Hydrochlorothiazide Losartan

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

  1. abdominal pain
  2. agranulocytosis
  3. alopecia
  4. anaphylactoid reactions
  5. anemia
  6. angina
  7. angioedema
  8. anorexia
  9. anxiety
  10. aplastic anemia
  11. arrhythmia exacerbation
  12. arthralgia
  13. asthenia
  14. ataxia
  15. atrial fibrillation
  16. AV block
  17. azotemia
  18. back pain
  19. blurred vision
  20. bradycardia
  21. chest pain (unspecified)
  22. confusion
  23. conjunctivitis
  24. constipation
  25. cough
  26. dental pain
  27. depression
  28. diaphoresis
  29. diarrhea
  30. dizziness
  31. drowsiness
  32. dysgeusia
  33. dyspepsia
  34. dyspnea
  35. ecchymosis
  36. edema
  37. elevated hepatic enzymes
  38. epistaxis
  39. erythema
  40. erythema multiforme
  41. exfoliative dermatitis
  42. fatigue
  43. fever
  44. flatulence
  45. flushing
  46. gastritis
  47. glycosuria
  48. gout
  49. headache
  50. hemolysis
  51. hemolytic anemia
  52. hepatitis
  53. hyperbilirubinemia
  54. hypercalcemia
  55. hypercholesterolemia
  56. hyperglycemia
  57. hyperkalemia
  58. hypertriglyceridemia
  59. hyperuricemia
  60. hypoesthesia
  61. hypokalemia
  62. hypomagnesemia
  63. hyponatremia
  64. hypotension
  65. hypovolemia
  66. impotence (erectile dysfunction)
  67. increased urinary frequency
  68. infection
  69. insomnia
  70. interstitial nephritis
  71. jaundice
  72. leukopenia
  73. libido decrease
  74. malaise
  75. memory impairment
  76. metabolic alkalosis
  77. migraine
  78. muscle cramps
  79. musculoskeletal pain
  80. myalgia
  81. myasthenia
  82. myocardial infarction
  83. myopia
  84. nasal congestion
  85. nausea
  86. nephrolithiasis
  87. nocturia
  88. ocular hypertension
  89. ocular irritation
  90. oliguria
  91. orthostatic hypotension
  92. palpitations
  93. pancreatitis
  94. paresthesias
  95. peripheral neuropathy
  96. pharyngitis
  97. photosensitivity
  98. pneumonitis
  99. pruritus
  100. pulmonary edema
  101. purpura
  102. rash
  103. renal failure (unspecified)
  104. restlessness
  105. rhabdomyolysis
  106. rhinitis
  107. sialadenitis
  108. sinus tachycardia
  109. sinusitis
  110. Stevens-Johnson syndrome
  111. stroke
  112. syncope
  113. teratogenesis
  114. thrombocytopenia
  115. tinnitus
  116. toxic epidermal necrolysis
  117. tremor
  118. urticaria
  119. vasculitis
  120. ventricular fibrillation
  121. ventricular tachycardia
  122. vertigo
  123. visual impairment
  124. vomiting
  125. weakness
  126. xanthopsia
  127. xerosis
  128. 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
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  • 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
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  • Atropine; Diphenoxylate
  • Atropine; Edrophonium
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Baclofen
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  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Belladonna; Opium
  • Benazepril
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  • Benzphetamine
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  • 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
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  • Darunavir
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  • Delavirdine
  • Desloratadine; Pseudoephedrine
  • Desvenlafaxine
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  • Dexlansoprazole
  • Dexmethylphenidate
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  • 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
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  • 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
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  • Pentamidine
  • Pentazocine
  • Pentazocine; Naloxone
  • Pentoxifylline
  • Perindopril
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  • Phendimetrazine
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  • Phenobarbital
  • Phenothiazines
  • Phentermine
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  • Phenylephrine
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  • Phenytoin
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  • Pimozide
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  • 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
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  • Tolvaptan
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  • Trandolapril
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  • Tranylcypromine
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  • Trospium
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  • Valdecoxib
  • Vecuronium
  • Vemurafenib
  • Venlafaxine
  • Verteporfin
  • Vigabatrin
  • Vilazodone
  • Vitamin D
  • Vitamin D analogs
  • Voriconazole
  • Vorinostat
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