In the article, we consider the instructions for use and reviews for the drug "Losartan".
It is an antihypertensive drug that represents the pharmacological category of angiotensin II receptor antagonists and modifiers of the renin-angiotensin-aldosterone system.
Composition and form of release
According to the instructions for use with "Losartan", the main active ingredient in this drug is potassium losartan. This medicine is produced in the form of yellow, film-coated oblong biconvex tablets, with a white core, which are packaged in blisters made of PVC or aluminum film. Blisters are contained in cardboard boxes.
The active ingredient in this medicine is losartan potassium (100 or 50 mg). Instructions for use with "Losartan" indicates that microcrystalline cellulose, sodium fumarate, colloidal anhydrous silicon dioxide, croscarmellose sodium, Prosolv HD 90 are used as additional substances in its production.
The composition of the tablet shell contains titanium dioxide, microcrystalline cellulose, macrogol stearate, hypromellose.
At what pressure is “Lozartan" prescribed according to the instructions for use?
Pharmacological properties
This is an antihypertensive pharmacological agent. That is, it is prescribed at elevated pressure. It is a non-peptide blocker of AT2 receptors; it blocks AT1, preventing Angiotensin II from binding to them. The drug levels the release of vasopressin, aldosterone, catecholamines and renin, preventing the occurrence of left ventricular hypertrophy and increased pressure. Not able to block angiotensin-converting enzyme, has no effect on kinin-kallikreinovy system, blocks the production of bradykinin.
The active metabolites of this pharmaceutical product, formed through biological transformation, produce an antihypertensive effect.
In accordance with the instructions for use with "Lozartan", after oral administration, the drug is well absorbed, and in the process of presystem metabolism forms a metabolite of carboxylic acid actively circulating in the bloodstream. The bioavailability of the drug is 34%. The maximum plasma concentration reaches 98%, binding to albumin. After 3-4 hours, the metabolite of the drug reaches its maximum level. The half-life of this medication is 2 hours, its metabolite is 9 hours. The antihypertensive effect of the use of the drug is observed after 2-3 weeks in patients of any age.
About 4% of the dosage of the drug is excreted by the kidneys, 6% - in the form of a metabolite, 35% comes out with urine, 59% - with feces. With a single dose, it does not accumulate in the body.
In elderly patients with arterial hypertension, the concentration of the active element and its active metabolite is almost the same as in young people with arterial hypertension. In women, the level of the drug in the blood is twice the concentration in men.
Indications for appointment
What else can you learn from the instructions for use with "Losartan"? This medication is prescribed for the following pathological conditions:
- essential hypertension;
- left ventricular hypertrophy and arterial hypertension (to reduce the likelihood of developing the disease and prevent mortality);
- heart failure of a chronic nature (as a medicine, which is part of complex treatment);
- diabetic nephropathy, which occurs against the background of hypercreatininemia and proteinuria in patients with type II diabetes mellitus;
- as an agent for complex antihypertensive treatment.
Contraindications
The list of main conditions in which the use of this medication is contraindicated includes:
- high sensitivity or intolerance to the components of the drug;
- pregnancy, lactation;
- liver disease
- dehydration (dehydration);
- hyperkalemia refractory;
- age less than 18 years;
- galactose-glucose malabsorption, lack of lactase, lactose intolerance;
- concomitant use of Aliskiren (in case of impaired renal function or diabetes mellitus).
Use with caution
According to the instructions for use, "Losartan" is taken with caution in the following cases:
- heart failure with renal failure;
- life-threatening arrhythmias;
- Ischemic heart disease;
- severe unilateral or bilateral renal artery stenosis;
- hyperkalemia
- decrease in bcc;
- disturbances in water-electrolyte balance;
- cerebrovascular pathology;
- kidney disease
- aortic or mitral stenosis;
- hyperaldosteronism;
- hypertrophic obstructive cardiomyopathy;
- angioedema.
Dosage and Administration
A common question for many patients is at what pressure can I start taking this medication? "Losartan" is indicated for treatment already at the initial stage of arterial hypertension. When the pressure rises above 140 mm. Hg. Art.
According to the instructions for use with "Losartan", 50 mg of the drug is prescribed once a day, regardless of the meal, to people suffering from hypertension.
In the absence of therapeutic efficacy, the daily dose is allowed to be increased to 100 mg. The highest therapeutic effect of the drug is observed after 3-7 weeks from the start of administration. Patients with reduced BCC are recommended to take this medication at 25 mg per day.
With kidney failure and in old age, the daily dose of a medical product is not corrected. In patients with chronic heart failure in a chronic form, medication is indicated in an initial dosage of 12.5 mg.
Drug interaction
With simultaneous use with "Rifampicin" or "Fluconazole" in plasma, a decrease in the level of metabolite is noted. The drug may enhance the effects of diuretics, adrenergic blockers and IACF.
With simultaneous use with diuretic potassium-sparing agents, hyperkalemia may occur (monitoring of potassium levels in the blood is necessary).
Non-steroidal anti-inflammatory drugs and selective CO2 inhibitors can reduce the hypotensive effect of this drug.
Side effects
Undesirable side effects include:
- cephalgia, dizziness;
- weakness, insomnia;
- pressure reduction;
- tachycardia;
- myalgia;
- nausea, dyspepsia, abdominal pain;
- symptoms of respiratory disease;
- dry mouth
- hepatitis;
- eosinophilia, anemia, thrombocytopenia;
- hyperkalemia
- increase in creatinine, residual nitrogen, urea;
- allergic reactions to the skin;
- angioedema;
- gout;
- anaphylaxis;
- nosebleeds.
Special recommendations
In patients with reduced BCC, this medication can provoke symptomatic arterial hypertension.
In patients with liver cirrhosis after using the drug, the concentration of the main component and its metabolite is higher than in other people. In this regard, lower dosages are required.
With impaired renal function, hyperkalemia may occur.
There is no information on the effect of drugs on the ability to drive vehicles and the speed of psychomotor reactions.
In the instructions for use, analogues of "Losartan" are not indicated.
Analogs
Medicines that are similar in therapeutic effect and composition to the medication are:
- Losartan Richter;
- Blocktran;
- "Lozap";
- Lorista.
Reviews
Reviews about this pharmacological agent are mostly positive. Patients who took it say that “Losartan” is an excellent medicine for lowering high blood pressure, acts gently, rarely causes undesirable side effects. In addition, many of them note that after the course of therapy they have disappeared symptoms of the disease, which indicates the prevention of the incidence of hypertension during treatment with this drug, but this only applies to cases when such a disease is detected in the initial stages.
We reviewed the drug "Losartan" instructions for use, reviews and analogues.