In order to significantly prolong human life, WHO experts have developed an initiative to combat cardiovascular disease. The most common pathology from their list is considered to be arterial hypertension. It causes damage to the walls of the vessels of the whole body. This is most acutely felt in the brain, heart, kidneys and retina. Because arterial hypertension leads to serious diseases that directly increase mortality. Also, due to high blood pressure, the quality of life of patients is reduced.
Since life expectancy and its quality are really important in the modern world, arterial hypertension must be controlled to prevent a strong and constant increase in pressure. This is achieved through the use of several classes of drugs: ACE inhibitors, blockers of its receptors, calcium antagonists with adrenergic blockers and diuretics. These substances form the basis of the treatment of hypertension. And the drug "Lorista", analogues and substitutes, as well as substances similar in action, remain effective, cost-effective and popular drugs.
General characteristics of the drug
Lorista, a substitute for which is widely represented in the class of antihypertensive drugs, contains losartan. This medicinal substance is a type II angiotensin receptor blocker. Its therapeutic effect is the inhibition of the binding of angiotensin to the endothelial receptor of the vessel, which mediates the impossibility of contracting the vessel. Blood pressure does not increase, but remains at the original level. The drug is produced by the Slovenian company KRKA.
It is noteworthy that Lorista is a generic, and the original losartan is Cozaar. But this drug is really high quality, as it is produced by a company that cares about its positive image. This proves the conducted bioequivalence study of “Kozaar” and “Lorista”, which confirms the effectiveness of the latter with its correct purpose.
Instructions for use
The instructions attached to the Lorista preparation, reviews of patients and specialists, as well as clinical use trials prove the effectiveness of the drug in the treatment of hypertension. Moreover, it is logical that the greatest success of therapy is possible if the recommendations specified in the instructions for use are observed. Among its provisions, the following points are highlighted:
Read about each of the provisions of the instructions for use below.
Indications
All indications should be studied in the attached instructions, where they are indicated in a list. The purpose of this publication is to highlight therapeutic windows for the use of the drug. So, “Lorista” is used to treat early stages of hypertension as part of monotherapy and in the development of dry cough in response to taking drugs from the group of ACE inhibitors. The latter are considered more effective, while Losartan is an alternative to them in the development of side effects from their use.
The second indication is the treatment of high degrees of hypertension as part of combination therapy and in patients with high cardiovascular risks. Here, its use is also limited by the likelihood of side effects on ACE inhibitors. If there are no side effects, then it is rational to use not “Losartan” and other angiotensin receptor blockers, but enzyme inhibitors.
"Lorista" is indicated for the treatment of heart failure in some patients in whom the antihypertensive effect escapes from treatment with enzyme inhibitors. Also, in the presence of diabetes mellitus “Lozartan”, the price of which is quite low, is the drug of choice. However, this is possible with intolerance to ACE inhibitors, which it loses in strength and speed of onset of the antihypertensive effect.
Dosage regimen and dose selection
Any analogue of "Lorista" is selected strictly individually. There is no and simply cannot exist a clear relationship between the degree of hypertension and the dosage of the drug. Only a few patterns associated with the severity of the underlying disease may be present. With first-degree hypertension with an already high cardiovascular risk, it is possible to prescribe 12.5 or 25 mg of Lorista per day. With an increase in the degree of hypertension, the dosage also increases.
For the drug "Losartan" price is the least important factor in choosing a particular brand name. Only dosage is always important. And it can reach up to 200 mg per day, divided into two doses. A criterion for treatment effectiveness is satisfactory blood pressure levels. When systolic blood pressure during treatment does not increase above 140, then this dose of the drug is sufficient for therapy.
In the case of chronic heart failure and the absence of hypertension, the appointment of an ACE inhibitor or ARB is also necessary in order to inhibit the processes of myocardial fibrosis. In this case, the medicine is prescribed in the maximum tolerated dose. It is titrated according to pressure levels so that it does not fall below 110.
Side effects
The drug "Lorista" acts on the biological mechanisms of pressure regulation, and therefore has some side effects. Some of them are also caused by toxic effects on the liver, the hematopoiesis system. The most frequent, that is, affecting about 1.7% of patients, side effects are the following: pain in the upper abdomen, fatigue and weakness, the development of edema of the face and limbs. For comparison, the frequency of the placebo effect is correlated with the frequency of these side effects, which is why the drug is considered conditionally safe.
"Lorista" is rare, that is, in 1% of cases, causes a rapid heartbeat. 2% of patients tend to complain about the development of diarrhea after taking the drug "Losartan". The price of such observations is very low, because the number of such cases is minimal. By the way, even without the use of the drug, but only due to placebo, diarrhea and dyspepsia developed in 1.9% of patients.
Rarely, less than 1 case per 100 patients, there is the appearance of pain in the muscles, in the back, the development of muscle cramps. This condition is not classified as myopathy caused by the use of "Losartan." This is only a general reaction, which is also observed in the comparison group. The drug is really well tolerated, much easier than Lorista N and Lorista ND, as their side effects include those phenomena that are additionally caused by hydrochlorothiazide. Despite this, all three Lorista variants are safe and important in therapeutic practice.
Contraindications
For all analogues of “Lorista” and “Kozaar”, including “Lozap”, the instruction (price is indicated below) prohibits use in the following situations:
with the development of an allergic reaction to any of the preparations containing "Losartan";
children under 18 years of age due to the unproven benefits and unknown side effects in this category of patients;
during pregnancy and lactation.
In patients with existing renal lesions, Lorista can and should be used, since it improves renal blood flow and has a nephroprotective effect. Also, “Lozartan" has a mild, but useful effect: it accelerates the excretion of uric acid, which slows the development of exacerbations of gout. However, it is used with caution in liver failure. This clinical condition is considered a relative contraindication.
Features of the reception
The price of Lorista, Lozap, Blocktran, Kozaar, Vazotens is different, but the application is similar. In particular, the drug is taken once with a good degree of control of blood pressure or with a low increase. If the hypertension is strong with frequent rises, then the use of “Losartan” is required twice. It is always advisable to use the drug at the same time, which improves the degree of pressure control and the prognosis of the course of the disease.
The drug "Lorista" can be taken regardless of food, washed down with the right amount of water. When initially prescribed, its antihypertensive develops gradually, and reaches a peak only after 1-2 weeks. In this, “Losartan” and others (ARBs) angiotensin receptor blockers are significantly inferior to ACE inhibitors. However, ARB has an important feature - it does not have a side effect in the form of a dry cough due to the accumulation of bradykinin. Also, ARBs are characterized by the absence of an anti-hypertensive effect slipping effect, which is typical with prolonged use of ACE inhibitors.
Release Forms
Lorista is available in hard-coated tablets. Dosages are determined by the mass of "Losartan" present in one tablet. There are three dose options for Lorista: 12.5, 25, 100 mg. Also under this trade name, a combined preparation is also sold that contains two active substances, “Lozartan” and “Hydrochlorothiazide,” which are successfully combined with each other. They are available in the following dosages:
100 mg of losartan + 12.5 mg of hydrochlorothiazide - the drug "Lorista N100";
50 mg of losartan + 12.5 mg of hydrochlorothiazide - the drug "Lorista N";
100 mg of losartan + 25 mg of hydrochlorothiazide - the drug "Lorista ND".
In tablets with a similar dosage, any analogue of Lorista sold to the pharmacy chain is also for sale.
Price "Lorists"
The price of Lorista is different in some regions of the country. It depends on the characteristics of supplies and admission to sale. A medicine is always cheaper in those cities where there are centers of expertise and drug testing. Since each of the medicines, regardless of whether it is imported or domestic, must undergo a batch testing phase, it is natural that in the country it is cheaper in the capital. In Moscow, for 30 tablets of Lorista, the price is as follows:
"Lorista 12.5 mg" costs 100-150 rubles;
"Lorista 25 mg" costs 160-210 rubles;
"Lorista 50 mg" costs 180-270 rubles;
“Lorista 100 mg” - 270-330 rubles;
Lorista N (50 mg) - 250-300 rubles.
The drug "Lorista" from pressure is packaged in 30, 60 and 90 tablets. For patients to whom the medicine helps and effectively controls hypertension, you can purchase a large package. This is economically advantageous because three packs of 30 tablets each cost a third more than one pack of 90 tablets.
Cheap analogues "Lorista"
KRKA is respected by consumers because its products meet clinical requirements. At the same time, their quality is proved by bioequivalence studies to the original “Lozartan” - “Cozaar”. However, there are other drugs containing "losartan". The drug "Lorista" analogues and substitutes may be cheaper. Examples include Vazotens, Blocktran, Presartan.
The cheapest analogue is Blocktran, which is inferior in the complexity of the dosage form, but has the same effectiveness as Lorista. Vazotens is slightly more expensive than Blocktran, although almost the same in effectiveness. The selection criterion in this case is the affordability. Moreover, the drug "Blocktran" indications are identical to those of any analogues containing "Losartan." This is natural.
Commercial analogues "Lorista"
There are many drugs that contain "losartan" as an active substance. They differ in different prices and quality. Moreover, any analogue of Lorista, except for the drug Kozaar, is a generic. Lorista is also a licensed copy of the original Lozartan, the drug Kozaar. Therefore, it is rational to take the original medicine made by the Swiss company MERCK SHARP & DOHME IDEA, Inc. as the basis for comparison in price and effectiveness. Among the commercial analogues of "Lorista" there are drugs of three price categories:
with a higher price ("Kosaar", "Amzaar", "Gizaar");
with approximately the same price ("Losartan-Teva", "Lozap", "Lorista", "Centor");
cheaper drugs (Losartan NAS, Losartan Richter, Losartan Belmedpreparaty, Presartan, Blocktran, Vazotens).
The price of drugs of the first category ranges from 500-1000 rubles per pack of 30 tablets containing 100 and 50 mg of “Losartan”. Combined preparations containing 25 or 12.5 mg of hydrochlorothiazide together with 100 or 50 mg of losartan, respectively, cost about 800-1000 rubles per 30 tablets.
Medications in the middle price range roughly correspond to the price of Loriste. Any specified analogue of "Lorista" fits into the price range of 300-600 rubles, depending on the dosage and combination with "Hydrochlorothiazide". And drugs of the lower price range cost up to 300 - 400 rubles, which are needed for a monthly treatment course.
The most cost-effective is the drug “Lorista”, “Centor”, “Lozap”, “Lozartan NAS”. Of the affordable alternatives, these are the best medicines. An unconditional favorite among any derivatives of "Lozartan" is the drug "Cozaar", which is original. With its use, the effectiveness of "Losartan" as an antihypertensive substance has been proven.
Reviews of specialists
Specialists treat Lorista quite well, because its effectiveness has been proven in the Cozaar bioavailability study. Therefore, it is generally accepted that Lorista is a cheaper original Kozaar. Positive feedback from experts was deserved due to the lack of an anti-hypertensive effect. However, the drug also has disadvantages inherent in the entire class of angiotensin receptor blockers. Their effect occurs more slowly, which makes it difficult to immediately begin treatment of high-grade arterial hypertension or to use the medicine for crises.
Patient Reviews
With constant admission, patients note a small number of side effects that are practically no different from the statistical indicators stated in the attached instructions. The drug controls blood pressure well and evenly, which significantly reduces the likelihood of crises. Also, male patients note that Lorista does not reduce potency, as is the case with ACE inhibitors. In general, Lorista is characterized as a reliable and safe treatment for hypertension.