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Lodestar Zid (Losartan, Hydrochlorothiazide)

Active Ingredient: Losartan, Hydrochlorothiazide
Dosage: 50/12.5 mg, 100/25 mg
Route of Administration: Oral
Dosage Form: Tablets
Quantity per package: 30 per pack

Lodestar Zid contains 2 active ingredients – Losartan, Hydrochlorothiazide. It is prescribed to treat hypertension and angina pectoris.

Lodestar Zid is out of stock at the moment but you can review other Losartan-based drugs on this page.

Indications

Lodestar Zid is indicated for the treatment of arterial hypertension of patients for whom combined therapy is indicated. It is also used in patients with hypertension and left ventricular hypertrophy.

Dosage and administration

The drug can be administered with other antihypertensive agents and with or without food. Hypertension: Initial and maintenance dosing: 1 tablet (losartan 50 mg / hydrochlorothiazide 12.5 mg) once daily. For patients who do not respond adequately to losartan 50 mg and hydrochlorothiazide 12.5 mg, the dose may be increased to 1 tablet (losartan 100 mg / hydrochlorothiazide 25 mg) once daily. The maximum recommended dosage is: 1 tablet of 100/25 mg once daily. Generally, the antihypertensive response is reached within three weeks of initiation of therapy. Severe hypertension (PAD in a sitting position ≥ 110 mmHg): The starting dose is: 1 tablet of 50 / 12.5 mg once daily. For patients who do not respond adequately to this dose after 2 to 4 weeks of therapy, the dose may be increased to: 1 tablet of 100/25 mg once daily. The maximum dose is 1 tablet of 100/25 mg once daily. Lodestar Zid should not be administered to patients with decreased intravascular volume (for example, those treated with high doses of diuretics), or to patients with severe renal impairment (creatinine clearance ≤ 30 ml / min) or with hepatic impairment. No initial adjustment of the dosage of Lodestar Zid (losartan 50 mg / hydrochlorothiazide 12.5 mg) is necessary in elderly patients. Lodestar Zid 100/25 mg should not be used as an initial treatment in elderly patients. Reduction of the risk of cardiovascular morbidity and mortality in patients with hypertension and left ventricular hypertrophy: The usual starting dose is: 50 mg losartan once daily. If blood pressure cannot be stabilized with losartan 50 mg, treatment should be adjusted using a combination of 50 / 12.5 mg and, if necessary, the dose should be increased to 100 / 12.5 mg once daily. If still necessary, the dose should be increased to 100/25 mg once daily. Lodestar Zid 50 / 12.5 mg and 100/25 mg are viable formulations in patients who can be treated with this combination.

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Contraindications

  • Hypersensitivity to any component of the formula;
  • Anuria;
  • Hypersensitivity to other sulfonamide medications.

Side effects

In general, treatment with losartan potassium and hydrochlorothiazide was well tolerated. Most of the adverse reactions have been mild and transient and it has not been necessary to stop treatment. Adverse events reported in patients with essential hypertension: dizziness in 1% or more of patients treated with Lodestar Zid. In hypertensive patients with left ventricular hypertrophy, the drug was generally well-tolerated, the most common adverse effects were: dizziness, asthenia/fatigue, and vertigo. After its release to the market, the following adverse reactions have been reported: hypersensitivity, rare cases of anaphylactic reactions, angioneurotic edema including swelling of the larynx and glottis, swelling of the face, lips, pharynx and/or the tongue in patients treated with losartan, some of whom had already experienced angioedema with other medications, including ACE inhibitors. In rare cases, the drug has caused vasculitis, including Schönlein-Henoch purpura, hepatitis, diarrhea, respiratory, cough, hives.

Overdose

There are no reports on the treatment of overdosing of Lodestar Zid. The treatment is symptomatic and supportive. Losartan: There are limited data related to overdose in humans. Probable manifestations would be hypotension and tachycardia; bradycardia can develop due to vagal stimulation. If symptomatic hypotension occurs, supportive treatment should be established. Neither losartan nor its active metabolite can be extracted by hemodialysis. Hydrochlorothiazide: The most common clinical picture of overdosing are: loss of electrolytes (hypokalemia, hypochloremia, hyponatremia) and dehydration caused by excessive diuresis. If the patient has also received digitalis, hypokalemia may accentuate cardiac arrhythmias. The degree to which hemodialysis extracts hydrochlorothiazide has not been determined.

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Interaction

Losartan: Clinical pharmacokinetic studies have identified no pharmacological interaction of clinical importance with hydrochlorothiazide, digoxin, warfarin, cimetidine, phenobarbital, ketoconazole, and erythromycin. It has been reported that rifampicin and fluconazole reduce the levels of the active metabolite. The clinical implications of this interaction have not been evaluated. Concomitant use of Lodestar Zid with potassium-sparing diuretics (for example, spironolactone, triamterene, amiloride), potassium supplements or salt substitutes may increase serum potassium. Nonsteroidal anti-inflammatory drugs (NSAIDs), including selective COX-2 inhibitors, can reduce the effect of diuretics and other antihypertensive medications. Therefore, the antihypertensive effect of angiotensin II antagonists can be attenuated by NSAIDs, including COX-2 inhibitors. In some patients with a compromised renal function who are being treated with NSAIDs, including COX-2 inhibitors, co-administration of angiotensin II antagonists may result in further deterioration of renal function. These effects are usually reversible.

Hydrochlorothiazide: The following medications can interact with thiazide diuretics when used at the same time: Alcohol, barbiturates or narcotics: They can enhance orthostatic hypotension. Antidiabetic medications (oral agents or insulin): It may be necessary to adjust the dosage of the antidiabetic. Other antihypertensives: Additive effect. Cholestyramine and colestipol resins: The absorption of hydrochlorothiazide decreases in the presence of anion exchange resins. Single doses of cholestyramine or colestipol fix hydrochlorothiazide and reduce its gastrointestinal absorption up to 85% and 43%, respectively. Corticosteroids, ACTH: Increased loss of electrolytes, particularly hypokalemia. Pressing amines (for example, adrenaline): It may decrease the response to pressor amines. Non-depolarizing muscle relaxants (for example, tubocurarine): increased sensitivity to the muscle relaxant. Lithium: Diuretics decrease the renal clearance of lithium and greatly increase the risk of toxicity of lithium, so its concomitant use is not recommended. Nonsteroidal anti-inflammatory drugs, including COX-2 inhibitors: In some patients, co-administration of a nonsteroidal anti-inflammatory drug, including selective COX-2 inhibitors, may decrease the diuretic, natriuretic and antihypertensive effects of diuretics.