Lozap - instructions for use, reviews, analogs and formulations (tablets 12.5 mg, 50 mg and 100 mg, Lozap plus in combination with a diuretic) drug for the treatment of pressure in adults, children and pregnancy
In this article, you can read the instructions for using the drug Lozap. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of Lozap in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Lozap with available structural analogues. Use to treat high blood pressure and reduce it in adults, children, as well as during pregnancy and lactation.
Lozap antihypertensive drug. Specific antagonist of angiotensin 2 receptors (subtype AT1). Does not inhibit kinase 2 - an enzyme that catalyzes the conversion of angiotensin 1 into angiotensin 2. Reduces OPSS, the concentration in the blood of adrenaline and aldosterone, blood pressure, pressure in a small circle of circulation; reduces afterload, has a diuretic effect. It prevents the development of myocardial hypertrophy, increases tolerance to physical activity in patients with chronic heart failure. Losartan (the active substance of the drug Lozap) does not inhibit ACE-kininase 2 and accordingly does not prevent the destruction of bradykinin, therefore side effects mediated by bradykinin (eg, angioedema) occur rarely.
In patients with arterial hypertension without concomitant diabetes mellitus with proteinuria (more than 2 g per day), the use of the drug significantly reduces proteinuria, albumin and immunoglobulin G excretion.
Stabilizes the level of urea in the blood plasma. Does not affect vegetative reflexes and does not have a long-term effect on the concentration of norepinephrine in the blood plasma.Losartan in a dose of up to 150 mg per day does not affect the level of triglycerides, total cholesterol and HDL cholesterol in the blood serum in patients with hypertension. At the same dose, losartan does not affect the fasting blood glucose level.
After a single oral intake, the hypotensive effect (systolic and diastolic blood pressure decreases) reaches a maximum after 6 hours, then gradually decreases within 24 hours.
The maximum hypotensive effect develops 3-6 weeks after the start of the drug.
The combined drug Lozap plus additionally contains hydrochlorothiazide - a thiazide diuretic. Reduces the reabsorption of sodium ions, increases the release of urine ions of potassium, bicarbonate and phosphate. Reduces blood pressure by reducing bcc, changing the reactivity of the vascular wall, reducing the pressor effect of vasoconstrictor substances and increasing the depressor effect on the ganglion.
The maximum antihypertensive effect is achieved within 3 weeks after the start of treatment.
Pharmacokinetics
When ingested, Lozap is well absorbed. Eating does not affect the bioavailability of losartan.Approximately 14% of losartan administered to the patient IV, or taken internally, becomes an active metabolite. When ingested, approximately 4% of the dose taken is excreted by the kidneys unchanged and about 6% is excreted by the kidneys in the form of an active metabolite.
Neither losartan nor its active metabolite is removed from the body by hemodialysis.
The concentrations of losartan and its active metabolite in blood plasma in elderly men with arterial hypertension do not differ significantly from the values of these parameters in young men with arterial hypertension.
Values of plasma concentrations of losartan in women with arterial hypertension are 2 times higher than the corresponding values in men with arterial hypertension. The concentrations of the active metabolite in men and women do not differ. This pharmacokinetic difference is not clinically relevant.
Indications
- arterial hypertension;
- chronic heart failure (as part of combination therapy, with intolerance or ineffective therapy with ACE inhibitors);
- reduction in the risk of developing cardiovascular diseases (incl.stroke) and mortality in patients with hypertension and left ventricular hypertrophy;
- diabetic nephropathy in hypercreatininemia and proteinuria (urine albumin and creatinine ratio more than 300 mg / g) in patients with type 2 diabetes and concomitant arterial hypertension (reduction in the progression of diabetic nephropathy to terminal chronic renal failure).
Forms of release
Tablets, film-coated 12.5 mg, 50 mg and 100 mg.
Lozap plus tablets (in combination with a diuretic hydrochlorothiazide to enhance the effect).
Instructions for use and dosage
The drug is taken orally, regardless of food intake. Multiplicity of admission - 1 time per day.
With arterial hypertension, the average daily dose is 50 mg. In some cases, to achieve a greater therapeutic effect, the daily dose can be increased to 100 mg in 2 or 1 reception.
The initial dose for patients with chronic heart failure is 12.5 mg once a day. Typically, the dose is increased with a weekly interval (ie 12.5 mg per day, 25 mg per day, 50 mg per day) to an average maintenance dose of 50 mg 1 time per day, depending on the tolerance of the drug.
When administering the drug to patients receiving diuretics in high doses, the initial dose of Lozap should be reduced to 25 mg once a day.
For elderly patients, there is no need for dose adjustment.
When the drug is prescribed to reduce the risk of developing cardiovascular diseases (including stroke) and mortality in patients with hypertension and left ventricular hypertrophy, the initial dose is 50 mg per day. In the future, hydrochlorothiazide can be added at a low dose and / or the dose of Lozap can be increased to 100 mg per day in 1-2 doses.
In patients with concomitant type 2 diabetes mellitus with proteinuria, the initial dose of the drug is 50 mg once a day, then the dose is raised to 100 mg per day (taking into account the degree of blood pressure reduction) in 1-2 doses.
Patients with a history of liver disease, dehydration, hemodialysis, and patients older than 75 years are recommended a lower initial dose of the drug - 25 mg (1/2 tablets 50 mg) once a day.
Side effect
- orthostatic hypotension (dose-dependent);
- nose bleed;
- bradycardia;
- arrhythmias;
- angina pectoris;
- vasculitis;
- myocardial infarction;
- anorexia;
- dryness of the oral mucosa;
- toothache;
- vomiting;
- flatulence;
- constipation;
- abnormal liver function;
- dry skin;
- erythema;
- ecchymosis;
- photosensitization;
- increased sweating;
- hives;
- skin rash;
- itching;
- angioedema (including swelling of the larynx and tongue, causing airway obstruction and / or swelling of the face, lips, pharynx);
- anemia (a slight decrease in the concentration of hemoglobin and hematocrit, an average of 0.11 g% and 0.09 volume%, respectively, rarely - having clinical significance), thrombocytopenia, eosinophilia;
- arthralgia (joint pain);
- anxiety;
- sleep disturbance;
- drowsiness;
- memory disorders;
- paresthesia;
- tremor;
- depression;
- fainting;
- migraine;
- tinnitus;
- a taste disorder;
- visual impairment;
- conjunctivitis;
- imperative urge to urinate;
- impaired renal function;
- decreased libido;
- impotence;
- gout.
Contraindications
- pregnancy;
- lactation period;
- age under 18 years (effectiveness and safety not established);
- hypersensitivity to the components of the drug.
Application in pregnancy and lactation
There are no data on the use of the drug Lopaz during pregnancy.However, it is known that drugs acting directly on RAAS, when applied in the 2nd and 3rd trimester of pregnancy, can cause a developmental defect or even the death of a developing fetus. Therefore, when pregnancy occurs, taking Lozap should be stopped immediately.
If Lozap should be used during lactation, a decision should be made either to stop breastfeeding, or to stop breastfeeding, or to stop treatment with the drug.
special instructions
It is necessary to correct the dehydration prior to the appointment of Lozap or to begin treatment with the use of the drug in a lower dose.
Drugs that affect RAAS can increase urea levels in the blood and serum creatinine in patients with bilateral renal artery stenosis or stenosis of the artery of a single kidney.
In patients with cirrhosis of the liver, the concentration of losartan in the blood plasma is significantly increased, and therefore, in the presence of liver diseases in the history, it should be prescribed in lower doses.
Joint intake of alcohol also increases the concentration of the drug Lozap in the body.
During the treatment period, the concentration of potassium in the blood should be monitored regularly, especially in elderly patients, with renal dysfunction.
Use in Pediatrics
The safety and efficacy of using Lozap in children and adolescents under the age of 18 years have not been established.
Impact on the ability to drive vehicles and manage mechanisms
Lozap does not affect the ability to drive vehicles or work with mechanisms.
Drug Interactions
The drug can be administered with other antihypertensive agents. There is a mutual enhancement of the effects of beta-blockers and sympatholytics. With the combined use of losartan with diuretics, an additive effect is observed.
There was no pharmacokinetic interaction of losartan with hydrochlorothiazide, digoxin, warfarin, cimetidine, phenobarbital, Ketoconazole and erythromycin.
Reportedly, rifampicin and Fluconazole reduce the concentration of the active metabolite of losartan in the blood plasma. The clinical significance of this interaction is still unknown.
As with the use of other agents that inhibit angiotensin 2 or its effect,joint use of losartan with potassium-sparing diuretics (eg spironolactone, triamterene, amiloride), potassium and potassium-containing salts, increases the risk of hyperkalemia.
NSAIDs, including selective inhibitors of COX-2, may reduce the effect of diuretics and other antihypertensive agents.
With the combined use of antagonists of angiotensin 2 and lithium receptors, an increase in the concentration of lithium in the blood plasma is possible. Given this, it is necessary to weigh the benefit and risk of joint use of losartan with preparations of lithium salts. If a joint application is necessary, the concentration of lithium in the blood plasma should be monitored regularly.
Analogues of medicinal product Lozap
Structural analogs for the active substance:
- Bloktran;
- Brozaar;
- Vasotensis;
- Vero-Losartan;
- Zisakar;
- Cardomin-Sanovel;
- Karzartan;
- Cosaar;
- Lacka;
- Lozarel;
- Losartan;
- Losartan potassium;
- Losartan McLeodz;
- Losartan-Richter;
- Losartan-Teva;
- Lorist;
- Losakor;
- Prezartan;
- Renikard.
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