LORISTA - instructions for use, reviews, analogs and formulations (tablets 12.5 mg, 25 mg, 50 mg and 100 mg, H and ND - plus with a diuretic hydrochlorothiazide) drugs for the treatment of hypertension in adults, children and pregnancy
In this article, you can read the instructions for using the drug Lorista. Comments of visitors of the site - consumers of this medication, as well as opinions of doctors of specialists on using Lorist in their practice are presented. 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 Loriste in the presence of existing structural analogues. Use to treat high blood pressure in adults, children, as well as during pregnancy and lactation.
Lorista - Selective antagonist of angiotensin 2 receptors of type AT1 of non-protein nature.
Lozartan (active substance of Lorist's preparation) and its biologically active carboxylic metabolite (EXP-3174) block all physiologically significant effects of angiotensin 2 on AT1-receptors regardless of the way of its synthesis: leads to an increase in renin plasma activity, reduces the concentration of aldosterone in the blood plasma.
Losartan indirectly causes the activation of AT2 receptors by increasing the level of angiotensin 2. Losartan does not inhibit the activity of kinase 2, an enzyme that participates in the metabolism of bradykinin.
Reduces OPSS, pressure in a small circle of blood 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.
Reception LORISTA once a day leads to a statistically significant reduction in systolic and diastolic blood pressure. During the day, losartan evenly Controls BP, while the antihypertensive effect corresponds to a natural circadian rhythm.Decrease in blood pressure at the end of the dose of the drug was approximately 70-80% of the effect at the peak of the drug, 5-6 hours after admission. The withdrawal syndrome is not observed; also losartan does not have a clinically significant effect on heart rate.
Losartan is effective in men and women, as well as in the elderly (≥65 years) and younger patients (≤ 65 years).
Hydrochlorothiazide is a thiazide diuretic whose diuretic effect is associated with a disruption of the reabsorption of sodium, chlorine, potassium, magnesium, water in the distal nephron; delays the excretion of calcium ions, uric acid. Has antihypertensive properties; the hypotensive effect develops due to the expansion of arterioles. Virtually no effect on normal blood pressure. Diuretic effect occurs in 1-2 hours, reaches a maximum after 4 hours and lasts 6-12 hours.
Antihypertensive effect occurs in 3-4 days, but it may take 3-4 weeks to achieve the optimal therapeutic effect.
Composition
Losartan potassium + auxiliary substances.
Losartan potassium + Hydrochlorothiazide + auxiliary substances (Lorista N and ND).
Pharmacokinetics
The pharmacokinetics of losartan and hydrochlorothiazide with simultaneous application does not differ from that in their separate application.
Losartan
Well absorbed from the digestive tract. The intake of the drug with food does not have a clinically significant effect on its serum concentrations. Virtually does not penetrate the blood-brain barrier (GEB). About 58% of the drug is excreted with bile, 35% - with urine.
Hydrochlorothiazide
After oral intake of hydrochlorothiazide is 60-80%. Hydrochlorothiazide is not metabolized and is rapidly excreted by the kidneys.
Indications
- arterial hypertension;
- reduction in the risk of stroke in patients with hypertension and left ventricular hypertrophy;
- chronic heart failure (as part of combination therapy, with intolerance or ineffective therapy with ACE inhibitors);
- protection of kidney function in patients with type 2 diabetes mellitus with proteinuria in order to reduce proteinuria, reduce the progression of kidney damage, reduce the risk of developing the terminal stage (preventing the need for dialysis, the probability of increasing serum creatinine levels) or the onset of death.
Forms of release
Tablets 12.5 mg, 25 mg, 50 mg and 100 mg.
Lorist H (additionally contains 12.5 mg of hydrochlorothiazide).
Lorista ND (additionally contains 25 mg of hydrochlorothiazide).
Instructions for use and dosage
The drug is taken orally, regardless of food intake, the frequency of intake is 1 time per day.
With arterial hypertension, the average daily dose is 50 mg. The maximum antihypertensive effect is achieved within 3-6 weeks of therapy. It is possible to achieve a more pronounced effect by increasing the dose of the drug to 100 mg per day in two divided doses or in one dose.
Against the background of taking diuretics in high doses, it is recommended to start Loristoy's therapy with 25 mg per day in one session.
Elderly patients, patients with impaired renal function (including patients on hemodialysis) do not need correction of the initial dose of the drug.
Patients with impaired liver function should be given a lower dose.
In chronic heart failure, the initial dose of the drug is 12.5 mg per day in one session. In order to achieve a normal maintenance dose of 50 mg per day, the dose should be increased gradually, at intervals of 1 week (eg, 12.5 mg, 25 mg, 50 mg per day). Lorist is usually prescribed in combination with diuretics and cardiac glycosides.
To reduce the risk of stroke in patients with hypertension and left ventricular hypertrophy, the standard initial dose is 50 mg inday. In the future, hydrochlorothiazide can be added at low doses and / or Lorista dose increased to 100 mg per day.
To protect the kidneys in patients with type 2 diabetes mellitus with proteinuria, the standard initial dose of Lorista is 50 mg per day. The dose of the drug can be increased to 100 mg per day, taking into account the decrease in blood pressure.
By-products
- dizziness;
- asthenia;
- headache;
- fatigue;
- insomnia;
- anxiety;
- sleep disturbance;
- drowsiness;
- memory disorders;
- peripheral neuropathy;
- paresthesia;
- hyposthenia;
- migraine;
- tremor;
- depression;
- orthostatic hypotension (dose-dependent);
- palpitation;
- tachycardia;
- bradycardia;
- arrhythmias;
- angina pectoris;
- nasal congestion;
- cough;
- bronchitis;
- edema of the nasal mucosa;
- nausea, vomiting;
- diarrhea;
- abdominal pain;
- anorexia;
- dry mouth;
- toothache;
- flatulence;
- constipation;
- imperative urge to urinate;
- impaired renal function;
- decreased libido;
- impotence;
- convulsions;
- pain in the back, chest, legs;
- tinnitus;
- a taste disorder;
- visual impairment;
- conjunctivitis;
- anemia;
- purple Shenlaine-Henoch;
- dry skin;
- increased sweating;
- alopecia;
- gout;
- hives;
- skin rash;
- itching;
- angioedema (including swelling of the larynx and tongue, causing airway obstruction and / or swelling of the face, lips, pharynx).
Contraindications
- arterial hypotension;
- hyperkalemia;
- dehydration;
- lactose intolerance;
- galactosemia or syndrome of impaired glucose / galactose absorption;
- pregnancy;
- lactation period;
- age under 18 years (efficacy and safety in children not established);
- increased sensitivity to losartan and / or other components of the drug.
Application in pregnancy and lactation
There are no data on the use of Lorist in pregnancy. Renal perfusion of the fetus, which depends on the development of the renin-angiotensin system, begins to function in the third trimester of pregnancy. The risk to the fetus increases with the use of losartan in the 2nd and 3rd trimesters. When establishing pregnancy, losartan should be discontinued immediately.
There is no data on the isolation of losartan with breast milk. Therefore, the question of stopping breastfeeding or abolishing losartan therapy should be addressed, taking into account its importance for the mother.
special instructions
Patients with a reduced volume of circulating blood (for example, with therapy with large doses of diuretics) may develop symptomatic arterial hypotension. Before starting losartan, it is necessary to eliminate the existing disorders, or start therapy with small doses.
In patients with mild and moderate cirrhosis of the liver, the concentration of losartan and its active metabolite in the blood plasma after ingestion is higher than in healthy ones. Therefore, patients with a history of liver disease are recommended therapy in lower doses.
In patients with impaired renal function, with or without diabetes mellitus, hyperkalemia often develops, which should be borne in mind, but only in rare cases does it stop treatment. During the treatment period, the concentration of potassium in the blood should be monitored regularly, especially in elderly patients, with renal dysfunction.
Drugs acting on the renin-angiotensin system can increase urea and creatinine in the serum in patients with bilateral renal artery stenosis or unilateral stenosis of the artery of a single kidney.Changes in kidney function can be reversible after the abolition of therapy. During the treatment period, it is necessary to regularly monitor the serum creatinine concentration at regular intervals.
Impact on the ability to drive vehicles and manage mechanisms
Data on the influence of Lorist on the ability to manage transport or other technical means are absent.
Drug Interactions
There was no clinically significant drug interaction with hydrochlorothiazide, digoxin, indirect anticoagulants, cimetidine, phenobarbital, Ketoconazole and erythromycin.
During simultaneous administration with rifampicin and fluconazole, a decrease in the level of the active metabolite of losartan potassium was noted. The clinical consequences of this phenomenon are unknown.
Simultaneous use with potassium-sparing diuretics (eg spironolactone, triamterene, amiloride) and potassium preparations increases the risk of hyperkalemia.
Simultaneous use of non-steroidal anti-inflammatory drugs, including selective inhibitors of COX-2, can reduce the effect of diuretics and other antihypertensive agents.
If Lorista is prescribed concomitantly with thiazide diuretics, the decrease in blood pressure is approximately additive. Strengthens (mutually) the effect of other antihypertensive drugs (diuretics, beta-blockers, sympatholytics).
Analogs of Lorist's drug
Structural analogs for the active substance:
- Bloktran;
- Brozaar;
- Vasotensis;
- Vero Losartan;
- Zisakar;
- Cardomin Sanovel;
- Karzartan;
- Cosaar;
- Lacka;
- Lozap;
- Lozarel;
- Losartan;
- Losartan potassium;
- Losakor;
- Lothor;
- Prezartan;
- Renikard.
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