LOZAP PILLS 50MG

Indications and usage

- arterial hypertension;

- chronic heart failure (as part of combination therapy, with intolerance or failure of therapy with ACE inhibitors);

- reducing the risk of cardiovascular diseases (including stroke) and mortality in patients with arterial hypertension and left ventricular hypertrophy;

- diabetic nephropathy in hypercreatininemia and proteinuria (the ratio of urine albumin to creatinine is more than 300 mg / g) in patients with type 2 diabetes and concomitant arterial hypertension (decrease in the progression of diabetic nephropathy to terminal chronic renal failure).

The drug is taken orally, regardless of the meal. Frequency of use - 1 time / day.

At hypertension the average daily dose is 50 mg. In some cases, to achieve a greater therapeutic effect, the daily dose may be increased to 100 mg in 2 or 1 dose.

Initial dose for patients with chronic heart failure is 12.5 mg 1 time / day. As a rule, the dose is increased with a weekly interval (ie, 12.5 mg / day, 25 mg / day, 50 mg / day) to an average maintenance dose of 50 mg 1 time / day, depending on the tolerance of the drug.

When prescribing the drug patients receiving diuretics in high doses, starting dose of Lozap® should be reduced to 25 mg 1 time / day.

For elderly patients No need for dose adjustment.

When prescribing the drug in order to reduce the risk of cardiovascular diseases (including stroke) and mortality in patients with arterial hypertension and left ventricular hypertrophy The initial dose is 50 mg / day. In the future, low-dose hydrochlorothiazide may be added and / or the dose of Lozap may be increased.® up to 100 mg / day in 1-2 doses.

Patients with concomitant type 2 diabetes with proteinuria the initial dose of the drug is 50 mg 1 time / day, then the dose is increased to 100 mg / day (taking into account the degree of blood pressure reduction) in 1-2 doses.

Patients with liver disease in history, dehydration, during the hemodialysis procedure, and patients over 75 recommended lower initial dose of the drug - 25 mg (1/2 tab. 50 mg) 1 time / day.

Adverse reactions

When using Losartan for the treatment of essential hypertension in controlled studies, among all side effects, only the incidence of vertigo differed from placebo by more than 1% (4.1% vs. 2.4%).

The dose-dependent orthostatic effect characteristic of antihypertensive agents was observed in less than 1% of patients treated with losartan.

Determination of the frequency of side effects: very often (≥ 1/10); often (≥ 1/100, ≤ 1/10); sometimes (≥ 1/1000, ≤ 1/100); rarely (≥ 1/10 000, ≤ 1/1000); very rarely (≤ 1/10 000, including individual messages).

Side effects occurring with a frequency of more than 1%

Side effects of losartan are usually transient and do not require discontinuation of the drug.

Side effects occurring with a frequency of less than 1%

Since the cardiovascular system: orthostatic hypotension (dose-dependent), epistaxis, bradycardia, arrhythmias, angina, vasculitis, myocardial infarction.

From the digestive system: anorexia, dryness of the oral mucosa, toothache, vomiting, flatulence, gastritis, constipation, hepatitis, abnormal liver function; very rarely, a moderate increase in AST and ALT activity, hyperbilirubinemia.

Dermatological reactions: dry skin, erythema, ecchymosis, photosensitivity, increased sweating, alopecia.

Allergic reactions: urticaria, skin rash, itching, angioedema (including swelling of the larynx and tongue, causing airway obstruction and / or swelling of the face, lips, pharynx).

From the hemopoietic system: sometimes anemia (a slight decrease in hemoglobin and hematocrit concentrations, on average by 0.11 g% and 0.09 volume%, respectively, rarely having clinical significance), thrombocytopenia, eosinophilia, Schenlein-Henoch purpura.

From the musculoskeletal system: arthralgia, arthritis, pain in the shoulder, knee, fibromyalgia.

From the side of the central nervous system and peripheral nervous system: anxiety, sleep disturbance, drowsiness, memory disorders, peripheral neuropathy, paresthesia, hypoesthesia, tremor, ataxia, depression, syncope, migraine.

Special senses: tinnitus, taste disturbance, visual disturbances, conjunctivitis.

From the urinary system: imperative urination to urinate, urinary tract infections, renal dysfunction; sometimes - an increase in the level of urea and residual nitrogen or creatinine in the blood serum.

From the reproductive system: decreased libido, impotence.

Metabolism: often - hyperkalemia (the level of potassium in the blood plasma is more than 5.5 mmol / l); gout.

- pregnancy;

- lactation period;

- age up to 18 years (efficacy and safety have not been established);

- hypersensitivity to the drug.

WITH caution the drug should be used in case of arterial hypotension, reduction of the BCC, impaired water and electrolyte balance, bilateral stenosis of the renal arteries or stenosis of the artery of a single kidney, in renal / hepatic failure.

Data on the use of the drug Lozap® during pregnancy is not.However, it is known that drugs acting directly on the RAAS, when used in the second and third trimesters of pregnancy, can cause a defect of development or even death of a developing fetus. Therefore, when pregnancy occurs, the use of the drug Lozap® should stop immediately.

If necessary, the use of Lozapa during lactation should make a decision either to stop breastfeeding or to discontinue treatment with the drug.

Patients with impaired liver function Lozap should be prescribed in lower doses.

In patients with impaired renal function, including patients on dialysis, no need to adjust the initial dose.

During the period of treatment should regularly monitor the concentration of potassium in the blood in violation of renal function.

The drug is contraindicated in children and adolescents under 18 years of age (efficacy and safety have not been established).

Have elderly patients no need to adjust the initial dose.

During the period of treatment should regularly monitor the concentration of potassium in the blood, especially in elderly patients.

It is necessary to carry out the correction of dehydration before the appointment of the drug Lozap® or start treatment with a lower dose of the drug.

Drugs that affect the RAAS can increase blood urea and serum creatinine in patients with bilateral stenosis of the renal arteries or stenosis of a single kidney artery.

In patients with cirrhosis of the liver, the concentration of losartan in the blood plasma increases significantly, and therefore, in the presence of liver diseases in history, it should be prescribed in lower doses.

During the period of treatment should regularly monitor the concentration of potassium in the blood, especially in elderly patients, with impaired renal function.

Use in pediatrics

Safety and efficacy of the drug Lozap® at children and adolescents under the age of 18 not installed.

Influence on ability to drive motor transport and control mechanisms

Lozap® does not affect the ability to drive vehicles or work with mechanisms.

Symptoms: pronounced decrease in blood pressure, tachycardia; Bradycardia may appear due to parasympathetic (vagal) stimulation.

Treatment: forced diuresis, symptomatic therapy; hemodialysis is not effective.

The drug can be prescribed with other antihypertensive drugs. There is a mutual enhancement of the effects of beta-blockers and sympatholytic. With the combined use of losartan with diuretics, an additive effect is observed.

Pharmacokinetic interaction of losartan with hydrochlorothiazide, Digoxin , Warfarin , cimetidine, phenobarbital, Ketoconazole and Erythromycin was not observed.

Rifampicin and Fluconazole are reported to reduce the concentration of the active metabolite of losartan in the blood plasma. The clinical significance of this interaction is not yet known.

As with the use of other agents that inhibit angiotensin II or its action, the combined use of losartan with potassium-saving diuretics (for example, spironolactone, triamterene, amiloride), potassium preparations and salts containing potassium, increases the risk of hyperkalemia.

NSAIDs, including selective COX-2 inhibitors, may reduce the effect of diuretics and other antihypertensive drugs.

The combined use of angiotensin II receptor antagonists and lithium may increase the plasma concentration of lithium. Given this, it is necessary to weigh the benefits and risks of losartan co-administration with lithium salts. If necessary, joint use should regularly monitor the concentration of lithium in the blood plasma.

List B. The drug should be kept out of the reach of children at a temperature not exceeding 30 ° C. Shelf life - 2 years.

Pharmacy sales terms

The drug is available on prescription.