack, stroke, angina pectoris is high.
The organ responsible for the bloodstream is the heart. Through it, fluid moves through the body and supplies oxygen to cells, the nutritional components necessary for normal functioning. Under the influence of various factors, the heart can increase its activity (for example, if the vessels are clogged or inelastic), while the pressure increases.
A distinctive feature of hypertension is the invisibility of this problem. For many years, she can hint at herself with a sick and dizzy, weakened working capacity and intelligence. Often people simply do not pay attention to these symptoms, do not attach importance to them until the condition undergoes a sharp deterioration. If hypertension is detected on time, under the supervision of a doctor, you can take Lorista N tablets to correct the general condition of the body and reduce risks, increase your chances of a long life, and a high level of daily quality.