Hydrochlorothiazide Losartan Brand Name– Hyzaar
What is Hydrochlorothiazide Losartan
Hydrochlorothiazide Losartan are used together in a once daily oral preparation to manage hypertension.
Hydrochlorothiazide is a thiazide diuretic. Losartan and its metabolite (E-3174) are specific and selective angiotensin II antagonists.
Because AT1 receptors are nearly saturated at the starting dose for most angiotensin II antagonists, the antihypertensive dose-response curve of these drugs are nonlinear, with proportionally small decreases in blood pressure attained with increased dosage.
Greater antihypertensive efficacy is achieved by adding a small dose of a diuretic to the angiotensin II antagonist. Losartan is associated with dose-related antiproteinuric and uricosuric effects.
Losartan tends to reverse the potassium loss and blunts the rise in serum uric acid levels associated with hydrochlorothiazide. Because losartan does not inhibit angiotensin converting enzyme (ACE), it does not result in bradykinin accumulation which is theorized to cause the cough and angioedema associated with ACE inhibitors.
However, angioedema has been rarely associated with losartan or other angiotensin II antagonists.
Hyzaar (50 mg losartan and 12.5 mg hydrochlorothiazide) was originally approved on April 28, 1995; the subsequent dosage strength (100 mg losartan and 25 mg hydrochlorothiazide) was approved on October 13, 1998.
Indications
- hypertension
- stroke prophylaxis
Side Effects
- abdominal pain
- agranulocytosis
- alopecia
- anaphylactoid reactions
- anemia
- angina
- angioedema
- anorexia
- anxiety
- aplastic anemia
- arrhythmia exacerbation
- arthralgia
- asthenia
- ataxia
- atrial fibrillation
- AV block
- azotemia
- back pain
- blurred vision
- bradycardia
- chest pain (unspecified)
- confusion
- conjunctivitis
- constipation
- cough
- dental pain
- depression
- diaphoresis
- diarrhea
- dizziness
- drowsiness
- dysgeusia
- dyspepsia
- dyspnea
- ecchymosis
- edema
- elevated hepatic enzymes
- epistaxis
- erythema
- erythema multiforme
- exfoliative dermatitis
- fatigue
- fever
- flatulence
- flushing
- gastritis
- glycosuria
- gout
- headache
- hemolysis
- hemolytic anemia
- hepatitis
- hyperbilirubinemia
- hypercalcemia
- hypercholesterolemia
- hyperglycemia
- hyperkalemia
- hypertriglyceridemia
- hyperuricemia
- hypoesthesia
- hypokalemia
- hypomagnesemia
- hyponatremia
- hypotension
- hypovolemia
- impotence (erectile dysfunction)
- increased urinary frequency
- infection
- insomnia
- interstitial nephritis
- jaundice
- leukopenia
- libido decrease
- malaise
- memory impairment
- metabolic alkalosis
- migraine
- muscle cramps
- musculoskeletal pain
- myalgia
- myasthenia
- myocardial infarction
- myopia
- nasal congestion
- nausea
- nephrolithiasis
- nocturia
- ocular hypertension
- ocular irritation
- oliguria
- orthostatic hypotension
- palpitations
- pancreatitis
- paresthesias
- peripheral neuropathy
- pharyngitis
- photosensitivity
- pneumonitis
- pruritus
- pulmonary edema
- purpura
- rash
- renal failure (unspecified)
- restlessness
- rhabdomyolysis
- rhinitis
- sialadenitis
- sinus tachycardia
- sinusitis
- Stevens-Johnson syndrome
- stroke
- syncope
- teratogenesis
- thrombocytopenia
- tinnitus
- toxic epidermal necrolysis
- tremor
- urticaria
- vasculitis
- ventricular fibrillation
- ventricular tachycardia
- vertigo
- visual impairment
- vomiting
- weakness
- xanthopsia
- xerosis
- xerostomia
Monitoring Parameters
- blood glucose
- blood pressure
- LFTs
- serum bilirubin (total and direct)
- serum creatinine/BUN
- serum electrolytes
- serum uric acid
Contraindications
- ACE-inhibitor induced angioedema
- angioedema
- anuria
- asthma
- breast-feeding
- children
- diabetes mellitus
- electrolyte imbalance
- geriatric
- gout
- heart failure
- hepatic disease
- hypercalcemia
- hyperglycemia
- hyperkalemia
- hyperuricemia
- hypokalemia
- hypomagnesemia
- hyponatremia
- hypotension
- hypovolemia
- infants
- neonates
- orthostatic hypotension
- pancreatitis
- penicillin hypersensitivity
- pregnancy
- renal artery stenosis
- renal disease
- renal failure
- renal impairment
- sulfonamide hypersensitivity
- sunlight (UV) exposure
- surgery
- sympathectomy
- syncope
- systemic lupus erythematosus (SLE)
- thiazide diuretic hypersensitivity
Interactions
- Acarbose
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
- Acetaminophen; Codeine
- Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
- Acetaminophen; Dextromethorphan; Phenylephrine
- Acetaminophen; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Dichloralphenazone; Isometheptene
- Acetaminophen; Guaifenesin; Phenylephrine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Pentazocine
- Acetaminophen; Pseudoephedrine
- Acetaminophen; Tramadol
- Acetazolamide
- Acetohexamide
- Aclidinium; Formoterol
- Acrivastine; Pseudoephedrine
- Albiglutide
- Albuterol
- Albuterol; Ipratropium
- Aldesleukin, IL-2
- Alemtuzumab
- Alendronate; Cholecalciferol
- Alfentanil
- Aliskiren
- Aliskiren; Amlodipine
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Aliskiren; Hydrochlorothiazide, HCTZ
- Aliskiren; Valsartan
- Allopurinol
- Alogliptin
- Alogliptin; Metformin
- Alogliptin; Pioglitazone
- Alpha-glucosidase Inhibitors
- Alprostadil
- Amifostine
- Amiloride
- Amiloride; Hydrochlorothiazide, HCTZ
- Aminolevulinic Acid
- Amiodarone
- Amlodipine; Benazepril
- Amlodipine; Celecoxib
- Amobarbital
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Amphetamine; Dextroamphetamine Salts
- Amphotericin B
- Amphotericin B cholesteryl sulfate complex (ABCD)
- Amphotericin B lipid complex (ABLC)
- Amphotericin B liposomal (LAmB)
- Amyl Nitrite
- Angiotensin II
- Angiotensin-converting enzyme inhibitors
- Anticholinergics
- Apomorphine
- Apraclonidine
- Aprepitant, Fosaprepitant
- Arformoterol
- Aripiprazole
- Arsenic Trioxide
- Articaine; Epinephrine
- Asenapine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Omeprazole
- Aspirin, ASA; Oxycodone
- Atazanavir
- Atazanavir; Cobicistat
- Atracurium
- Atropine
- Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Atropine; Difenoxin
- Atropine; Diphenoxylate
- Atropine; Edrophonium
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Baclofen
- Barbiturates
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Belladonna; Opium
- Benazepril
- Benazepril; Hydrochlorothiazide, HCTZ
- Benzhydrocodone; Acetaminophen
- Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Benzphetamine
- Benztropine
- Beta-agonists
- Boceprevir
- Bortezomib
- Bosentan
- Brexpiprazole
- Brompheniramine; Carbetapentane; Phenylephrine
- Brompheniramine; Dextromethorphan; Phenylephrine
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Brompheniramine; Pseudoephedrine
- Budesonide; Formoterol
- Buprenorphine
- Buprenorphine; Naloxone
- Cabergoline
- Calcium
- Calcium Phosphate, Supersaturated
- Calcium; Vitamin D
- Canagliflozin
- Canagliflozin; Metformin
- Captopril
- Captopril; Hydrochlorothiazide, HCTZ
- Carbamazepine
- Carbetapentane; Chlorpheniramine; Phenylephrine
- Carbetapentane; Diphenhydramine; Phenylephrine
- Carbetapentane; Guaifenesin; Phenylephrine
- Carbetapentane; Phenylephrine
- Carbetapentane; Phenylephrine; Pyrilamine
- Carbetapentane; Pseudoephedrine
- Carbidopa; Levodopa
- Carbidopa; Levodopa; Entacapone
- Carbinoxamine; Dextromethorphan; Pseudoephedrine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Carbinoxamine; Phenylephrine
- Carbinoxamine; Pseudoephedrine
- Cardiac glycosides
- Cariprazine
- Celecoxib
- Cetirizine; Pseudoephedrine
- Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
- Chlophedianol; Guaifenesin; Phenylephrine
- Chlordiazepoxide; Clidinium
- Chloroprocaine
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dextromethorphan; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Phenylephrine
- Chlorpheniramine; Pseudoephedrine
- Chlorpropamide
- Cholestyramine
- Cidofovir
- Cisapride
- Cisatracurium
- Citalopram
- Clindamycin; Tretinoin
- Clozapine
- Co-Enzyme Q10, Ubiquinone
- Cobicistat
- Cocaine
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Colchicine; Probenecid
- Colestipol
- Conivaptan
- Corticosteroids
- Cosyntropin
- Cyclophosphamide
- Cyclosporine
- Dabrafenib
- Dapagliflozin
- Dapagliflozin; Metformin
- Dapagliflozin; Saxagliptin
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Delavirdine
- Desloratadine; Pseudoephedrine
- Desvenlafaxine
- Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
- Dexlansoprazole
- Dexmethylphenidate
- Dextromethorphan; Diphenhydramine; Phenylephrine
- Dextromethorphan; Guaifenesin; Phenylephrine
- Dextromethorphan; Guaifenesin; Pseudoephedrine
- Dextromethorphan; Quinidine
- Diazoxide
- Dichlorphenamide
- Diclofenac
- Diclofenac; Misoprostol
- Dicyclomine
- Diethylpropion
- Diflunisal
- Digitoxin
- Digoxin
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Diphenhydramine; Phenylephrine
- Dobutamine
- Dofetilide
- Dolasetron
- Donepezil; Memantine
- Dopamine
- Doxacurium
- Dronedarone
- Droperidol
- Drospirenone
- Drospirenone; Estradiol
- Drospirenone; Ethinyl Estradiol
- Drospirenone; Ethinyl Estradiol; Levomefolate
- Dulaglutide
- Duloxetine
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elbasvir; Grazoprevir
- Elexacaftor; tezacaftor; ivacaftor
- Elvitegravir
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Empagliflozin
- Empagliflozin; Linagliptin
- Empagliflozin; Linagliptin; Metformin
- Empagliflozin; Metformin
- Enalapril, Enalaprilat
- Enalapril; Felodipine
- Enalapril; Hydrochlorothiazide, HCTZ
- Enflurane
- Ephedrine
- Epinephrine
- Eplerenone
- Epoprostenol
- Ergocalciferol, Vitamin D2
- Ertugliflozin; Metformin
- Ertugliflozin; Sitagliptin
- Erythromycin
- Erythromycin; Sulfisoxazole
- Escitalopram
- Esomeprazole
- Esomeprazole; Naproxen
- Estradiol
- Estradiol Cypionate; Medroxyprogesterone
- Ethanol
- Etodolac
- Etomidate
- Exenatide
- Famotidine; Ibuprofen
- Fenofibric Acid
- Fenoprofen
- Fentanyl
- Fexofenadine; Pseudoephedrine
- Fish Oil, Omega-3 Fatty Acids (Dietary Supplements)
- Flavoxate
- Fluconazole
- Fluocinolone; Hydroquinone; Tretinoin
- Fluoxetine
- Fluoxetine; Olanzapine
- Flurbiprofen
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Fluvoxamine
- Formoterol
- Formoterol; Mometasone
- Fosinopril
- Fosinopril; Hydrochlorothiazide, HCTZ
- Fosphenytoin
- Fospropofol
- Gallium Ga 68 Dotatate
- General anesthetics
- Glimepiride
- Glimepiride; Pioglitazone
- Glimepiride; Rosiglitazone
- Glipizide
- Glipizide; Metformin
- Glyburide
- Glyburide; Metformin
- Glycopyrrolate
- Glycopyrrolate; Formoterol
- Granisetron
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Guaifenesin; Phenylephrine
- Guaifenesin; Pseudoephedrine
- Halobetasol; Tazarotene
- Halofantrine
- Haloperidol
- Halothane
- Homatropine; Hydrocodone
- Hydralazine; Isosorbide Dinitrate, ISDN
- Hydrochlorothiazide, HCTZ; Lisinopril
- Hydrochlorothiazide, HCTZ; Moexipril
- Hydrochlorothiazide, HCTZ; Quinapril
- Hydrochlorothiazide, HCTZ; Spironolactone
- Hydrochlorothiazide, HCTZ; Triamterene
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydromorphone
- Hyoscyamine
- Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
- Ibritumomab Tiuxetan
- Ibuprofen
- Ibuprofen lysine
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Icosapent ethyl
- Idelalisib
- Iloperidone
- Iloprost
- Imatinib
- Inamrinone
- Incretin Mimetics
- Indacaterol
- Indacaterol; Glycopyrrolate
- Indapamide
- Indomethacin
- Inotersen
- Insulin Degludec; Liraglutide
- Insulin Glargine; Lixisenatide
- Insulins
- Intravenous Lipid Emulsions
- Isavuconazonium
- Isocarboxazid
- Isoflurane
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Isoproterenol
- Isosorbide Dinitrate, ISDN
- Isosorbide Mononitrate
- Ivacaftor
- Ketamine
- Ketoprofen
- Ketorolac
- Lansoprazole
- Lansoprazole; Naproxen
- Lesinurad; Allopurinol
- Levalbuterol
- Levodopa
- Levomethadyl
- Levomilnacipran
- Levorphanol
- Linagliptin
- Linagliptin; Metformin
- Liraglutide
- Lisdexamfetamine
- Lisinopril
- Lithium
- Lixisenatide
- Loop diuretics
- Lopinavir; Ritonavir
- Loratadine; Pseudoephedrine
- Lovastatin; Niacin
- Lumacaftor; Ivacaftor
- Lumacaftor; Ivacaftor
- Lurasidone
- Magnesium Salts
- Magnesium Sulfate; Potassium Sulfate; Sodium Sulfate
- Mannitol
- Meclofenamate Sodium
- Mefenamic Acid
- Meglitinides
- Meloxicam
- Memantine
- Mepenzolate
- Meperidine
- Meperidine; Promethazine
- Mequinol; Tretinoin
- Mestranol; Norethindrone
- Metaproterenol
- Metformin
- Metformin; Pioglitazone
- Metformin; Repaglinide
- Metformin; Rosiglitazone
- Metformin; Saxagliptin
- Metformin; Sitagliptin
- Methadone
- Methamphetamine
- Methazolamide
- Methenamine
- Methenamine; Sodium Acid Phosphate
- Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
- Methohexital
- Methotrexate
- Methoxsalen
- Methscopolamine
- Methylphenidate
- Metoclopramide
- Midodrine
- Miglitol
- Milnacipran
- Milrinone
- Mirtazapine
- Mitotane
- Mivacurium
- Moexipril
- Morphine
- Morphine; Naltrexone
- Nabumetone
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Nateglinide
- Nefazodone
- Nesiritide, BNP
- Neuromuscular blockers
- Niacin, Niacinamide
- Niacin; Simvastatin
- Nitrates
- Nitroglycerin
- Nitroprusside
- Nonsteroidal antiinflammatory drugs
- Norepinephrine
- Octreotide
- Olanzapine
- Olodaterol
- Ombitasvir; Paritaprevir; Ritonavir
- Omeprazole
- Omeprazole; Amoxicillin; Rifabutin
- Omeprazole; Sodium Bicarbonate
- Ondansetron
- Oprelvekin, rh-IL-11
- Oxaprozin
- Oxybutynin
- Oxycodone
- Oxymetazoline
- Oxymorphone
- Paliperidone
- Pancuronium
- Pantoprazole
- Paroxetine
- Pasireotide
- Pazopanib
- Pentamidine
- Pentazocine
- Pentazocine; Naloxone
- Pentoxifylline
- Perindopril
- Perindopril; Amlodipine
- Phendimetrazine
- Phenelzine
- Phenobarbital
- Phenothiazines
- Phentermine
- Phentermine; Topiramate
- Phenylephrine
- Phenylephrine; Promethazine
- Phenytoin
- Photosensitizing agents (topical)
- Pimozide
- Pioglitazone
- Pirbuterol
- Piroxicam
- Polycarbophil
- Polyethylene Glycol; Electrolytes
- Polyethylene Glycol; Electrolytes; Ascorbic Acid
- Porfimer
- Potassium
- Potassium Phosphate
- Potassium Phosphate; Sodium Phosphate
- Pramlintide
- Prazosin
- Prilocaine; Epinephrine
- Probenecid
- Procainamide
- Procaine
- Propantheline
- Propofol
- Pseudoephedrine
- Quetiapine
- Quinapril
- Quinidine
- Rabeprazole
- Ramipril
- Rapacuronium
- Rasagiline
- Remifentanil
- Repaglinide
- Rifampin
- Risperidone
- Ritonavir
- Rocuronium
- Rofecoxib
- Rosiglitazone
- Salicylates
- Salmeterol
- Saxagliptin
- Scopolamine
- Selegiline
- Semaglutide
- Serotonin norepinephrine reuptake inhibitors
- Sertraline
- Sevoflurane
- SGLT2 Inhibitors
- Silodosin
- Simvastatin; Sitagliptin
- Sitagliptin
- Sodium Phosphate Monobasic Monohydrate; Sodium Phosphate Dibasic Anhydrous
- Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
- Solifenacin
- Spironolactone
- St. John’s Wort, Hypericum perforatum
- Streptozocin
- Succinylcholine
- Sufentanil
- Sulfacetamide
- Sulfacetamide; Sulfur
- Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
- Sulfinpyrazone
- Sulfonamides
- Sulfonylureas
- Sulindac
- Tapentadol
- Tazarotene
- Tegaserod
- Telotristat Ethyl
- Terbutaline
- Tetrabenazine
- Tetracaine
- Tezacaftor; Ivacaftor
- Thiazolidinediones
- Thiopental
- Thiothixene
- Tiotropium; Olodaterol
- Tizanidine
- Tolazamide
- Tolbutamide
- Tolmetin
- Tolterodine
- Tolvaptan
- Topiramate
- Toremifene
- Tramadol
- Trandolapril
- Trandolapril; Verapamil
- Tranylcypromine
- Trazodone
- Treprostinil
- Tretinoin, ATRA
- Triamterene
- Trihexyphenidyl
- Trimethoprim
- Trospium
- Tubocurarine
- Umeclidinium; Vilanterol
- Valdecoxib
- Vecuronium
- Vemurafenib
- Venlafaxine
- Verteporfin
- Vigabatrin
- Vilazodone
- Vitamin D
- Vitamin D analogs
- Voriconazole
- Vorinostat
- Vortioxetine
- Yohimbine
- Zafirlukast
- Ziconotide
- Ziprasidone