For the most effective treatment of hypertension, it is recommended to use combined medicines.
Lozap plus combines two active components that have a powerful hypotensive effect without the risk of developing severe side effects, which distinguishes this drug from other antihypertensive drugs.
However, despite the high level of safety of use, the dosage and regimen should be made exclusively by the attending physician or other qualified specialist.
Pharmacy sales terms
It is released on prescription.
How much does Lozap Plus cost? The average price in pharmacies is 400 rubles.
Release form and composition
Medicine Lozap, indications for use of which will be described below, has its own dosage form of release:
- Tablets on 12.5 mg of a white or cream shade, the extended form, in a cover in the form of a film.
- Tablets on 50 mg of a white or cream shade, extended, in a cover with a notch for convenience of division.
- Tablets of 100 mg white or cream-colored, elongated, coated, with a notch for dose adjustment.
The active ingredient is potassium losartan and additional components that do not have a therapeutic effect. The shell consists of white sepifilm, hypromellose, macrogol, MCC and titanium dioxide.
Losartan is a specific angiotensin II receptor antagonist (AT1 subtype) that inactivates bradykinin and does not inhibit the kinase II enzyme. Decreases round focal disease (total peripheral vascular resistance), concentration of aldosterone and adrenaline in the blood, blood pressure (blood pressure), pressure in the vessels of the pulmonary circulation; reduces afterload, has a diuretic effect. Interferes with the appearance of myocardial hypertrophy, improves tolerance to physical stress in patients with CHF (chronic heart failure).
Hydrochlorothiazide - thiazide diuretic inhibits the reabsorption of sodium ions, increases the excretion of bicarbonate, potassium ions and phosphates in the urine. Decreases blood pressure by reducing the bcc (circulating blood volume), suppressing the pressure of the vasoconstrictor substances, changing the reactivity of the vascular wall and increasing the inhibitory effect on the ganglion.
Indications for use
What helps? Lozap plus is recommended for use in the presence of the following diseases:
- chronic heart failure (in the framework of complex therapy, with the ineffectiveness or intolerance of treatment with inhibitors);
- arterial hypertension, in order to reduce the risk of heart disease;
- diabetic nephropathy, which is accompanied by proteinuria and hypercreatininemia in diabetics with concomitant arterial hypertension.
Contraindications for treatment are as follows:
- breastfeeding period;
- age up to 18 years (efficacy and safety have not been established);
- hypokalemia or hypercalcemia resistant to treatment;
- severe liver dysfunction;
- obstructive diseases of the biliary tract;
- refractory hyponatremia;
- hyperuricemia and / or gout;
- severe impaired renal function (CK≤30 ml / min);
- Hypersensitivity to any of the components of the drug or to other drugs that are derivatives of sulfonyl amide.
Caution is indicated in patients with bilateral renal artery stenosis or arterial stenosis of a single kidney, hypovolemic conditions (including diarrhea, vomiting), hyponatremia (increased risk of arterial hypotension in patients on a low-salt or salt-free diet), hypochloremic alkalosis, hypomagium , with diseases of the connective tissue (including SLE), patients with impaired liver function or with progressive liver diseases, diabetes mellitus, bronchial asthma (including a history of), burdens allergic history, simultaneously with NSAIDs, including COX-2 inhibitors, as well as members of the Negroid race.
Use during pregnancy and lactation
Information about taking Lozapa Plus during pregnancy is not available, but it is known that medications that affect the renin-angiotensin system at the 2 nd and 3 rd trimester of pregnancy can provoke developmental defects and even fetal death.
For this reason, it is recommended to stop taking the drug immediately when a pregnancy occurs.
When breastfeeding should abandon it or discontinue treatment.
Dosage and method of use
The instructions for use indicate that Lozap plus is taken orally, regardless of the meal.
- With increased pressure (arterial hypertension), the usual initial and maintenance dose is 1 tab. / Day. If the use of the drug in this dose fails to achieve adequate blood pressure control, the dose of Lozap Plus may be increased to 2 tab. 1 time / day
- The maximum dose is 2 tab. 1 time / day In general, the maximum hypotensive effect is achieved within 3 weeks after the start of treatment.
- There is no need for a special selection of the initial dose in elderly patients.
In order to reduce the risk of developing cardiovascular diseases and mortality in patients with arterial hypertension and left ventricular hypertrophy, lozartan (Lozap) is prescribed in the standard initial dose of 50 mg / day. Patients who failed to achieve the target level of blood pressure while using losartan at a dose of 50 mg / day required selection of therapy by combining losartan with hydrochlorothiazide at a low dose (12.5 mg), which is ensured by prescribing Lozap Plus.
If necessary, the dose of Lozap Plus can be increased to 2 tab. (100 mg of losartan and 25 mg of hydrochlorothiazide) 1 time / day.
Controlled clinical studies of the treatment of essential hypertension with losartan and hydrochlorothiazide in combination showed the development of a single adverse reaction with a frequency of 1% or more compared to placebo-vertigo. Other side effects reported during joint therapy with losartan and hydrochlorothiazide on the part of systems and organs:
- liver and biliary tract: rarely - hepatitis;
- nervous system: with uncertain frequency - dysgeusia;
- vessels: with an uncertain frequency - orthostatic effect, dependent on the dose;
- skin and subcutaneous tissue: with an indefinite frequency - the skin form of systemic lupus erythematosus;
- instrumental and laboratory studies: rarely - increased activity of hepatic transaminases, hyperkalemia.
Also the use of Lozap plus can cause adverse reactions characteristic of each of the active components of the drug separately.
Side effects associated with the use of hydrochlorothiazide:
- organ of vision: infrequently - xantopsia, temporary decrease in visual acuity;
- gastrointestinal tract: infrequently - nausea / vomiting, constipation, diarrhea, gastritis, cramps, sialadenitis;
- cardiovascular system: infrequently - skin vasculitis, necrotic vasculitis;
- skin and subcutaneous tissue: infrequently - urticaria, photosensitivity, toxic epidermal necrolysis;
- liver and biliary tract: infrequently - pancreatitis, cholecystitis, cholestatic jaundice;
- respiratory system, chest and mediastinal organs: infrequently - respiratory distress syndrome (RDS), including non-cardiogenic pulmonary edema and pneumonitis;
- blood and lymphatic system: infrequently - hemolytic anemia, aplastic anemia, leukopenia, thrombocytopenia, purpura, agranulocytosis;
- metabolism: infrequently - hypokalemia, hyperuricemia, hyponatremia, hyperglycemia, anorexia;
- immune system: rarely - anaphylactic reactions up to shock;
- nervous system: often - headache;
- psyche: infrequently - insomnia;
- kidneys and urinary tract: infrequently - renal failure, interstitial nephritis, glycosuria;
- musculoskeletal system and connective tissue: infrequently - muscle cramps;
- common disorders: infrequent - dizziness, fever.
Side effects associated with the use of losartan:
- immune system: rarely - the occurrence of hypersensitivity, including anaphylactic reactions, angioedema of the glottis and larynx with the occurrence of airway obstruction, swelling of the face, pharynx, tongue, lips;
- genitals and mammary gland: infrequently - erectile dysfunction, decreased libido;
- organ of vision: infrequently - burning sensation in the eyes, decreased visual acuity, conjunctivitis, blurred vision;
- organ of hearing and labyrinth disturbances: infrequently - vertigo, tinnitus;
- skin and subcutaneous tissue: infrequently - dermatitis, hyperemia, rash, itching, sweating, photosensitivity, dry skin, alopecia;
- liver and biliary tract: with an indefinite frequency - liver failure;
- common disorders: often - chest pain, asthenia, fatigue; infrequently - fever, swelling of the face; with uncertain frequency - weakness, flu-like symptoms;
- gastrointestinal tract: often - diarrhea, nausea, dyspepsia, abdominal pain; infrequently - vomiting, gastritis, dry mouth, constipation, flatulence, toothache;
- metabolism: infrequently - gout, anorexia;
- musculoskeletal system and connective tissue: often - pain in the back, legs, sciatica, muscle cramps; infrequently - pain in muscles and bones, swelling of joints, muscle weakness, fibromyalgia, arthritis, arthralgia, stiffness of joints; with indefinite frequency - rhabdomyolysis;
- psyche: often - insomnia; infrequently - impaired memory, depression, confusion, sleep disturbance, unusual dreams, drowsiness, panic attacks, anxiety, anxiety;
- respiratory system, chest and mediastinal organs: often - sinusitis, nasal congestion, upper respiratory tract infections, cough; infrequently - rhinitis, nasal bleeding, bronchitis, dyspnea, laryngitis, pharyngitis;
- blood and lymphatic system: infrequently - hemolysis, anemia, ecchymosis, Schönlein – Genoch disease; with unspecified frequency - thrombocytopenia;
- nervous system: often - dizziness, headache; infrequently - paresthesia, hyperexcitability, syncopal states, migraine, tremor, peripheral neuropathy;
- cardiovascular system: infrequently - vasculitis, atrioventricular block II degree, angina pectoris, stomach pain, orthostatic hypotension, decreased blood pressure, arrhythmias (tachycardia, sinus bradycardia, ventricular tachycardia, atrial fibrillation, ventricular fibrillation, cardioplasty, cardiac fibrillation, ventricular fibrillation
- kidneys and urinary tract: often - impaired renal function; infrequently - infectious diseases of the urinary tract, imperative calls for urination, nocturia;
- laboratory and instrumental studies: often - hyperkalemia, insignificant decrease in hemoglobin and hematocrit; infrequently - a slight increase in the content of creatinine and urea in the blood plasma; very rarely - increased activity of bilirubin and hepatic transaminases; with an indefinite frequency - hyponatremia.
In case of an overdose of Lozap plus, the following symptoms are observed: due to the content of losartan - bradycardia, tachycardia, decrease in blood pressure; caused by the content of hydrochlorothiazide - loss of electrolytes and dehydration.
Symptomatic overdose treatment. It is necessary to stop taking the drug, flush the stomach and carry out activities aimed at restoring water and electrolyte balance. With an excessive decrease in blood pressure, supportive infusion therapy is indicated. Hemodialysis for the elimination of losartan is not effective. The degree of removal of hydrochlorothiazide using hemodialysis has not been established.
Patients with cases of development of angioedema in the past, drug treatment should be carried out with caution and under strict medical supervision.
In case of liver cirrhosis or moderate organ dysfunction, drug treatment should be prescribed under the supervision of specialists, since it is possible to increase the concentration of the active components of the drug in the blood plasma, which increases the likelihood of overdose and severe side effects.
Lozap and Lozap plus can cause dizziness, drowsiness and fainting, which adversely affects the ability to control mechanisms, therefore against the background of the use of these drugs it is recommended to abandon any activities that require high concentration of attention and reaction rate.
The tool has the property to enhance the action of other antihypertensive drugs. An increase in the effect of non-depolarizing muscle relaxants is also noted. Simultaneous use of NSAIDs can cause a weakening of the action of hydrochlorothiazide. The use of Lozap Plus with lithium preparations increases the risk of intoxication. Kolestiramin helps to reduce the absorbability of hydrochlorothiazide.
With the simultaneous use of Lozapa plus and hypoglycemic drugs, dosage adjustment is required.
We picked up some reviews of people taking the drug Lozap plus:
- Olga I drank only one pill Lozap + (prescribed by a doctor). Every five minutes I began to run to the toilet, and after 20 minutes my back got sick (apparently, not my back, but my kidneys). From the pain just could not even turn in bed. By morning passed. No more drinking. But from simple Lozap nothing hurts.
- Valentine. For the fourth year I have been taking pressure reducing drugs. At first she took Enap, but there was a strong cough from him. The doctor advised Lozap. Helped well. The pressure has become 120/70. But recently she began to drink Lozap + and the pressure sharply went up. Today jumped to 180/110. I had to drink the second pill, but already Lozap. Pressure in an hour - 135/87. Did anyone get worse from Lozap +? What can it be from?
- Helena. My blood pressure rises extremely rarely, most often when I get very nervous. Once I jumped to 170 per 100, I even had to call a doctor (I don’t like to self-medicate). The doctor advised “Lozap Plus”, for the normalization of my blood pressure, only half of the pill was enough, and the pressure decreased quite quickly. Now I always have Lozap Plus pills in my stockpiles.
- Tatyana. Saw a lot of things from constantly increased pressure, in my 26 years I always have it 140-150 ... That only I did not write out Lozap was discharged, she began to drink ... And the whole was covered with a terrible rash, blisters and some kind of abscesses. The husband forbade drinking, after I had been at bedtime, if it was itching for about 20 minutes, I did not fall asleep. I stopped drinking them and everything went away. What now to drink I do not know.
Doctors reviews about Lozap plus differ. So, doctors consider the drugs to be good and, accordingly, respond positively to them only in relation to cases of mild hypertension. That is, if a person has mild hypertension, then Lozap or Lozap plus is effective and can be successfully used for long-term therapy.
If hypertension is severe and is combined with heart disease, then Lozap’s effectiveness is very low. The drug's action lasts only 5 to 8 hours, as a result of which people have to take additional, more powerful medicines.Accordingly, in such situations it is unreasonable to take Lozap, since you need to immediately focus on other more powerful antihypertensive drugs, for example, beta-blockers.
Structural analogues of the active substance:
- Block octane;
- Cardomin Sanovell;
- Losartan potassium;
- Losartan MacLeodz;
Before using analogues consult your doctor.
Storage conditions and shelf life
The tool should be stored in a dark dry place, without access of children at a temperature not higher than 30 degrees.
Shelf life - 3 years.