Hydrochlorothiazide + Losartan

Find more information about this combination medication at the webpages for Hydrochlorothiazide and Losartan

Hypertension, Left Ventricular Hypertrophy ... show more

Advisory

  • This medicine contains a combination of 2 drugs Hydrochlorothiazide and Losartan.
  • Hydrochlorothiazide and Losartan are both used to treat the same disease or symptom but work in different ways in the body.
  • Most doctors will advise making sure that each individual medicine is safe and effective before using a combination form.

Drug Status

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Government Approvals

None

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WHO Essential Medicine

NO

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Known Teratogen

NO

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Pharmaceutical Class

Angiotensin 2 Receptor Blocker and Thiazide Diuretic

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Controlled Drug Substance

NO

Summary

  • Hydrochlorothiazide and Losartan are used to treat high blood pressure, also known as hypertension. Additionally, Hydrochlorothiazide can be used to treat edema, which is fluid retention associated with conditions like heart failure, kidney disease, and liver disease. Losartan is also used to reduce the risk of stroke in patients with hypertension and left ventricular hypertrophy, and to treat kidney disease in people with type 2 diabetes.

  • Hydrochlorothiazide works by acting as a diuretic, helping the kidneys eliminate excess water and salt from the body, which reduces blood volume and lowers blood pressure. Losartan blocks the action of substances that tighten blood vessels, allowing them to relax and improve blood flow, thereby reducing blood pressure. Together, they address both fluid retention and vascular resistance, leading to more effective blood pressure control.

  • The usual adult daily dose for Hydrochlorothiazide is typically 25 mg once daily, while for Losartan, the starting dose is usually 50 mg once daily. When combined in a single tablet, the typical starting dose is 50 mg of Losartan and 12.5 mg of Hydrochlorothiazide once daily. This combination can be adjusted based on the patient's needs and response to treatment.

  • Common side effects of Hydrochlorothiazide include frequent urination, dizziness, and electrolyte imbalances such as low potassium levels. Losartan may cause dizziness, back pain, and muscle cramps. Both medications can lead to low blood pressure, especially when standing up quickly. Severe allergic reactions, kidney problems, and changes in vision are significant adverse effects.

  • Both medications should be used cautiously in patients with kidney or liver disease. Losartan is not recommended during pregnancy due to the risk of fetal harm. Hydrochlorothiazide can cause electrolyte imbalances, so monitoring is essential. Patients with a history of angioedema should avoid Losartan. Regular monitoring and communication with a healthcare provider are crucial to manage these risks effectively.

Indications and Purpose

How does combination of Hydrochlorothiazide and Losartan work?

Hydrochlorothiazide works by acting as a diuretic, helping the kidneys eliminate excess water and salt from the body, which reduces blood volume and lowers blood pressure. Losartan, on the other hand, is an angiotensin II receptor antagonist that blocks the action of substances that tighten blood vessels, allowing them to relax and improve blood flow, thereby reducing blood pressure. Together, they provide a dual approach to managing hypertension by addressing both fluid retention and vascular resistance, leading to more effective blood pressure control.

How effective is combination of Hydrochlorothiazide and Losartan?

The effectiveness of hydrochlorothiazide and losartan in treating high blood pressure is supported by clinical trials and studies. Hydrochlorothiazide has been shown to effectively reduce blood pressure by decreasing fluid volume, while losartan has demonstrated its ability to lower blood pressure by relaxing blood vessels. Together, they provide a complementary approach, with hydrochlorothiazide addressing fluid retention and losartan improving vascular resistance. Studies have also shown losartan's effectiveness in reducing the risk of stroke and managing kidney disease in diabetic patients, further supporting its role in comprehensive cardiovascular care.

Directions for Use

What is the usual dose of combination of Hydrochlorothiazide and Losartan?

The usual adult daily dose for hydrochlorothiazide when used alone is typically 25 mg once daily, but it can vary based on the condition being treated. For losartan, the starting dose is usually 50 mg once daily, which can be adjusted based on the patient's response. When combined in a single tablet, the typical starting dose is 50 mg of losartan and 12.5 mg of hydrochlorothiazide once daily. This combination can be adjusted to a maximum of 100 mg of losartan and 25 mg of hydrochlorothiazide daily, depending on the patient's needs and response to treatment.

How does one take combination of Hydrochlorothiazide and Losartan?

Hydrochlorothiazide and losartan can be taken with or without food, but it's important to take them consistently at the same time each day to maintain stable blood levels. Patients should avoid using salt substitutes containing potassium without consulting their doctor, as losartan can increase potassium levels. It's also advisable to follow any dietary recommendations provided by a healthcare provider, such as a low-salt diet, to enhance the effectiveness of the treatment. Staying hydrated is important, especially when taking hydrochlorothiazide, to prevent dehydration.

For how long is combination of Hydrochlorothiazide and Losartan taken?

Hydrochlorothiazide and losartan are typically used as long-term treatments for managing high blood pressure. While hydrochlorothiazide can be used for short-term relief of fluid retention, its role in hypertension management is ongoing. Losartan is also used for long-term control of blood pressure and may take several weeks to achieve its full effect. Both medications are usually continued indefinitely to maintain blood pressure control and prevent complications unless otherwise directed by a healthcare provider.

How long does it take for combination of Hydrochlorothiazide and Losartan to work?

Hydrochlorothiazide and losartan both work to lower blood pressure, but they do so in different ways. Hydrochlorothiazide, a diuretic, helps reduce fluid retention and starts working within a few hours, with its effects lasting about 6 to 12 hours. Losartan, an angiotensin II receptor antagonist, may take a week to start lowering blood pressure, with full effects seen in 3 to 6 weeks. When combined, these medicines can provide a more comprehensive approach to managing high blood pressure, with hydrochlorothiazide offering quicker initial relief and losartan providing longer-term control.

Warnings and Precautions

Are there harms and risks from taking combination of Hydrochlorothiazide and Losartan?

Common side effects of hydrochlorothiazide include frequent urination, dizziness, and electrolyte imbalances, such as low potassium levels. Losartan may cause dizziness, back pain, and muscle cramps. Both medications can lead to low blood pressure, especially when standing up quickly. Significant adverse effects include severe allergic reactions, kidney problems, and changes in vision. It's important to monitor for signs of dehydration and electrolyte imbalance, as these can be serious. Patients should report any unusual symptoms to their healthcare provider promptly.

Can I take combination of Hydrochlorothiazide and Losartan with other prescription drugs?

Hydrochlorothiazide and losartan can interact with several prescription medications. Nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce the effectiveness of both medications in lowering blood pressure. Combining losartan with other drugs that increase potassium levels, such as certain diuretics or ACE inhibitors, can lead to hyperkalemia. Hydrochlorothiazide can interact with lithium, increasing the risk of lithium toxicity. Patients should inform their healthcare provider of all medications they are taking to manage potential interactions effectively and adjust dosages as needed.

Can I take combination of Hydrochlorothiazide and Losartan if I am pregnant?

Losartan is contraindicated during pregnancy, especially in the second and third trimesters, due to the risk of fetal harm, including kidney damage and death. Hydrochlorothiazide is generally not recommended during pregnancy as it can affect fetal development and lead to complications such as electrolyte imbalances. Pregnant women or those planning to become pregnant should discuss alternative treatments with their healthcare provider to manage their blood pressure safely. It's crucial to discontinue these medications immediately if pregnancy is detected and seek medical advice.

Can I take combination of Hydrochlorothiazide and Losartan while breastfeeding?

Hydrochlorothiazide is known to be excreted in breast milk, and while it is generally considered safe in low doses, it can potentially reduce milk production due to its diuretic effect. Losartan's safety during breastfeeding is less clear, as there is limited information on its excretion in human milk. Due to potential risks to the nursing infant, healthcare providers may recommend alternative treatments or advise against breastfeeding while taking these medications. It's important for breastfeeding mothers to discuss their treatment options with their healthcare provider to ensure the safety of their infant.

Who should avoid taking combination of Hydrochlorothiazide and Losartan?

Hydrochlorothiazide and losartan have important warnings and contraindications. Both should be used cautiously in patients with kidney or liver disease. Losartan is contraindicated during pregnancy due to the risk of fetal harm. Hydrochlorothiazide can cause electrolyte imbalances, so monitoring is essential. Patients with a history of angioedema should avoid losartan. Both medications can cause dizziness, especially when standing up quickly, so patients should rise slowly from sitting or lying positions. Regular monitoring and communication with a healthcare provider are crucial to manage these risks effectively.