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Losartan 50 mg

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Q: If a tablet contains 50 mg losartan potassium and 12.5 mg hydrochlorothiazide how many tablets do I take?
If a tablet contains 50 mg losartan potassium and 12.5 mg hydrochlorothiazide how many tablets do I take in one day.

A: Hyzaar(Losartan/hydrochlorothiazide)50mg/12.5mg

DOSAGE AND ADMINISTRATION
Hypertension Dosing must be individualized.
The usual starting dose of losartan is 50 mg once daily, with 25 mg recommended for patients with intravascular volume depletion (e.g., patients treated with diuretics) and patients with a history of hepatic impairment

Losartan can be administered once or twice daily at total daily doses of 25 to 100 mg. If the antihypertensive effect measured at trough using once-a-day dosing is inadequate, a twice-a-day regimen at the same total daily dose or an increase in dose may give a more satisfactory response.

Hydrochlorothiazide is effective in doses of 12.5 to 50 mg once daily and can be given at doses of 12.5 to 25 mg as HYZAAR. To minimize dose-independent side effects, it is usually appropriate to begin combination therapy only after a patient has failed to achieve the desired effect with monotherapy.

The side effects of losartan are generally rare and apparently independent of dose; those of hydrochlorothiazide are a mixture of dose-dependent (primarily hypokalemia) and dose-independent phenomena (e.g., pancreatitis), the former much more common than the latter.

Therapy with any combination of losartan and hydrochlorothiazide will be associated with both sets of dose-independent side effects.

Replacement Therapy: The combination may be substituted for the titrated components.

Dose Titration by Clinical Effect: A patient whose blood pressure is not adequately controlled with losartan monotherapy (see above) or hydrochlorothiazide alone, may be switched to HYZAAR 50-12.5 (losartan 50 mg/hydrochlorothiazide 12.5 mg) once daily. If blood pressure remains uncontrolled after about 3 weeks of therapy, the dose may be increased to two tablets of HYZAAR 50-12.5 once daily or one tablet of HYZAAR 100-25 (losartan 100 mg/hydrochlorothiazide 25 mg) once daily. A patient whose blood pressure is not adequately controlled with losartan 100 mg monotherapy (see above) may be switched to HYZAAR 100-12.5 once daily. If blood pressure remains uncontrolled after about 3 weeks of therapy, the dose may be increased to two tablets of HYZAAR 50-12.5 once daily or one tablet of HYZAAR 100-25 (losartan 100 mg/hydrochlorothiazide 25 mg) once daily.A patient whose blood pressure is inadequately controlled by 25 mg once daily of hydrochlorothiazide, or is controlled but who experiences hypokalemia with this regimen, may be switched to HYZAAR 50-12.5 (losartan 50 mg/hydrochlorothiazide 12.5 mg) once daily, reducing the dose of hydrochlorothiazide without reducing the overall expected antihypertensive response. The clinical response to HYZAAR 50-12.5 should be subsequently evaluated, and if blood pressure remains uncontrolled after about 3 weeks of therapy, the dose may be increased to two tablets of HYZAAR 50-12.5 once daily or one tablet of HYZAAR 100-25 (losartan 100 mg/hydrochlorothiazide 25 mg) once daily.The usual dose of HYZAAR is one tablet of HYZAAR 50-12.5 once daily. More than two tablets of HYZAAR 50-12.5 once daily or more than one tablet of HYZAAR 100-25 once daily is not recommended. The maximal antihypertensive effect is attained about 3 weeks after initiation of therapy.Use in Patients with Renal Impairment: The usual regimens of therapy with HYZAAR may be followed as long as the patient’s creatinine clearance is >30 mL/min. In patients with more severe renal impairment, loop diuretics are preferred to thiazides, so HYZAAR is not recommended.

Patients with Hepatic Impairment: HYZAAR is not recommended for titration in patients with hepatic impairment because the appropriate 25 mg starting dose of losartan cannot be given. Severe Hypertension The starting dose of HYZAAR for initial treatment of severe hypertension is one tablet of HYZAAR 50-12.5 once daily (see CLINICAL PHARMACOLOGY, Pharmacodynamics and Clinical Effects). For patients who do not respond adequately to HYZAAR 50-12.5 after 2 to 4 weeks of therapy, the dosage may be increased to one tablet of HYZAAR 100-25 once daily. The maximum dose is one tablet of HYZAAR 100-25 once daily. HYZAAR is not recommended as initial therapy in patients with hepatic impairment because the appropriate 25 mg starting dose of losartan cannot be given. It is also not recommended for use as initial therapy in patients with intravascular volume depletion (e.g., patients treated with diuretics.

HYZAAR®50-12.5 (Losartan Potassium-Hydrochlorothiazide Tablets)
HYZAAR®100-12.5 (Losartan Potassium-Hydrochlorothiazide Tablets)
HYZAAR®100-25 (Losartan Potassium-Hydrochlorothiazide Tablets)

16 Hypertensive Patients with Left Ventricular Hypertrophy Treatment should be initiated with COZAAR 50 mg once daily. Hydrochlorothiazide 12.5 mg should be added or HYZAAR 50-12.5 substituted if the blood pressure reduction is inadequate. If additional blood pressure reduction is needed, COZAAR 100 mg and hydrochlorothiazide 12.5 mg or HYZAAR 100-12.5 may be substituted, followed by COZAAR 100 mg and hydrochlorothiazide 25 mg or HYZAAR 100-25. For further blood pressure reduction other antihypertensives should be added

HYZAAR may be administered with other antihypertensive agents. HYZAAR may be administered with or without food

Q: What high-blood pressure medicine is least likely to increase plaque deposit in veins and arteries?
Please give the chemical name that is the active ingredient in the medicine you mention. Thank You. Currently using losartan 50 mg/day. Eco carotid shows plaque deposits.

A: No hypertensive medications have been shown to decrease or stablilize plaque formation; rather you need an anti-hyperlipidemic medication or medications.

Statin medications such as atorvastatin sometimes in combination with long acting niacin (Niaspan) can be very effect per the HATS and ARBITOR2 trials. Get your cholesterol checked. If you do not have known heart disease (like a prior heart attack or stent) then your LDL should be at 100 or less and your HDL, as high as possible.

Good luck.

Q: with stress thallium test being normal what are the chances of a heart attack?
The patient is my wife diabetic for last 15 years and insulin dependent for 5 years and has blood pressure ranging 160/80 with medication of metroprollol 100 mg twice daily and losartan 50 mg twice daily .She also has renal problems with 4% protein in urine what should be line of treatment for her ?

A: A negative stress test doesn’t have much predictive value in terms of future heart attacks.

Q: prescription drugs insurance urine test medicine?
i use amlodipine 5mg and losartan 50 mg for hypertension along with glimiperide 1 mg and metformin 500 for diabetes. Will these prescription drugs show up in my urine? I expect an insurance cover test in seven days and don’t want to reveal it.

A: Insurance companies often take blood samples and they will find out that you have diabetes and high blood pressure. If you try to conceal the fact, it considered fraud.

Q: Popping pain in right eye & Throbbing pain in right temple?
My wife, 62 years, wt.78 kg, vegetarian. suffering from Throbbing pain in the right temple with popping pain from back of right eye (day and night) since october, 2009.

To start with high BP was noticed and she was treated for hypertension for about 6 weeks and there was no relief from head-ache. Neuro-psyt. treated her for depression etc for 3months but no relief from pain. She has been treated for migrain for 2 months without any successful results. Temporal artiritis was suspected by almost all the neurologists. Finally, she was advised steriod (Prednisolone) therapy for Temporal artiritis. Prednisolone single dose (60 mg) used for 8 days (morning time) but no relief from pain. Not even 1% relief. Constant severe headache still persists as such.
Peridnisolone treatment has been in-effective and. is being tapered down now.
No relief at all with any pain killers.

Investigations –

ESR- varied from 60 to 85.
CRP- 8.1
BP: 110/170 (October,2009), 180/100 (30.6.2010)
Body temp normally about 37c.
No wt. loss for the last 2 years.
No eye sight loss.
MRI angiography – Normal
MRI (contrast) of the brain – Normal.
Bilateral optic nerve appear normal.No active brain parenchymal.lesion.
Colour Dopplar of the Bilateral Superficial Temporal artiritis. – Normal
Skull x-ray – AP/Lateral 28th. May,2010 – no abnormal calcification/vasculature seen. Sella turcica normal, No feature of raised ICT.
No bony injury seen, No sutural separation is seen.
Eyesight – Normal for the last 2 years. Optic disc- Arterioschrolic changes observed and Hypertensive retinopathy done on 28th May,2010. No abnormality reported.

Biopsy – Biopsy of the temple not done.

Medicines being used wef-7th June,2010
1-Amlozaar Tab.50 mg twice/day (Losartan Potassium and Amlodipine),
2-Omnacortil-60 (Peridnisolone-20mgx3 single doze,morning time) and Peridnisolone
being tapered down now.
3-Pantocid Tab.(40mg)
Help please,
Tewari

A: All headaches, migraines and all, have their origins in the neck muscles. They get so tight that the pain becomes so intense that when the brain receives the message all it feels is pain, your headache. To get rid of it you have to release the neck muscles. Because she has had this ongoing for so long it may be necessary to repeat the release if any pain remains after the initial use. Here is how to release your neck muscles to get relief from the headaches:
Neck
Put your hands alongside your head so your thumbs are on the front of the muscle under your ear and your fingers are on the back of the muscle behind your head. Squeeze your thumb and fingers together and hold. Relax your body. After 45 seconds, slowly lower your head as far as you can, release the pressure but hold your neck lowered for another 30 seconds.
With your neck in the lowered position, replace your thumbs in under the ears and your fingers behind your head but right next to your skull this time. Press your fingers and thumbs together again and hold. Relax your body while waiting. When the muscles have all released, slowly lift your head until it’s level again, release the pressure but hold your head like that for another 30 seconds.
For best results relax your body first by taking a deep breath and exhaling then remain this relaxed.

Q: A case of peripheral vascular disease, vascular surgons/ intervention cardiologist please?
One of my patient named Mr. Dhirajbhai Shah 69yrs/ male, he is known case of

Diabetes > 10 yrs

Hypertension > 10 yrs

Ventricular outflow obstruction in brain > 10 yrs

Diabetic nephropathy for last 3 yrs

Benign prostatic hypertrophy for last 6 months

Operated case of CABG and Cholecystectomy,

He developed pain in both legs, pain increases at the time of walking, one limb is swalloen because of filariasis from a long time, his sugar level is under control, s. creatinine is 2.3, no other gross abnormalities in blood reports.

His MR angio of both lowerlimb reveals,

* Narrowing of the distal portion of abdominal aorta

* Non visualisation of right common iliac artery with reformation of right external iliac via collaterals

* Block of proximal and middle thirds of superficial femoral arteries, bilaterally with reconsitution of lower thirds.

* Non visualisation of right anterior and posterior arteries

* non visualisation of middle and distal thirds of left tibial arteries.

Medication : at present he on Oral hypoglycemic agents with sos insulin

Losar H ( Losartan with hydrochlorthiazide 50 + 12.5)

Ecosprin 150 mg ( Aspirin)

Clopidogral 75 mg

Acitrom 2 mg

Atorvastatin 20 mg bed time

Trental 400 mg tds

Symptomatic medicine

As patient is not very much co operative and inspite of chances of renal failure requiring dialysis personally relatives would like to go for non invesive procedure.

Thanking you

Yours sincerly

Dr. Nemish gandhi M.D.
Consultant physician.

Krishna clinic
1/1026 choki street,
Nanpura,
Surat. : 395001
Gujarat
India

m :092279 02941
098252 89330

A: MR angio is famous for not well visualising the lower extremity arteries in detail.

Without seeing the angios, it hard to tell if an endovascular procedure would work. It might be worth it to get a standard angiogram (after proper premedication and hydration). This would provide the interventionalist with badly needed info. If there is significant stenosis in the aorto-iliac vessels, it might be treated with stents.

One possiblity is athrectomy using a device called the Silver Hawk.

However, this isn’t always possible/successful.

A bypass would only work if there are good target vessels below the SFAs.

Difficult situation. Best of luck.

Q: hi there ? i have questions? Currently Ezetimibe with attorvastatin is used to control LDL in particular and l
Currently Ezetimibe with attorvastatin is used to control LDL in particular and lipids in general. In my case, My Lp(a)is 55 while lipid range is normal. Is it necessary to add Ezetimibe to statin for Lp(a) in the drug regimen ? 2. Diruitic like Indapamide 1.5 SR or HCTZ 12.5 is contraindicated in person having high uric acid levels without gouty manifestations and on allopurinol 300 ? 4. What are the pssible options for me who is on amlodipine 10 mg Losartan 100 and Atenolol-100. Doctor wants me to delete Amlodipine because of pedal edema- Mild incompetent sapheno femoral junction. If Amlodipine is deleted, what are other options ? Does combinations of Ramipril 10 + Losartan 100 + Atenolol 100 take care of amlodipine ? I am male 50 hypertensive with obesity 105 kg. Non diabetic non smoker non alcoholic stricy vegitarian. Please guide. 5. Is Nicotinic Acid or Fenofibrate helpful in increasing HDL.? I am a brisk walker but unable to increase my HDL. I shall be obliged to receive your gu

A: Omega 3 fish oil supplements
Almonds
Fish
OATMEAL for breakfast everyday

These are all things you can do to help lower your cholesterol levels. Of course, you need to cut fat out of your diet. It is a lifestyle change. Good luck.

Q: prescription drugs insurance urine test medicine?
i use amlodipine 5m g and losartan 50 m g for hypertension along with glimiperide 1 mg and metformin 500 mg for diabetes. Will these prescription drugs show up in my urine? I expect an insurance cover test in seven days and don’t want to reveal it.

A: Anything you’ve got a prescription for should be legal, although certain medications may preclude your participating in certain activities (prescription narcotics-school bus driver)

You may have personal reasons for not wanting to share medical info, but these don’t seem to me to warrant any disclosure reticence.

Nonetheless, these aren’t included on the standard panel of drugs that are tested for and (to the best of my knowledge) shouldn’t trigger a positive response to any other drugs. Other posters, please correct me if I’m wrong on this.

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