Losartan film-coated tablets 25 mg 30 pcs. in Moscow

Losartan is a drug produced by domestic and imported pharmaceutical manufacturers to reduce blood pressure and the risk of developing heart and vascular diseases and complications. The cost of the medication varies from 50 to 400 rubles, depending on the dosage (50, 100 mg, with a diuretic component), the manufacturing company, and the raw materials.

Losartan analogues presented in pharmacies differ in indications, features of use and nuances of prescription. Group - substitutes with the same composition, differ in bioavailability, effectiveness, frequency of adverse reactions, study and price.

pharmachologic effect

Manufacturer: Ozone, Vertex, Pranapharm, Canon, etc., Russia, Richter (Hungary), Teva (Russia), Alkaloid (Macedonia)

Release form: tablets

Active ingredient: losartan

Synonyms: Lozap, Lorista, Presartan, Gizaar, Vasotens, Cozaar, Bloktran, etc.

The drug belongs to the group of angiotensin II receptor antagonists. It lowers and maintains normal blood pressure, reduces the risk of complications, disability and death.

Important! Losartan is a cumulative drug. The maximum effect is observed with continuous use for 3-6 weeks. During therapy, monitoring blood pressure and collaborating with a doctor to accurately select the dosage of an antihypertensive drug are extremely important.

Losartan film-coated tablets 25 mg 30 pcs. in Moscow

Losartan is a specific angiotensin II receptor (AT1 type) antagonist for oral administration. Angiotensin II selectively binds to AT1 receptors found in many tissues (vascular smooth muscle, adrenal glands, kidneys and heart) and performs several important biological functions, including vasoconstriction and aldosterone release. Angiotensin II also stimulates the proliferation of smooth muscle cells.

Losartan and its pharmacologically active metabolite (E 3174) both in vitro and in vivo block all physiological effects of angiotensin II, regardless of the source or route of synthesis. Losartan selectively binds to AT1 receptors: it does not bind to or block the receptors of other hormones and ion channels that play an important role in regulating the function of the cardiovascular system. In addition, losartan does not inhibit angiotensin-converting enzyme (ACE), which promotes the degradation of bradykinin, so side effects indirectly related to bradykinin (for example, angioedema) are rare.

When using losartan, the absence of negative feedback influence on renin secretion leads to an increase in plasma renin activity. An increase in renin activity leads to an increase in the concentration of angiotensin II in the blood plasma.

However, antihypertensive activity and a decrease in plasma aldosterone concentrations persist, indicating effective blockade of angiotensin II receptors. After discontinuation of losartan, plasma renin activity and angiotensin II concentration decreased within 3 days to the initial values ​​observed before starting the drug.

Losartan and its active metabolite have a high affinity for angiotensin II receptors (type AT1).

Plasma concentrations of losartan and its active metabolite, as well as the antihypertensive effect of losartan, increase with increasing dose of the drug.

The maximum antihypertensive effect develops 3-6 weeks after starting the drug.

In patients with arterial hypertension, proteinuria (more than 2 g per day), without diabetes mellitus, the use of the drug significantly reduces proteinuria, albumin and immunoglobulin G (IgG) excretion.

In postmenopausal women with arterial hypertension who took losartan at a dose of 50 mg/day for 4 weeks, there was no effect of therapy on the renal and systemic levels of prostaglandins.

Losartan does not affect autonomic reflexes and does not have a long-term effect on the level of norepinephrine in the blood plasma.

In patients with arterial hypertension, losartan in doses up to 150 mg per day does not cause clinically significant changes in the concentration of triglycerides, total cholesterol and high-density lipoprotein cholesterol. At the same doses, losartan has no effect on fasting blood glucose concentrations. Losartan caused a decrease in serum uric acid concentration (usually less than 0.4 mg/dL), which persisted during long-term therapy. In controlled clinical studies involving patients with arterial hypertension, there were no cases of drug withdrawal due to an increase in creatinine or potassium in the blood serum.

Losartan - instructions for use

The medicine is released strictly according to prescription and is taken constantly, regardless of blood pressure. Dosages are selected based on indicators, the patient’s condition, the presence of concomitant diseases and medications taken, the patient’s age and other factors.

Important! At first, the drug does not maintain normal blood pressure. According to the instructions for use, Losartan has a cumulative effect and maximum concentration, and therefore the therapeutic effect is observed after 3–6 weeks. This is important to consider during therapy; the patient should record pressure values ​​daily in the morning, afternoon and evening.

How to take Losartan - in the morning or in the evening, is discussed with the doctor based on the individual characteristics of the patient and other medications taken. Complex drugs with a diuretic effect are drunk in the morning, before meals.

It doesn’t matter how you take mono medications, before or after meals.

At the beginning of therapy, an average or minimum dose of an antihypertensive drug is prescribed, and the patient is advised to keep a diary. It records blood pressure readings in the morning, afternoon and evening, taking emergency medications, and well-being. If necessary, the dosage is adjusted.

Losartan is taken once a day. If the therapeutic effect is not enough, combinations with diuretics or other antihypertensive drugs are possible.

Instructions for use LOSARTAN

Hypersensitivity

Patients with a history of angioedema (swelling of the face, lips, larynx and/or tongue) should be closely monitored.

Arterial hypotension and water-electrolyte balance

In patients with reduced blood volume and/or sodium content, symptomatic hypotension may develop as a result of enhanced diuretic therapy, salt restriction, diarrhea and vomiting. These conditions should be corrected before starting the use of losartan or the initial dose of the drug should be reduced.

Double blockade of the RAAS

Dual blockade of the RAAS is accompanied by an increased risk of arterial hypotension, hyperkalemia and renal dysfunction (including acute renal failure) compared with monotherapy.

Dual blockade of the RAAS using an ACE inhibitor, an angiotensin II receptor antagonist and aliskiren cannot be recommended for any patient, especially patients with diabetic nephropathy.

In some cases, when the combined use of an ACE inhibitor and an angiotensin II receptor antagonist is absolutely indicated, careful supervision by a specialist and mandatory monitoring of renal function, water-electrolyte balance, and blood pressure are necessary. This applies to the prescription of candensartan or valsartan as adjunctive therapy to ACE inhibitors in patients with chronic heart failure. Carrying out double blockade of the RAAS under the careful supervision of a specialist and mandatory monitoring of renal function, water-electrolyte balance and blood pressure is possible in patients with chronic heart failure with intolerance to aldosterone antagonists (spironolactone), who have persistence of symptoms of chronic heart failure, despite other adequate therapy .

Electrolyte imbalance

It should be taken into account that electrolyte imbalances are common in patients with impaired renal function (with or without diabetes mellitus). According to data from a clinical study involving patients with type 2 diabetes mellitus and nephropathy, the incidence of hyperkalemia in the group receiving losartan was higher compared to the group receiving placebo. Therefore, potassium levels in the blood plasma and creatinine clearance should be carefully monitored, especially in patients with heart failure and creatinine clearance 30-50 ml/min.

It is not recommended to take losartan with potassium-sparing diuretics, potassium supplements, or potassium-containing salt substitutes.

Liver dysfunction

According to pharmacokinetic data, a significant increase in plasma concentrations of losartan was detected in patients with liver cirrhosis; therefore, patients with impaired liver function should be prescribed the drug in lower doses. Losartan should not be used in patients with severe liver dysfunction.

Renal dysfunction

Due to inhibition of the RAAS, renal dysfunction, including renal failure, has been reported with the drug (particularly in patients whose renal function is dependent on the activity of the RAAS, such as patients with severe heart failure or patients with existing renal impairment). As with the use of other drugs that affect the RAAS, increased serum urea and creatinine concentrations have been reported in patients with bilateral renal artery stenosis or arterial stenosis of a solitary kidney; these changes in renal function may be reversible after discontinuation of therapy. Losartan should be used with caution in the treatment of patients with bilateral renal artery stenosis or arterial stenosis of a solitary kidney.

When treating with losartan, renal function should be regularly monitored, because its violation is possible. This is especially true when losartan is used against the background of other pathological conditions (fever, dehydration) that may affect kidney function.

The simultaneous use of losartan and ACE inhibitors worsens renal function, so this combination is not recommended.

Kidney transplant

There is no experience using the drug to treat patients who have recently undergone kidney transplantation.

Primary hyperaldosteronism

In patients with primary hyperaldosteronism, antihypertensive drugs that act by inhibiting the RAAS are generally ineffective. Therefore, the use of losartan is not recommended.

IHD and cerebrovascular diseases

As with the use of other antihypertensive drugs, an excessive decrease in blood pressure in patients with coronary artery disease and cerebrovascular diseases can lead to the development of myocardial infarction or stroke.

Heart failure

As with other drugs that affect the RAAS, patients with heart failure with or without renal impairment are at risk of developing severe hypotension and (often acute) renal impairment.

There is insufficient therapeutic experience with losartan in patients with heart failure and concomitant severe renal impairment, in patients with severe heart failure (NYHA class IV), and in patients with heart failure and symptomatic, life-threatening cardiac arrhythmia. Therefore, losartan should be used with caution in this group of patients. Losartan should be used with caution in combination with beta-blockers.

Stenosis of the aortic and mitral valves, obstructive hypertrophic cardiomyopathy

As with the use of other vasodilators, the drug should be prescribed with extreme caution to patients with aortic or mitral valve stenosis or obstructive hypertrophic cardiomyopathy.

Lactose intolerance

The drug contains lactose. The drug should not be prescribed to patients with such rare hereditary pathologies as galactose intolerance, lapp lactase deficiency or glucose-galactose malabsorption.

Use in pediatrics

Losartan is contraindicated in children and adolescents under 18 years of age.

, since there is insufficient data regarding the use of the drug in this group of patients.

Ethnic differences

It has been established that ACE inhibitors, losartan and other angiotensin antagonists are significantly less effective in reducing blood pressure in patients of the Negroid race than in representatives of other races; This may be due to the fact that among black patients suffering from arterial hypertension, individuals with low renin activity predominate.

Impact on the ability to drive vehicles and operate machinery

Studies of the effect of the drug on the ability to drive a car and operate machinery have not been conducted. However, when driving or operating machinery, it is necessary to take into account that when using antihypertensive drugs, sudden onset of dizziness or drowsiness is possible, especially at the beginning of treatment or when the dose is increased.

Losartan's analogs

The drug for high blood pressure and hypertension is produced by several manufacturers. The price of Losartan depends on the dosage, number of tablets, company, and pharmacy markup. The minimum cost of the medicine is 40–60 rubles, the maximum is 370–400 rubles.

Important! Losartan for 40 and 400 rubles cannot be the same in terms of effect and quality. Due to the use of different raw materials and production technologies, the bioavailability of the product, effectiveness, safety and frequency of adverse reactions differ. When deciding what can replace Losartan 50 mg or 100 mg, consult a cardiologist and choose trusted manufacturers. The most famous are Losartan Teva, Losartan Canon.

List of Losartan analogues

Perindopril

Manufacturer: Pranafarm, Biokhimik, Northern Star, Teva, etc., Russia, Richter (Hungary)
Release form: tablets

Active ingredient: perindopril

Synonyms: Perineva, Parnavel, Prestarium

An analogue of Losartan in tablets is the drug Perindopril, which belongs to the group of ACE inhibitors. The medicine lowers blood pressure without affecting heart rate. The disadvantage of the analogue is severe side effects such as cough and shortness of breath.

In pharmacies there are combinations of perindopril with indapamide, a component that has a diuretic and hypotensive (blowing blood pressure) effect. They are produced under the names Noliprel, Ko-perineva, Ko-parnavel. These combined analogues are prescribed when blood pressure correction is ineffective with an antihypertensive drug based on one component.

Telmisartan

Manufacturer: North Star, Ozone, Russia
Release form: tablets

Active ingredient: telmisartan

Synonyms: Mikardis, Telpres, Telmista, Telzap, etc.

The drug Telmisartan is a substitute for Losartan with fewer side effects. A pronounced therapeutic effect appears within 4–8 weeks, provided that the drug is taken continuously. The analogue is also used once a day to control blood pressure.

Bisoprolol

Manufacturer: Ozone, Pranapharm, Teva, etc., Russia
Release form: tablets

Active ingredient: bisoprolol

Synonyms: Concor, Biprol, Biol, Bidop, Bisogamma, Coronal, Cordinorm, Niperten, etc.

The Losartan analogue is a beta blocker. The therapeutic effect depends on the dosage: the higher the concentration of the substance in the blood, the stronger the effect.

Indications for the use of the analogue:

• arterial hypertension;
• angina pectoris;
• tachycardia;
• prevention of angina pectoris and heart attack;
• other types of arrhythmia.

The Bisoprolol analogue is used exclusively as prescribed by a therapist or cardiologist as an adjuvant in the early stages of heart disease and as an addition to the main treatment for advanced conditions.

Captopril

Manufacturer: Ozone, Pranapharm, Russia
Release form: tablets

Active ingredient: captopril

Synonyms: Kapoten

The drug is used as a means to maintain blood pressure or as an emergency measure to quickly lower blood pressure. The method of application of the analogue is inside or under the tongue, respectively.

The Physiotens analogue has a similar effect. The modern substitute is better tolerated and does not cause coughing. Synonyms of the drug are Moxonidine, Tenzotran, Moxarel, etc.

Other analogues of Losartan of the new generation:

• olmesartan (Cardosal);
• azilsartan (Edarbi and the combination drug Edarbi Clo);
• candesartan (Atacand, Ordiss).

Analogs of Losartan 50 mg are characterized by high cost, rapid and stable therapeutic effect, good tolerability, and lower incidence of side effects.

Cheap analogues of Losartan are the medications Metoprolol and Ramipril.

Losartan tablet p/pl/o 25 mg N30 (Vertex)

Losartan is a specific angiotensin II receptor antagonist (AT1) for oral administration. Angiotensin II selectively binds to AT1 receptors found in many tissues (vascular smooth muscle, adrenal glands, kidneys and heart) and performs several important biological functions, including vasoconstriction and aldosterone release. Angiotensin II also stimulates the proliferation of smooth muscle cells. Losartan and its pharmacologically active metabolite (E 3174) both in vitro and in vivo block all physiological effects of angiotensin II, regardless of the source or route of synthesis. Losartan selectively binds to AT1 receptors: it does not bind to or block the receptors of other hormones and ion channels that play an important role in regulating the function of the cardiovascular system. In addition, losartan does not inhibit angiotensin-converting enzyme (ACE), which promotes the degradation of bradykinin, so side effects indirectly associated with bradykinin (for example, angioedema) occur quite rarely. When using losartan, the lack of negative feedback influence on renin secretion leads to increased activity blood plasma renin. An increase in renin activity leads to an increase in the concentration of angiotensin II in the blood plasma. However, antihypertensive activity and a decrease in plasma aldosterone concentrations persist, indicating effective blockade of angiotensin II receptors. After discontinuation of losartan, plasma renin activity and angiotensin II concentration decreased within 3 days to the initial values ​​observed before starting the drug. Losartan and its active metabolite have a high affinity for angiotensin II receptors (AT1 type). Concentrations of losartan and its active metabolite in blood plasma, as well as the antihypertensive effect of losartan increase with increasing dose of the drug. The maximum antihypertensive effect develops 3-6 weeks after starting the drug. In patients with arterial hypertension, proteinuria (more than 2 g per day), without diabetes mellitus, the use of the drug is reliable reduces proteinuria, excretion of albumin and immunoglobulin G (IgG). In women in the postmeionatal period with arterial hypertension, taking losartan at a dose of 50 mg/day for 4 weeks, no effect of therapy on the renal and systemic levels of prostaglandins was detected. Losartan has no effect pas autonomic reflexes and does not have a long-term effect on the level of norepinephrine in the blood plasma. In patients with arterial hypertension, losartan in doses of up to 150 mg per day does not cause clinically significant changes in the concentration of triglycerides, total cholesterol and high-density lipoprotein cholesterol. At the same doses, losartan has no effect on fasting blood glucose concentrations. Losartan caused a decrease in serum uric acid concentration (usually less than 0.4 mg/dL), which persisted during long-term therapy. In controlled clinical studies involving patients with arterial hypertension, there were no cases of drug withdrawal due to an increase in creatinine or potassium in the blood serum. Pharmacokinetics Absorption When taken orally, losartan is well absorbed from the gastrointestinal tract. The systemic bioavailability of losartan is approximately 33%; food intake does not affect the bioavailability of losartan. The average maximum concentrations of losartan and its active metabolite are reached after 1 hour and after 3-4 hours, respectively. Distribution Losartan and its active metabolite are bound to plasma proteins (mainly albumin) by more than 99%. The volume of distribution of losartan is 34 liters. Losartan practically does not penetrate the blood-brain barrier. Metabolism Losartan undergoes the effect of “primary passage” through the liver and is metabolized with the participation of the CYP2C9 isoenzyme of cytochrome P450. Approximately 14% of a dose of losartan administered intravenously or orally is converted to its active metabolite (EXP3174) with a carboxyl group. Biologically inactive metabolites are also formed: two main ones (as a result of hydroxylation of the butyl side chain) and a less significant one - N-2-tetrazole glucuronide. Excretion Plasma clearance of losartan and its active metabolite is 600 ml/min and 50 ml/min, respectively. The renal clearance of losartan and its active metabolite is approximately 74 ml/min and 26 ml/min, respectively. When losartan is taken orally, about 4% of the dose is excreted unchanged by the kidneys and within 6% of the dose is excreted by the kidneys in the form of an active metabolite. Losartan and its active metabolite have linear pharmacokinetics when losartan is administered orally in doses up to 200 mg. After oral administration, plasma concentrations of losartan and its active metabolite decrease polyexponentially with final T1/2 of approximately 2 and 6-9 hours, respectively. Elimination of losartan and its metabolites occurs in the bile and kidneys. After oral administration of losartan labeled with 14C, about 35% of the radioactive label is found in urine and 58% in feces. Pharmacokinetics in special groups of patients Plasma concentrations of losartan and its active metabolite in elderly male patients with arterial hypertension do not differ significantly from these indicators in younger male patients with arterial hypertension. Plasma concentrations of losartan were 2 times higher in women with arterial hypertension compared with men with arterial hypertension. Concentrations of the active metabolite did not differ between men and women. This obvious pharmacokinetic difference has no clinical significance. When losartan was taken orally in Nazis with mild to moderate alcoholic liver cirrhosis, the concentrations of losartan and its active metabolite in the blood plasma were 5 and 1.7 times (respectively) higher than in young people healthy male volunteers. Plasma concentrations of losartan in patients with creatinine clearance above 10 ml/min did not differ from those in patients with normal renal function. In patients requiring hemodialysis, the area under the concentration-time curve (AUC) is approximately 2 times greater than in patients with normal renal function. Plasma concentrations of the active metabolite do not change in patients with impaired renal function or in patients on hemodialysis. Losartan and its active metabolite are not removed from the bloodstream by hemodialysis.

Losartan or Lorista – which is better?

Manufacturer: KRKA, Slovenia or Russia
Release form: tablets

Active ingredient: losartan

Losartan and Lorista are drugs for lowering and stabilizing blood pressure based on a single component. Similarities between analogues:

• the same active ingredient, so the information in the instruction leaflet does not differ;
• possibility of use for the treatment and prevention of cardiovascular diseases;
• Compared with other groups of antihypertensive drugs, with the constant use of analogues, side effects occur less frequently, in particular, headache, cough, shortness of breath;
• positive reviews from doctors and patients;
• analogues are taken once a day;
• For a lasting antihypertensive effect, it is necessary to take medications in the prescribed dosage for at least 2–4 weeks.

The difference between the drugs Losartan and Lorista is insignificant. Manufactured by various pharmaceutical companies, Losartan is cheaper. Lorista is a drug from KRKA, a joint production of Slovenia and Russia. Losartan is most often a domestic medicine, less commonly produced in Macedonia and Hungary.

The advantage of the analogue is that Lorista is available in dosages of 12.5, 25, 50 and 100 mg. Losartan is available only in dosages of 50 and 100 mg. If small doses are needed, an analogue is preferable.

What to choose - Losartan or Lorista, the doctor recommends based on the individual characteristics of the patient.

Losartan 25 mg 30 pcs. film-coated tablets pranapharm

pharmachologic effect

Diuretic, hypotensive.

Composition and release form Losartan 25 mg 30 pcs. film-coated tablets pranapharm

Tablet - 1 tablet:

• Active substance: losartan potassium 25 mg;
• Excipients: pregelatinized starch, lactose monohydrate, magnesium stearate, sodium carboxymethyl starch, microcrystalline cellulose;
• film shell composition: hyprolose, titanium dioxide (E171).

Tablets 25 mg, in blisters, 30 pieces per pack.

Description of the dosage form

Round, biconvex, white film-coated tablets, scored. On cross-section, the tablet is white or almost white.

Directions for use and doses

For arterial hypertension, the average daily dose is 50 mg. If necessary, the daily dose can be increased to a maximum daily dose of 100 mg once a day.

Reducing the risk of cardiovascular disease and mortality in patients with arterial hypertension and LV hypertrophy: initial dose - 50 mg 1 time per day, subsequently it is recommended to additionally prescribe hydrochlorothiazide in low doses or increase the dose to 100 mg 1 time per day (taking into account the degree decrease in blood pressure).

Diabetes mellitus type 2 with proteinuria: initial dose - 50 mg 1 time per day with a further increase in dose to 100 mg/day (taking into account the degree of blood pressure reduction).

CHF: the initial dose for patients with CHF is 12.5 mg 1 time per day. As a rule, the dose is doubled at weekly intervals (i.e. 12.5, 25, 50 mg/day) to an average maintenance dose of 50 mg/day, 100 mg/day to a maximum (for this indication only) dose of 150 mg/day depending on individual tolerance.

Pharmacodynamics

Antihypertensive agent. It is a non-peptide angiotensin II receptor blocker. It has high selectivity and affinity for AT1 type receptors (with the participation of which the main effects of angiotensin II are realized). By blocking these receptors, losartan prevents and eliminates the vasoconstrictor effect of angiotensin II, its stimulating effect on the secretion of aldosterone by the adrenal glands and some other effects of angiotensin II. It is characterized by a long-term effect (24 hours or more), which is due to the formation of its active metabolite.

Pharmacokinetics

Suction.

Rapidly absorbed from the gastrointestinal tract (GIT). Bioavailability - 25-35%. Average maximum plasma concentrations (Cmax) of losartan and its active metabolite are achieved after 1 hour and after 3-4 hours, respectively. There was no effect of food intake on the absorption of losartan.

Distribution.

Communication with blood plasma proteins (mainly albumin) - 92% (losartan), 99% (metabolite). Practically does not penetrate the blood-brain barrier.

Metabolism.

It has the effect of “primary passage” through the liver, is metabolized by carboxylation with the participation of the CYP2C9 isoenzyme of cytochrome P450 with the formation of an active (10-40 times) metabolite.

Excretion.

The half-life (T1/2) is 1.5-2 hours, and that of its main metabolite is 6-9 hours.

35% is excreted by the kidneys (of which 4% - in the form of unchanged drug and 6% - in the form of the main metabolite); the remaining amount (60%) is through the intestines.

In patients with mild to moderate alcoholic cirrhosis, the concentration of losartan is 5 times higher, the active metabolite is 1.7 times higher than in healthy male volunteers.

When creatinine clearance (CC) is above 10 ml/min, the concentration of losartan in the blood plasma does not differ from that with normal renal function.

In patients requiring hemodialysis, the area concentration-time curve (AUC) is approximately twice as high as in patients with normal renal function.

Neither losartan nor its active metabolite is removed from the body by hemodialysis.

Plasma concentrations of losartan and its active metabolite in elderly male patients with arterial hypertension do not differ significantly from the values ​​of these parameters in young male patients with arterial hypertension.

Plasma concentrations of losartan in women with arterial hypertension are 2 times higher than the corresponding values ​​in men with arterial hypertension.

Concentrations of the active metabolite do not differ between men and women. This pharmacokinetic difference is not clinically significant.

Indications for use Losartan 25 mg 30 pcs. film-coated tablets pranapharm

Arterial hypertension.

Chronic heart failure with ineffective treatment with ACE inhibitors.

Kidney failure.

Left ventricular hypertrophy.

Contraindications

Hypersensitivity to any component of the drug, severe liver dysfunction (more than 9 points on the Child-Pugh scale) (no experience with use), pregnancy, breastfeeding, age under 18 years (efficacy and safety of use have not been established), simultaneous use with aliskiren or aliskiren-containing drugs in patients with diabetes mellitus and/or impaired renal function (glomerular filtration rate (GFR) less than 60 ml/min/1.73 m2), lactose intolerance, lactase deficiency, glucose-galactose malabsorption syndrome (the drug contains lactose).

Use with caution in case of arterial hypotension, decreased blood volume, water-electrolyte imbalance, bilateral renal artery stenosis or stenosis of the artery of a single kidney, and renal/liver failure.

Application Losartan 25 mg 30 pcs. film-coated tablets pranapharm during pregnancy and lactation

Contraindicated.

special instructions

For patients who have fluid and/or sodium deficiency, fluid and electrolyte disturbances should be corrected or a lower initial dose should be used before starting treatment.

In patients with dehydration (for example, those receiving high-dose diuretics), symptomatic hypotension may occur when losartan treatment is initiated.

If renal function is impaired, a dose reduction of losartan may be required.

In patients with a history of liver disease, losartan should be used in low doses. In liver cirrhosis, the concentration of losartan in the blood plasma increases significantly.

During treatment, potassium levels in the blood should be regularly monitored, especially in elderly patients with impaired renal function.

The simultaneous use of losartan with potassium-sparing diuretics should be avoided.

Overdose

Marked decrease in blood pressure, change in heart rate (HR) (tachycardia or bradycardia due to parasympathetic (vagal) stimulation).

Side effects Losartan 25 mg 30 pcs. film-coated tablets pranapharm

From the cardiovascular system: dizziness, orthostatic hypotension.

Metabolism: hyperkalemia.

Allergic reactions: angioedema (including swelling of the face, lips, pharynx and/or tongue), urticaria.

From the digestive system: diarrhea, increased ALT activity.

From the side of the central nervous system: headache.

Dermatological reactions: itching.

Other: renal dysfunction, myalgia.

Drug interactions

When used simultaneously with diuretics in high doses, arterial hypotension is possible.

When used simultaneously with potassium preparations and potassium-sparing diuretics, the risk of developing hyperkalemia increases.

When used simultaneously with indomethacin, the effectiveness of losartan may be reduced.

There is a report of the development of lithium intoxication when used simultaneously with lithium carbonate.

When used simultaneously with orlistat, the antihypertensive effect of losartan decreases, which can lead to a significant increase in blood pressure and the development of a hypertensive crisis.

When used simultaneously with rifampicin, the clearance of losartan increases and its effectiveness decreases.

Losartan or Lozap – which is better?

Manufacturer: Saneka Pharmaceuticals a.s., Slovakia
Release form: tablets

Active ingredient: losartan

Lozap is a substitute for Losartan, with the same properties and active substance. Produced by a foreign pharmaceutical company in the form of tablets of 50 and 100 mg in packages of 30, 60 and 90 pieces. There are also combined forms - Lozap Plus (with the diuretic component hydrochlorothiazide) and Lozap AM (together with amlodipine).

Lozap and Losartan differ in manufacturer, raw materials used and price. Analogue is more expensive. Reviews from doctors about Lozap are positive.

Otherwise, the drugs are similar - the same indications, contraindications, side effects. The choice in favor of Losartan or an analogue should be agreed with your doctor.

Losartan or Lisinopril

Manufacturer: Ozon, Alsi, Akrikhin, Stada, Teva, etc., Russia, Hungary or Slovenia
Release form: tablets

Active ingredient: lisinopril

Synonyms: Lisinoton, Diroton, etc.

Lisinopril is an ACE inhibitor, Losartan is an angiotensin 2 receptor antagonist.

Losartan is safer for the elderly, since the analogue has a number of disadvantages:

• negatively affects the liver, worsening laboratory parameters;
• when treated for more than 2–3 years, the analogue is less effective; a constant increase in the therapeutic dose is required;
• side effect in the form of barking cough, shortness of breath.

Lisinopril can be used twice a day, Losartan is recommended once a day. Which is better for blood pressure is individual and depends on the results of the patient’s laboratory tests.

Losartan-N Canon tablets 25 mg+100 mg 30 pcs.

Losartan. Can be used simultaneously with other antihypertensive drugs. There were no clinically significant drug interactions between losartan and hydrochlorothiazide, digoxin, warfarin, cimetidine, phenobarbital, ketoconazole and erythromycin. Rifampicin and fluconazole have been reported to reduce plasma concentrations of the active metabolite. The clinical significance of these interactions is currently unknown. As with the use of other drugs that block the formation of angiotensin II and its effects, the concomitant administration of potassium-sparing diuretics (spironolactone and eplerenone, triamterene, amiloride), potassium supplements and salts containing potassium may lead to an increase in the content of potassium ions in the blood serum. Antihypertensive drugs may increase the antihypertensive effect of losartan. Tricyclic antidepressants, antipsychotics, baclofen, amifostine, which reduce blood pressure as a main or side effect and may increase the risk of arterial hypotension, can also enhance the antihypertensive effect of losartan. With simultaneous use of angiotensin II receptor antagonists and nonsteroidal anti-inflammatory drugs (NSAIDs) (including selective cyclooxygenase-2 inhibitors, acetylsalicylic acid as an anti-inflammatory agent), the antihypertensive effect of losartan may be reduced. In patients with impaired renal function, concomitant use of angiotensin II receptor antagonists or diuretics and NSAIDs may cause a further deterioration of renal function, including acute renal failure and an increase in serum potassium. This combination should be used with caution, especially in elderly patients. With simultaneous use of lithium with ACE inhibitors, a reversible increase in the concentration of lithium in the blood serum and the development of toxicity were recorded; in very rare cases this has been observed with the use of angiotensin II receptor antagonists. Caution should be used when lithium is used concomitantly with losartan. If this combination is necessary, it is recommended to monitor the concentration of lithium in the blood serum. Mutually enhances the effect of beta-blockers and sympatholytics; combined use of losartan with diuretics causes an additive effect. Dual blockade of the RAAS (eg, by combining an angiotensin II receptor antagonist with an ACE inhibitor or aliskiren) in patients with established atherosclerosis, heart failure, or diabetes mellitus with end-organ damage is associated with a higher incidence of hypotension, syncope, hyperkalemia, and dysfunction. kidneys (including the development of acute renal failure) compared with the use of a single-component blockade of the RAAS. The issue of using double blockade of the RAAS should be decided in each case individually and with careful monitoring of blood pressure, water-electrolyte balance of the blood and renal function. Hydrochlorothiazide. With thiazide diuretics, drugs such as ethanol, barbiturates and narcotics may potentiate the risk of orthostatic hypotension. Hypoglycemic agents (oral and insulin) - dosage adjustment of hypoglycemic agents may be required. Metformin should be used with caution due to the risk of lactic acidosis due to possible renal failure associated with hydrochlorothiazide. Other antihypertensive drugs – additive effects are possible. Corticosteroids, ACTH (adrenocorticotropic hormone) - a marked decrease in electrolyte levels, in particular hypokalemia. Pressor amines (for example, epinephrine, norepinephrine) - decreased response to pressor amines. Muscle relaxants of a non-depolarizing type of action (for example, tubocurarine) - enhance the effect of muscle relaxants. Lithium - diuretics reduce the renal clearance of lithium and increase the risk of lithium toxicity; simultaneous use is not recommended. NSAIDs (including cyclooxygenase-2 inhibitors) - may reduce the diuretic, natriuretic and antihypertensive effects of diuretics. Probenecid, sulfinpyrazone, allopurinol - co-administration with drugs for the treatment of gout may require dose adjustment of these drugs, since hydrochlorothiazide can increase the concentration of uric acid in the blood serum: increase the dose of probenecid or sulfinpyrazone. Concomitant use of thiazide diuretics may increase the incidence of hypersensitivity to allopurinol. Anticholinergics (atropine, biperiden) - increase the bioavailability of thiazide diuretics due to a decrease in gastrointestinal motility and the rate of gastric emptying. Cytotoxic drugs (cyclophosphamide, methotrexate) - Thiazides can reduce the renal excretion of cytotoxic drugs and stimulate their myelotoxic effect. Salicylates - when taking high doses of salicylates, hydrochlorothiazide can enhance their toxic effect on the central nervous system. Methyldopa: Cases of hemolytic anemia have been reported separately with the concomitant use of hydrochlorothiazide and methyldopa. Cyclosporine - co-administration with cyclosporine may increase the risk of hyperuricemia and gout-like complications. Cardiac glycosides - Thiazide-stimulated hypokalemia or hypomagnesemia may contribute to the development of cardiac arrhythmias when co-administered with cardiac glycosides. Medicines that can cause aritis. Due to the risk of hypokalemia, caution is required when using Losartan-N Canon simultaneously with the following drugs that can cause torsade de pointes: antiarrhythmic drugs (for example, quinidine, hydroquinidine, disopyramide, amiodarone, sotalol) some antipsychotic drugs (for example, thioridazine, chlorpromazine, levomepromazine, trifluoperazine, cyamemazine, sulpiride, sultopiride, amisulpiride, tiapride, pimozide, haloperidol, droperidol); others (eg, bepridil, cisapride, difemanil, erythromycin IV, halofantrine, mizolastine, pentamidine, terfenadine, vincamycin IV, saprofloxacin, moxifloxacin, astemizole). Calcium salts - thiazide diuretics can increase the calcium level in the blood serum due to a decrease in its excretion. If it is necessary to use calcium supplements, the dose is selected under the control of calcium levels in the blood serum. Vitamin D - increases the risk of hypercalcemia. Impact on laboratory results - Due to their effect on calcium excretion, thiazides may interfere with the results of tests of parathyroid function. Carbamazepine – increases the risk of symptomatic hyponatremia. Serum sodium levels must be monitored. Iodine contrast agents – with dehydration caused by taking diuretics, the risk of developing acute renal failure increases, especially when high doses of iodine-containing drugs are administered. Before administering such drugs, the patient must be rehydrated. Amphotericin B, corticosteroids, adrenocorticotropic hormone and laxatives - when used together, hydrochlorothiazide can aggravate electrolyte imbalances, especially causing the development of hypokalemia.

Losartan or Enalapril – which is better?

Manufacturer: Ozone, Hemofarm, Russia, Hexal (Germany)
Release form: tablets

Active ingredient: enalapril

Synonyms: Enap, Enam

Enalapril is a cheap domestic or imported analogue of Losartan. Available in tablets in dosages of 5, 10 and 20 mg. With long-term use, it is necessary to increase the therapeutic dose and use other drugs due to the ineffectiveness of the analogue.

Losartan is more effective and does not cause coughing and shortness of breath, unlike Enalapril. What to choose should be decided with your doctor. Both drugs are available with a prescription.

Losartan or Valsartan

Manufacturer: KRKA, Russia
Release form: tablets

Active ingredient: valsartan

Synonyms: Valsacor, Valz, Valsacor

Preparations based on Valsartan are currently represented on the pharmaceutical market by Valsacor, all others (Valsartan, Valz) have been withdrawn due to unsafety and possible side effects.

The Valsacor analogue belongs to the same group as Losartan. Contains another substance – valsartan. To provide a lasting therapeutic effect, the drug must accumulate in the body for 2–4 weeks.

The choice in favor of a particular drug should be made with a doctor and the appropriate prescription form should be written out. You cannot change medications on your own due to the risk of side effects, including insufficient blood pressure control, disability, heart attack and death.

Losartan or Amlodipine

Manufacturer: Pranafarm, Biokhimik, Veropharm, Teva, etc., Russia
Release form: tablets

Active ingredient: amlodipine

Synonyms: Amlotop, Normodipin, Kalchek, etc.

Amlodipine is an antihypertensive drug from the group of slow calcium channel blockers. In addition to lowering blood pressure, the medicine helps to improve well-being during physical activity and angina pectoris.

Amlodipine and Losartan are often prescribed together when monotherapy is ineffective. The side effects of the analogue should be taken into account - allergic reactions, swelling.

There is another combination of Amlodipine and Valsartan - the drug Vamloset.

The pressing question is what to replace Losartan with. The medication is a prescription antihypertensive drug. According to the rules for writing a prescription, the patient can choose any drug with the international name Losartan that is affordable and suitable in terms of cost and quality. These are Lozap, Lorista and others.

Answers on questions

1. Losartan - diuretic or not?
   

   The drug is an antihypertensive drug, i.e. it reduces blood pressure, normalizes blood pressure, and may have some effect on kidney function. The combination of Losartan and Hydrochlorothiazide has a diuretic effect.

2. Is Losartan banned or not?
   

   No, the medicine is approved for use and is safe if you follow your doctor’s recommendations and select the correct dosage.

3. Does Losartan Cause Cancer or Not?
   

   According to a report from the European Medicines Agency in 2018, when testing one of the manufacturers of Losartan, a carcinogen was discovered that can cause cancer in 1 in 8 thousand patients taking the drug for 4 years and older. This percentage of negative effects on the body is extremely small to confirm the carcinogenic properties of the drug. And the substance contained is also present in tobacco smoke and the atmosphere.