Hyzaar
Hyzaar (Losartan/Hydrochlorothiazide)Indications To Application
Hyzaar it is used for treatment of a hypertensia at patients for whom the combined therapy is optimum.
Dosage and way of application
Usual initial and maintenance Hyzaar dose (Losartan50 mg, Hydrochlorthiazidum of 12,5 mg) make one tablet in day. For those patients from whom at this dosage it is not possible to achieve the adequate control of arterial pressure, Hyzaar dose can be enlarged to two tablets once a day. The maximum dose makes two tablets once a day. As a whole, the maximum hypotensive effect is reached within three weeks after the treatment beginning.
Hyzaar is not necessary to prescribe to patients with a hypovolemia (for example, receiving high doses of diuretics).
Hyzaar is not recommended to patients with the expressed disturbance of function of kidneys (a clearance of a creatinine of 30 ml/mines) or to patients with disturbances of function of a liver.
There is no necessity for special selection of an initial dose to patients of advanced age.
Hyzaar is possible to prescribe together with other antihypertensives.
Hyzaar is possible to accept without dependence from food intake.
CONTRAINDICATIONS
Hyzaar is contraindicative:
- To patients with a hypersensibility to any of components of the given preparation;
SAFETY MEASURES
Disturbance of function of a liver and kidneys
Hyzaar is not recommended to patients with disturbance of function of a liver or serious disturbances of function of kidneys (30 ml/c) (the DOSAGE And the WAY of APPLICATION see).
Losartan
Disturbance of function of kidneys
The medical products influencing system a renin-angiotensin, can raise urea level in blood and a creatinine in plasma at patients with a bilateral stenosis of renal arteries or a renal artery stenosis of a unique kidney. Though such data for Losartan is not received, this reaction can potentially take place and at therapy by antagonists of receptors of angiotensin II.
Hydrochlorothiazide
Hypotension and disturbance of vodno-electrolytic balance
Some patients receiving Hyzaar therapy, as well as at treatment by other antihypertensives, can have a symptomatic hypotension. Patients should be under the medical control for revealing of symptoms of disturbance of vodno-electrolytic balance (reduction of volume of circulating blood, a hyponatremia, a hypomagnesiemia) which can arise owing to a diarrhoeia or vomiting. At such patients during treatment it is necessary to supervise level of electrolytes periodically.
Influence on a metabolism and endocrine system
Therapy can break tolerance to a glucose that can demand correction of antidiabetic therapy, including insulin preparations (INTERACTION of MEDICAL PRODUCTS see).
USE DURING PREGNANCY
At use of the preparations immediately operating on system a renin-angiotensin during the second and third trimesters of pregnancy, damage and even destruction of a foetus are possible. At pregnancy occurrence, Hyzaar should be immediately excellent.
Though data on Hyzaar use at pregnant women are not present, at Losartan tests a potassium on animals damage and destruction of a foetus and the newborn became perceptible. Perfusion of kidneys of a foetus of the person which depends on development of system a renin-angiotensin, is carried out since the second trimester of pregnancy. Thus, the risk of damage of a foetus increases at Hyzaar application in the second and third trimesters of pregnancy.
Use of diuretics usually is not recommended to rather healthy pregnant women, as subjects mother and a foetus to unnecessary risk of occurrence of an icterus of a foetus and the newborn, a thrombocytopenia and other collateral reactions which can arise at adults. Therapy by diuretics does not warn development of a toxicosis of pregnancy. A reliable data confirming positive influence of diuretics on a current of a toxicosis is not available.
USE IN PEDIATRICS
Safety and Hyzaar efficiency at children was not studied.
USE AT PEOPLE OF ADVANCED AGE
According to clinical researches, authentic differences in efficiency and Hyzaar safety at elderly patients (65 years) and younger (65 years) were revealed not.
INTERACTION OF MEDICAL PRODUCTS
Losartan
Clinically significant interactions of medical products it was not observed. Farmakinetichesky clinical tests were spent with Hydrochlorthiazidum, digoxin, warfarin, Cimetidinum and phenobarbital (Hydrochlorthiazidum, Alcohol, barbiturates or narcotics see).
As well as other preparations blocking angiotensin II or its action, simultaneous appointment the potassium of saving up diuretics (for example, Spironolactonum, Triamterenum, amiloride), preparations of a potassium or the assistants to salt containing a potassium, can lead to a hyperpotassemia.
Hydrochlorothiazide
Following medical products can co-operate with diuretics at simultaneous appointment:
Alcohol, barbiturates or narcotics - can arise potentiation of an orthostatic hypotension.
Antidiabetic preparations - (preparations for intake and insulin) - can be demanded correction of a dose of antidiabetic agents.
Other hypotensive preparations - the additive effect is possible.
Corticosteroids,intensifying of loss of electrolytes, in particular hypopotassemias.
Lithium preparations - diuretics reduce a renal clearance of lithium and raise risk of an intoxication lithium, therefore simultaneous use is not recommended. The necessary information on application of a preparation of lithium can be received from the instruction applied on it on application.
Nonsteroid resolvents - at some patients introduction of nonsteroid antiinflammatory preparations can reduce diuretic, hypotensive effects of diuretics.
Influence on results of laboratory researches
SIDE-EFFECTS
During clinical Hyzaar tests a potassium - Hydrochlorthiazidum, any collateral reactions bound to a combination of these preparations it did not become perceptible. All arisen collateral reactions were limited observed earlier at Hyzaar application a potassium and-or Hydrochlorthiazidum. The percent of the patients, compelled to stop treatment.
As a whole, at Hyzaar treatment a potassium - Hydrochlorthiazidum, its good shipping became perceptible. In most cases, collateral reactions were insignificant, had transient character and did not serve as the reason of cancellation of a preparation.
At wide application in clinical practice in rare instances at the patients receiving Hyzaar treatment, reactions of hypersensitivity in the form of a Quincke's disease (including a face edema, labiums and-or tongue) were observed.
DATA OF LABORATORY RESEARCHES
According to controllable clinical tests, clinically significant changes of standard laboratory indicators have been seldom bound to Hyzaar application. The hyperpotassemia (potassium level in Serum of 5,5 mekv/l) was observed at 0,7 % of patients, but did not serve as the reason of the termination of Hyzaar therapy.
OVERDOSAGE
Concrete data on treatment of Hyzaar overdosage is not available. Treatment is reduced to symptomatic and a maintenance therapy. It is necessary to stop Hyzaar treatment and to provide careful observation over the patient. It is possible to carry a gastric lavage if the preparation is accepted recently, to offered methods of therapy of an overdosage correction of a dehydration and electrolytic disturbances, hepatic coma and hypotension treatment by the methods accepted now.
THE RELEASE FORM
The tablets containing Losartan 50 mg and 12,5 mg of Hydrochlorthiazidum. 14 or 28 tablets in packing.
STORAGE
Hyzaar is stored at a room temperature 15-30 C. Packing in which there is a preparation, should be densely closed.
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