Expiration date: 08/2025
Release form and composition:
Tablets, film-coated pink, round, lenticular, with the dividing mark on one side.
1 tablet contains:
losartan potassium 25, 50 or 100 mg
Auxiliary substances: starch dried, microcrystalline cellulose, purified talc, silicon dioxide colloidal (Aerosil-200), sodium starch of glycolate (primogel), magnesium stearate, isopropanol, methylene chloride, Opadry OY-55030, dye red Ponceau 4R Lake f Pnceau.
Pharmacological action:
Antihypertensive drug, specific receptor antagonist of angiotensin type II ( AT2). He suppresses kinase II, the enzyme that destroys bradykinin. Reduces round, reduces afterload, reduces systemic blood pressure and the pressure in the pulmonary circulation.
Pharmacokinetics:
Suction
After receiving the drug inside, losartan is well absorbed from the gastrointestinal tract. Bioavailability is about 33%.
Distribution and metabolism
Undergoes first pass effect through the liver. The bonding with blood plasma proteins of losartan and its metabolite is 92-99%. Not koumouliruet.
Excretion
T1/2 is 2 h. Losartan is excreted in the urine and bile.
Indications:
— arterial hypertension
— coronary heart disease, accompanied by symptoms of heart failure (in combination therapy with diuretics and cardiac glycosides).
Dosing regimen:
In arterial hypertension initial daily dose is 25 mg, average daily dose of 50 mg, the multiplicity of reception - 1 time/day.
The maximum hypotensive effect develops within 3-6 weeks after start of treatment. If necessary, the dose may be increased to 100 mg/day, with the possible admission of the drug 2 times/day.
In heart failure the initial dose is 12.5 mg 1 times/day. Usually, the dose is titrated at weekly intervals (i.e. 12.5 mg/day 25 mg/day 50 mg/day) to the average maintenance dose 50 mg 1 times/day depending on tolerability of the therapy.
In appointing the drug patients, receiving diuretics in high doses, the initial dose should be reduced to 25 mg 1 times/day.
Patients with impaired liver function should be prescribed losartan to lower doses.
The elderly and patients with impaired renal function, including hemodialysis, is not necessary initial dose adjustment of the drug.
Presartan can be assigned in conjunction with other antihypertensive agents.
Tablets can be taken regardless of meals.
Side effects:
From the digestive system: diarrhea, dyspepsia rare - increase in liver transaminases and bilirubin in the blood.
CNS: dizziness, insomnia, and headache.
The respiratory system: rarely – violation of breath, cough.
Allergic reactions: rare - angioneurotic edema (including swelling of the face, lips, pharynx and/or tongue), urticaria.
Other: myalgia, edema, hyperkalemia (blood potassium greater than 5.5 mEq/l) rarely – tachycardia.
The drug is generally well tolerated.
Contraindications:
— child and adolescence to 18 years
— pregnancy
— hypersensitivity to the drug.
Pregnancy and lactation:
The drug is contraindicated during pregnancy.
Unknown, selects whether losartan in breast milk. If you need Presartan the appointment during lactation should decide on the termination of breastfeeding.
Special instructions:
In patients with dehydration (for example, in the treatment dioretikami in high doses) in the beginning of treatment with Presartan may experience symptomatic hypotension. It is necessary to carry out the correction of water-electrolyte balance prior to the appointment Presartan or to start treatment with a lower dose.
Pharmacological data suggest that the concentration of losartan in plasma in patients with liver cirrhosis is greatly increased, so patients with liver disease history should be prescribed in low doses. Some drugs that have an impact on the system the kinin-angiotensin, may increase blood urea and serum creatinine in patients with impaired renal function.
Overdose:
Symptoms: arterial gipotenzia, tachycardia.
Treatment: if necessary, symptomatic therapy. Hemodialysis is not effective.
Drug interactions:
The simultaneous appointment of potassium-sparing diuretics, potassium supplements or salt substitutes containing potassium may lead to hyperkalemia.
With simultaneous use of losartan with other antihypertensive drugs there is a mutual enhancement of the hypotensive action.
The simultaneous use of NSAIDs (especially indomethacin) may cause weakening of the hypotensive action of losartan.
The combination of losartan with diuretics can cause a drop in blood pressure.
Terms and conditions of storage:
The drug should be stored in a dry, dark, inaccessible to children place at temperature below 25°C. shelf Life - 3 years.
