What to take in the morning and what to take in the evening. At what pressure is the use of Lozap plus tablets indicated according to the instructions and what cardiologists say in their reviews about the drug and its analogues

The modern pharmaceutical market offers a significant number of medications that help normalize the functioning of the cardiovascular system, as well as lower blood pressure and have an antihypertensive effect. One of these remedies is a highly effective drug - Lozap. In this article you will learn what Lozap is, what these tablets are for, and also familiarize yourself with the composition of the medicine and detailed instructions.

This drug is intended to lower blood pressure, as well as maintain it within normal limits.. The medication not only helps lower blood pressure, it helps in minimizing the load on the heart. Moreover, the diuretic effect of the drug is known.

In addition, the product helps prevent hypertrophy of the heart muscle and increase stress tolerance, both emotional and physical. The use of tablets is often prescribed for the treatment of pathologies such as arterial hypertension and heart failure.

However, it is not recommended to take the product without the knowledge of a specialist.

Self-medication can harm you. Before you start using the medicine, be sure to read the instructions and consult a cardiologist about the advisability of taking it in your case.

As already mentioned, the pharmacological effect of Lozap is to lower blood pressure and minimize the load on the heart. This is due to the ability of the drug to suppress the angiotensin converting enzyme, which ensures the transformation of angiotensin I into angiotensin II. This medicine belongs to the group of ACE inhibitors; it is an angiotensin II receptor antagonist.

After taking the drug, there is no formation of a substance in the body that promotes vasoconstriction. Regular and, importantly, appropriate use of Lozap helps to reduce and maintain normal blood pressure levels. The first effect can be noticed after an hour and a half. It is stored, as a rule, throughout the day. In order to permanently reduce blood pressure, it is recommended to take the drug for a month. The drug is effective for the treatment of hypertension in adults; it is not prescribed for children.

The medicine combines well with other medications that have antihypertensive properties. In addition, it has diuretic properties, so a person does not suffer from fluid retention and swelling.

Worth noting

The medicine helps eliminate uric acid and, consequently, reduce its content in the blood. When the drug is discontinued, the development of withdrawal syndrome is not observed. In addition, the drug does not cause addiction.

The form of production of Lozapa is tablets for internal use, film-coated. The drug Lozap, which contains the active ingredient losartan potassium, is a biconvex tablet. They have an oblong shape and a white color. In addition to the active ingredient, the drug contains a small amount of auxiliary components: mannitol, microcrystalline cellulose, crospovidone, silicon dioxide, talc and magnesium stearate.

Remember, treatment with this drug can only be prescribed by the attending physician. In some cases, in particular in the presence of renal pathologies (unilateral or bilateral stenosis), as well as in elderly people, it is necessary to take the medicine with extreme caution. Be vigilant and do not self-medicate, this can lead to disastrous consequences.

The drug is effective, its price is reasonable, and the effectiveness is confirmed by reviews of patients who took it. Today there are many analogues of the drug.

Lozap blood pressure tablets: instructions for use

As already mentioned, the only form of production of Lozap for blood pressure is tablets. The medicine is produced in several dosages: 12.5, 50 and 100 mg. The tablets have an oblong biconvex shape, a whitish color, and are produced in blisters No. 30, 60, 90. There is another effective remedy - Lozap plus. This drug has almost identical properties, but unlike the blood pressure tablets Lozap, it is more effective. And this is due to the fact that Lozap plus, in addition to the active component losartan potassium, contains hydrochlorothiazide, which helps remove excess fluid, as well as enhance the hypotensive effect of the first component.

Blood pressure tablets Lozap are prescribed for therapy:

arterial hypertension;
chronic heart failure (combined treatment);
diabetic nephropathy.

In addition, the medicine is prescribed to people with an increased risk of cardiovascular disease, in particular stroke, as well as to reduce mortality among patients suffering from hypertension and left ventricular hypertrophy.

Lozap blood pressure tablets are contraindicated for people with: individual intolerance, renal failure, anuria, severe renal dysfunction, hypoglycemia, hypercalcemia, obstructive biliary tract diseases, cholestasis, gout.

People suffering from:

low blood pressure;
arrhythmias;
diabetes;
myopia or glaucoma;
connective tissue diseases;
hypertrophic obstructive cardiomyopathy;
liver or kidney failure, the medicine should be taken with extreme caution.

In addition, for elderly people, and those who have undergone a kidney transplant, as well as those who are prescribed the use of NSAIDs, for example, Nimesulide, Ibuprofen, Nurofen, the dosage and treatment regimen are selected carefully.

Inappropriate use, non-compliance with the dosages prescribed by the attending physician, or, even worse, exceeding the doses, is fraught with disastrous consequences. Therefore, before you start taking this medication, be sure to consult a qualified specialist and read the instructions.

In case of an overdose of the drug, the following symptoms may appear: dehydration, collapse, pre-fainting and fainting states, disturbances in water and electrolyte balance, a significant decrease in blood pressure, as well as tachycardia.

If an overdose has developed, symptomatic therapy is carried out to help maintain normal functioning of the body. If the blood pressure has dropped significantly due to medication, the patient should be placed on a flat surface and the leg end should be raised. If there is such a need, the patient is prescribed saline or sympathomimetics. These actions will help normalize blood pressure. To quickly remove the drug from the body, diuretics are prescribed.

In addition, during therapy with Lozap, side effects may occur from:

hematopoietic system: anemia, eosinophilia, thrombocytopenia;
immunity: itching and rashes, Quincke's edema, photosensitivity, urticaria;
CNS: sciatica, confusion, neuropathy, tremor, paralysis, insomnia, dizziness, malaise, depression, anxiety;
SSS: sensations of your own heartbeat, fainting, arrhythmias, hypotension, nosebleeds, orthostatic hypotension, bradycardia, second degree atrioventricular block, heart attack;
respiratory system: dyspnea, chest pain, bronchitis, pharyngitis, laryngitis, runny nose, sinusitis, shortness of breath, cough, nasal congestion;
Gastrointestinal tract: pain in the epigastric region, stool disorders (diarrhea or constipation), xerostomia, gastritis, hepatitis, nausea, vomiting, belching, flatulence, intestinal obstruction;
genitourinary system: failures in kidney function, impotence, renal failure, decreased libido, nocturia.

If the above symptoms appear, immediately inform your doctor.

Medicine Lozap for blood pressure: how to take it, interaction with other medications

The medicine Lozap for blood pressure can be taken regardless of the meal. The tablet is swallowed whole and does not need to be crushed or chewed. Take the medicine with still water. Since the medicine Lozap for blood pressure has a long-lasting effect, the entire daily dosage is taken in one dose, that is, one tablet is prescribed once a day. It is preferable to use the product at the same time every day, in the evening.

The exact dose and treatment regimen is selected by the attending physician, depending on the disease. The standard course is usually long - from a month to several years.

The duration of treatment with Lozap is selected purely individually, taking into account the effectiveness and possible side effects.

For the treatment of hypertension, fifty milligrams of medication is prescribed once a day.. The course of treatment for the disease is long. Sometimes, to achieve a better effect, the dosage is increased to one hundred milligrams. At this dosage, the medicine is taken either once or twice a day, 50 mg.
A decrease in blood pressure after using the drug Lozapa for blood pressure is usually observed after a month of treatment with this drug. Since the medicine does not provoke withdrawal symptoms, its effect is quite mild, treatment can be started immediately with the full dose - fifty milligrams per day.
To treat a disease such as heart failure, 12.5 mg is prescribed once a day.. The medicine at this dose must be taken for a week. Then the dosage is doubled. The prescribed dose is 25 mg once a day. Then the effectiveness of the drug is assessed, and if the effect is not pronounced, the dose is increased to fifty milligrams. This dosage is the maximum. If even after increasing the dose the effect remains less pronounced, the drug is replaced with another. When the 25 mg dose is effective, it is not adjusted.
In order to reduce the likelihood of cardiovascular pathologies, as well as reduce mortality among patients with hypertension and left ventricular hypertrophy, fifty milligrams of the blood pressure medication Lozapa is prescribed once a day. After half a month, the effect is assessed. If it is sufficient, the therapy regimen is extended for a long time. If the effect is insignificant, the dose is increased to 100 mg per day. Sometimes they do it differently - they prescribe combination therapy: leave Lozap 50 mg and add 50 mg hydrochlorothiazide.
In order to maintain normal functioning of the urinary system in diabetes complicated by hypertension, the use of fifty milligrams of the drug per day for two weeks is prescribed. Then the dose is increased to 100 mg. For long-term treatment of complications from the urinary system, Lozap is prescribed at a dosage of 100 mg once a day.

If the patient is prescribed complex therapy and takes a diuretic drug together with Lozap, or suffers from dehydration, for example, diarrhea or vomiting, the dose is reduced to 25 mg per day. Elderly people are prescribed to use the drug in the usual dosage; it is not reduced or increased. The maximum permissible dose of Lozap is 150 milligrams.

The drug is contraindicated for use during pregnancy and pregnancy. Women taking this medicine and planning pregnancy are advised to consult a doctor to change the drug. If the conception was unplanned, you should refrain from taking the drug.

Lozap has a detrimental effect on the fetus, provokes impaired kidney function, and also slows down the ossification of the skull bones. Taking the drug during pregnancy is fraught with the development of renal failure, hypercalcemia and hypotension in the newborn.

The medicine should not be taken by women who are breastfeeding. The active ingredients can get into the milk and have a negative effect on the baby's body. In this case, either change the drug or switch to artificial mixtures.

The drug can only be prescribed by a qualified specialist. Do not self-medicate. The effect of the drug Lozapa on the body can be different, but more often it is harmful, especially if it is prescribed to be taken with other drugs. Now more about medications:

when Lozap is used in combination with Fluconazole or Rifampicin, a decrease in the concentration of the active substance Lozap is observed;
when taking Lozap with diuretics, in particular Veroshpiron or Amiloride or potassium preparations - Asparkam, Panangin, an increase in potassium in the blood is possible;
taking Lozap in combination with lithium preparations may slow down the excretion of lithium from the body;
when Lozap is taken together with other blood pressure lowering drugs (Atenolol, Metoprolol), an increased effect of beta blockers is observed;
simultaneous use of the drug in question with NSAIDs (Ibuprofen, Aspirin, Ketanov) is fraught with a decrease in the effectiveness of Lozap and an increased risk of developing renal pathologies;
taking Lozap with ACE inhibitors, for example, Captopril, Enalapril, is fraught with disruption of the functioning of the urinary system and disruption of water and electrolyte balance;
the use of Lozap in combination with tetracyclic antidepressants can cause a sharp and persistent decrease in blood pressure;
when using Lozap with glucocorticosteroids (Prednisolone, Betamethasone), there is a deficiency of electrolytes: calcium, sodium, potassium;
when Lozap is taken together with adrenaline, there is a decrease in the severity of the action of the second;
simultaneous use of Lozap with antiarrhythmic drugs (Disopyramide, Quinidine), neuroleptics (Droperidol, Tiapride, Pimozide), as well as Vincamycin, Erythromycin, Cisapride, Terfenadine is fraught with the development of arrhythmia;
Taking Lozapa with an angiotensin-converting enzyme inhibitor is fraught with the development of serious side effects, in particular arterial hypotension and fainting.

Lozap is a highly effective antihypertensive drug that helps normalize pressure, in particular in the pulmonary circulation, reduce afterload, and is also a non-peptide AT2 receptor blocker that levels arterial hypertension, the release of aldosterone, renin, vasopressin, can only be prescribed by a specialist, taking into account all the side and effects and interactions with other prescribed drugs.

The drug Lozap and Lozap Plus: analogues, price and reviews

A fairly frequently asked question: “Which is better - Lozap or Lorista?” In fact, these drugs have the same active ingredient - losartan potassium. Lorista is prescribed in the same way as Lozap for people suffering from such ailments as chronic heart failure and arterial hypertension. The properties and effects of the drugs are almost identical.

The main difference is the lower price of Lorista, which is the main advantage of this drug. The average cost of Lozap No. 30 is 300 rubles, in Lorista - 150 rubles. You can take a cheaper analogue only with the permission of a doctor.

What are the differences between Lozapa and Lozapa Plus?

If you need to undergo a course of therapy with this drug, the question arises which is better: Lozap or Lozap Plus.

The main difference is that the second drug is a combination drug - the active ingredients are losartan potassium and hydrochlorothiazide, which is a diuretic and has a diuretic effect.

Both drugs are angiotensin receptor blockers. They help prevent narrowing of the arteries. The concentration of losartan in them is the same, but the drug Lozap Plus differs from Lozap in being more effective, since it contains two active components that complement each other.

Another difference between the drug Lozap Plus and Lozap is that the former is produced in a single dosage - 50 mg of losartan + 12.5 hydrochlorothiazide.

There are a considerable number of analogues of this drug. The most common include: Nortivan, Irsar, Giposart, Valz, Atakand, Naviten, Aprovel, Diovan, Kandecor, Mikardis, Valsartan.

In addition, there are also synonyms for the drug in question - they contain identical active ingredients: Brozaar, Vasotens, Losartan, Losacar, Lotor, Renicard, Lorista.

Your doctor may also prescribe medications based on the substance guanfacine.

The average cost of Lozap 12.5 No. 30 is 200 rubles; 12.5 No. 90 - 550 rubles; 50 mg No. 30 - 270 rubles; 50 mg No. 60 - 470 rubles; 50 mg No. 90 - 670 rubles; 100 mg No. 30 - 320 rubles, 100 mg No. 60 - 560 rubles; 100 mg No. 90 - 750 rubles.

The average price of Lozap plus 12.5 mg No. 30 is 350 rubles, No. 90 is 800 rubles.

Hypertension is a rather complex and dangerous disease, but in most cases it responds quite well to drug treatment. Lozap tablets are one of the most modern and widespread medications used to lower blood pressure.

Lozap is produced in the form of white film-coated tablets, convex on both sides. The product is intended for oral administration. It is packaged in blisters of 10 tablets and packed in packs of 30, 60, 90 pieces. Each tablet contains:

The modern pharmaceutical market offers two dosage forms of this drug: Lozap and Lozap plus. The first option contains the only active substance – losartan. It is an angiotensin-converting enzyme (ACE) inhibitor. The second additional component that enhances the effect of losartan potassium is hydrochlorothiazide. It removes excess fluid, which also helps reduce blood pressure. For the treatment of arterial hypertension, especially severe forms, it is preferable to use combination drugs, since they have a stronger hypotensive effect.

At the pharmacy you can buy Lozap blood pressure tablets in various dosages: 12.5 mg, 50 and 100. Lozap plus only in one - 50 mg of losartan potassium and 12.5 mg of hydrochlorothiazide.

Pharmacological action

Lozap effectively lowers blood pressure and reduces the load on the heart muscle. This property of the drug is ensured by its ability to suppress the activity of ACE, which promotes the conversion of angiotensin-I to angiotensin-II.

As a result, the body completely ceases to form a substance that has a positive effect on the process of vasoconstriction, and as a result, an increase in blood pressure - angiotensin-II. Only by blocking the production of this hormone is it possible to significantly reduce blood pressure and normalize it.

The effect of the drug begins within an hour after the first dose of the first tablet and lasts up to 24 hours. The maximum effect is achieved with regular use of the drug. The average course of therapy is 4-5 weeks. It is possible to use Lozap in both elderly and young people, especially with the development of malignant arterial hypertension.

Due to the fact that the blood vessels dilate, it becomes easier for the heart muscle to push blood through them. As a result, the body's resistance to physical and emotional stress significantly increases, which alleviates the condition of patients suffering from chronic heart disease. In addition, the blood pressure medicine Lozap increases blood supply to the heart, improves blood flow in the kidneys, and therefore can be used for diabetic nephropathy and heart failure.

Lozap can be combined well with other drugs to lower blood pressure. Thanks to its moderate diuretic effect, it helps remove excess fluid from the body. Lozap plus tablets have a more powerful effect, since the hydrochlorothiazide contained in the composition enhances the hypotensive effect of losartan.

An additional and very important property of the drug is its ability to remove uric acid from the body and reduce its concentration in the blood. Upon completion of treatment, withdrawal syndrome does not develop.

Pharmacodynamics and pharmacokinetics

Losartan is a specific angiotensin II receptor antagonist. It reduces overall resistance in blood vessels and helps reduce aldosterone and adrenaline in the blood. There is a normalization of pressure in the pulmonary circulation, as well as blood pressure indicators. When taken regularly, Lozap prevents thickening of the myocardium and increases the heart's resistance to physical stress.

After a single use, the effect of the drug reaches its peak after 6 hours, and then gradually decreases and stops after 24 hours. The maximum hypotensive effect occurs after approximately 3-5 weeks of course administration.

Losartan is absorbed fairly quickly from the gastrointestinal system. Its bioavailability is approximately 33%, and is 99% bound to blood proteins. Its maximum amount in the blood serum is reached after 3-4 hours. The rate of absorption of the drug does not change either before or after meals.

When losartan is taken orally, about 5% is excreted by the kidneys in unchanged form and slightly more than 5% as an active metabolite. In severe cases of alcoholic cirrhosis, the concentration of the active substance is 5 times higher than in healthy people, and the active metabolite is 17 times higher.

Indications for use, to whom it is prescribed

The drug is used both as an independent medicine and as part of complex therapy. It is prescribed for the treatment of the following conditions and diseases:

hypertension;
heart failure (as an additional remedy);
diabetic nephropathy in patients with diabetes mellitus;
to reduce the risk of developing cardiovascular diseases.

Contraindications

The use of Lozap is contraindicated in case of hyperkalemia, pregnancy, and lactation. The drug is not prescribed to children under the age of 18 years, since its safety and effectiveness have not been established. Hypersensitivity to the components of the drug or intolerance to them is also a contraindication. Use Lozap with caution in case of renal or hepatic failure, arterial hypotension or dehydration.

Instructions for use

One of the advantages of Lozap is the frequency of use - once a day. It is prescribed regardless of meals. The standard daily dose for arterial hypertension is 50 mg. If necessary, it can be increased to 100 mg in one or two doses. If the drug is prescribed to patients who take high doses of a diuretic, then the initial dose of Lozap should be no more than 25 mg per day.

The instructions for use of Lozap indicate that in case of heart failure, the drug is started at 12.5 mg, then the dose is gradually increased (observing a weekly interval) to an average maintenance dose of 50 mg. In patients with impaired liver function, kidney function or on dialysis, the initial dose should also be reduced.

What else are Lozap tablets prescribed for? They are effective when it comes to reducing the risk of cardiovascular disease and death in hypertensive patients. To correct such conditions, a daily dose of 50 mg per day is prescribed. If it is not possible to achieve the required level of blood pressure, then a change in dose and addition of hydrochlorothiazide treatment is required.

The doctor must select the dose of the drug, since only he knows at what pressure and in what quantity Lozap is most effective. Changing the dosage on your own can lead to negative consequences.

Side effects

In many cases, losartan potassium is well tolerated. Side effects occur rarely, pass rather quickly, and do not require discontinuation of the drug. Adverse events that occur in less than 1% of cases are not associated with taking Lozap.

From the side of the central nervous system, the development of dizziness, asthenic conditions, increased fatigue, apathy, and sleep disturbances is possible. Sometimes various parasthesias, tremors, tinnitus, and depressive disorders appear. In rare cases, visual disturbances, conjunctivitis, and migraine headaches have been reported.

The respiratory system may react to taking the drug with the appearance of nasal congestion, dry cough, the development of rhinitis, bronchitis and shortness of breath.

From the gastrointestinal system: nausea, vomiting, diarrhea, bloating, flatulence, increased acidity of gastric juice, constipation. Also, when taking the drug, disturbances in the functioning of the cardiovascular system may occur: tachycardia, arrhythmia, bradycardia, angina.

Side effects arising from the skin, genitourinary system and musculoskeletal system occur in less than 1% of cases.

Overdose

Excessive use of the drug Lozap may result in a sharp decrease in blood pressure and the development of tachycardia. In case of accidental intake of high doses of the drug, supportive symptomatic therapy is carried out. It is necessary to stimulate vomiting, gastric lavage, and force diuresis.

Important: Hemodialysis is not able to remove losartan potassium and its active metabolite from the body.

Interaction with other drugs

It is possible to use Lozap in combination with other antihypertensive drugs. At the same time, their action is enhanced. There is no significant interaction of losartan with digoxidine, phenobarbital, anticoagulants, cimetidine and hydrochlorothiazide. Flucanazole and rifampicin can reduce the level of the active metabolite, but clinical changes resulting from this interaction have not been studied.

When Lozap is prescribed in combination with potassium-sparing diuretics, hyperkalemia may develop. The enhanced effect of losartan, like other antihypertensive drugs, can be reduced with indomethacin.

Interaction with alcohol

It is forbidden to drink alcohol during the course of treatment with the drug. Ethanol contained in alcoholic beverages increases the concentration of the active substance in the blood, which can lead to unpredictable consequences.

Use in childhood and old age

Lozap is not used in children under 18 years of age because its effectiveness and safety have not been tested. The initial dosage for elderly patients should not be higher than 50 mg. In this case, treatment should be carried out under the constant supervision of a doctor and with regular testing. If the drug is ineffective, a dose adjustment or replacement is required.

Losap and pregnancy

The use of the drug is not recommended in the first trimester of pregnancy, and is contraindicated in later stages. The data obtained from studies of the effects of ACE inhibitors on the fetus in the first three months of its development are not convincing enough, but the risk cannot be completely excluded.

It is reliably known that the use of losartan potassium in the second and third trimesters of pregnancy has a negative effect on the developing fetus. There is a decrease in kidney function and a slowdown in the development of skull bones. Therefore, when pregnancy is confirmed, losartan potassium is immediately stopped, and the patient is prescribed another, more gentle course of therapy.

There is no information about the excretion of Lozap into breast milk. Therefore, breastfeeding women should also avoid taking this medicine. If there is an urgent need to use this particular medicine during lactation, breastfeeding should be stopped.

Special instructions

In addition to combining Lozap with other antihypertensive drugs, its use can be combined with insulin and hypoglycemic drugs (Gliclazide, Metformin and others). If the patient has a history of Quincke's edema, constant medical supervision is required during the course of taking losartan. This is necessary to eliminate the possible risk of a recurrence of the allergic reaction.

If the volume of fluid in the body is reduced, which could be caused by salt-free diets, diarrhea, uncontrollable vomiting or uncontrolled use of diuretics, then taking the drug may cause too much reduction in blood pressure (hypotension). Before using Lozap, it is recommended to restore the water and electrolyte balance in the body or use the drug in a minimum dosage.

When prescribing the drug to patients with renal impairment, heart failure or diabetes mellitus, it is necessary to monitor creatinine and potassium levels throughout the course of treatment, since the risk of developing hyperkalemia is quite high. Since kidney disease or renal artery stenosis can also lead to renal failure, losartan should be used with extreme caution.

Lozap should not be taken together with other ACE inhibitors, such as Enalopril and Captopril. Hypotension may develop during the use of general anesthesia.

Impact on the ability to drive vehicles

Since taking losartan potassium can cause dizziness and fainting, it is therefore recommended to avoid any activities that require concentration while taking such drugs. Including driving.

Analogs

Modern pharmaceutical companies offer many analogues of Lozap from various manufacturers. Among them you can find more expensive or cheaper drugs. The drug in question and its analogues may have different effects, so when selecting it, you should first consult with your doctor.

Among modern analogues of Lozap, the most common are:

Losarel;
Lorista;
Presartan;
Losartan;
Kozaar;
Sentor.

All of the drugs listed have the same indications and contraindications for use; they differ only in dosage, cost and manufacturer.

Important: The drug is not designed for severe cases of arterial hypertension. In such cases, complex therapy is required.

Lorista and Lozap - which is better

The active ingredient in both drugs is the same. They are prescribed to patients with hypertension and chronic heart failure. However, the price of Lorista is an order of magnitude lower than Lozapa. The first can be purchased within 130 rubles for 30 tablets, and the second for 280 rubles.

Lozap is a drug that has an antihypertensive effect. It belongs to the group of angiotensin 2 receptor antagonists. Lozap contains the active ingredient - losartan. Tablets of the drug are available in the following dosages: 12.5; 50; 100 mg.

The drug acts on blood vessels, removing their peripheral resistance, thereby lowering blood pressure. Its therapeutic effects also include a decrease in adrenaline and aldosterone, which means the load on the myocardium is reduced. The drug also has a diuretic effect on the body, which also reduces blood pressure.

An important aspect of the drug’s action is that it affects the heart muscle, and this is important for heart failure. In such patients, the drug increases the ability to exercise. Taking Lozap is a kind of prophylaxis against the occurrence of hypertrophy of the cavities of the heart.

It should be noted that after taking the medicine, its main hypotensive effect is achieved after 6 hours. And it decreases gradually throughout the day. But still, the maximum therapeutic effect is observed after a course of treatment of 3 weeks.

The bioavailability of this drug is small - 33%, and is not affected by food intake.

Lozap tablets are well absorbed, and immediately the active substance undergoes all metabolic processes in the liver, resulting in the formation of an active metabolite.

About 14% of losartan is converted into the active metabolite. It does not matter how it enters the body, whether it is administered intravenously or orally.

Indications and contraindications

The main indications for taking Lozap are:

The instructions for the medicine note the following contraindications:

Lozap is prescribed with extreme caution for kidney diseases, namely, with stenosis of both renal arteries or with unilateral stenosis, if the patient has one kidney. This group also includes insufficient functioning of the kidneys and/or liver.

Doses

Lozap tablets can be taken regardless of when your last meal was. An individual dosage and regimen should be prescribed by a doctor. The instructions recommend taking the tablets once a day.

For high blood pressure, the standard dosage is 50 mg. But if there is a need, then it can be 100 mg. The reception can be divided into 2 times.

For chronic heart failure, treatment should begin with 12.5 mg once a day. You need to increase the dose after a week of taking it, that is, in the 3rd week the dose is 50 mg. The average dose, in this case, is 50 mg per day. But it all depends on the patient’s individual tolerance to the drug Lozap.

It should be borne in mind that if the patient is taking complex therapy, which includes diuretics, then the dosage of Lozap is reduced to 25 mg.

If you are prescribed to take the drug for prophylactic purposes, that is, against the development of complications, then the doctor must set an individual dosage. The instructions recommend starting treatment with 50 mg per day. And then you should double it, take 100 mg per day, and the dose can be divided into 2 times.

Also, starting with 50 mg is taking this medicine for type 2 diabetes mellitus, which occurs along with hypertension. And then the dose can also be increased to 100 mg.

Overdose and side effects

If the drug is taken uncontrolled, an overdose may occur. You definitely need to know the signs of an overdose of Lozap:

a sharp decrease in blood pressure (hypotension);
tachycardia;
bradycardia occurs when the parasympathetic system is stimulated.

In case of overdose, you should go to the hospital. There they will carry out forced diuresis and other symptomatic therapy. Hemodialysis is not performed in this case, as it is ineffective.

Lozap tablets rarely have side effects. Clinical studies have shown that if they occur, there is no need to discontinue the drug. When treating hypertension, the most common side effect is dizziness. It should also be noted:

Interaction

Lozap tablets interact well with other medications that have a hypotensive effect on the body. When taken together with sympatholytics and beta-blockers, Lozap enhances their therapeutic effect. Also, such drugs include diuretics; together with them, Lozap is much more effective.

Clinical studies have shown that Lozap is compatible with medications that are often used for hypertension and heart failure. Namely, Digoxin, Hydrochlorothiazide, Warfarin, Erythromycin, etc. Both studies and reviews have shown that this combination does not cause side effects.

If you take Lozap tablets in combination with potassium-sparing diuretics, hyperkalemia may occur.

If you combine losartan (the active substance) with rifampicin and/or fluconazole, its concentration as an active metabolite in plasma decreases.

Peculiarities

Doctors usually prescribe Lozap, starting with the smallest doses. And also while taking this drug, it is necessary to monitor and, possibly, adjust the water-electrolyte balance.

If a person with liver cirrhosis needs to take this medication, then it is important to understand that the dosage should be minimal, since the concentration of the active substance in the body of such a patient will be increased.

When treating with Lozap, it is important to monitor the level of potassium in the blood. But it can occur in older people, as well as in patients with kidney problems.

After taking Lozap, you can drive a car and other complex mechanisms, as it does not affect a person’s concentration and reactions. Clinical studies have not established whether the drug is safe to use in patients under 18 years of age.

If you are pregnant, you should not use Lozapa tablets. Since it was previously proven that drugs that affect the RAAS (including Lozap) can cause various defects in fetal development. Especially when taking such drugs in the 2nd and 3rd trimesters. Sometimes this can cause fetal death. It is recommended to immediately stop treatment with this drug during pregnancy.

As for the use of medicine during lactation, this is also prohibited. If treatment with Lozap is necessary, breastfeeding should be stopped.

Price and analogues

Lozapa tablets 12.5 mg No. 30 cost 224 rubles, 50 mg No. 30 - 290 rubles, 100 mg No. 30 - 327 rubles.

Analogues of this medicine include:

Vasotens. 50 mg No. 14 – 70 rub.;
Losartan. 50 mg No. 30 – 149 rubles;
Losarel. 50 mg+12.5 No. 30 – 194;
Presartan. 50 mg No. 30 – 181 rub.

Irina Zakharova

Treatment for symptoms of arterial hypertension involves medications, many of which have the same basic substance, but differ in additional components. This makes it possible to take them to patients with different reactions to medications.

Among the modern remedies for hypertension, Lozap can be distinguished; the instructions for use describe at what pressure it is effective, in what doses and how to take it. It is gratifying that pharmacologists are trying to provide patients with medications that have a minimum of side effects and act comprehensively on the symptoms of the disease.

Release form and composition

The medicine produced by Czech manufacturers is intended for oral use. The oblong tablets contain losartan potassium, a substance belonging to a group of drugs designed to block the action of angiotensin II receptors. The combination drug, along with the antihypertensive agent, contains the diuretic hydrochlorothiazide.

Among the excipients in the tablets there is a small amount of:

microcrystalline cellulose, as a leavening agent, helping to break the mold during contact with liquid;
magnesium stearate, which can reduce the formation of scratches on the surface;
ethanol as a pure solvent;
talc, which prevents particles of substances from sticking together;
yellow quinoline and crimson dye to improve the appearance of the dosage form.

The tablets are coated, it was created using opasprey yellow, simethicone emulsion.

Tablets are produced in a dosage of 50 milligrams. There is a notch in the middle. Instructions for use of the drug are included with the medicine.

Indications for use

The action of losartan is directed against high blood pressure. The drugs of this group of angiotensin II receptor antagonists are associated with the fact that they affect the chains of the hormonal transformation system, renin-angiotensin - aldesterone, inhibiting its pathological effect on the body. The main vasoconstrictor hormones of this system lead to an increase in blood pressure. That is why Lozap is prescribed to patients who have hypertension.

Since losartan has a positive effect on the removal of uric acid from the body, the advantages of treating hypertension with Lozap are obvious. Moreover, it contains 12.5 milligrams of thiazide diuretic. Therefore, the drug prevents the development of complications in patients with hypertension. It is also recommended to take it to reduce the risk of cardiovascular pathologies. With the prescription of tablets, the mortality rate among people suffering from symptoms of hypertension and its consequences associated with left ventricular hypertrophy decreases.

It has been studied that substances that block angiotensin receptors are of great importance in the prevention of type 2 diabetes mellitus.

The mechanism of the drug’s effect on blood pressure

As an angiotensin-receptor type 1 inhibitor, losartan acts to prevent blood pressure from rising by:

narrowed lumen of blood vessels;
uptake of sodium ions by renal tubules;
changes in the structure of the walls of blood vessels and heart muscle;
enhancing the production of the hormone aldosterone;
stimulation of the nervous system.

Acting on type 1 receptors, Lozap serves to improve myocardial function, reducing vascular tone. Together with angiotensin-converting enzyme blockers, the substance losartan is used for high blood pressure. Moreover, both types of drugs lead to improved kidney function, reducing the filtering capacity of the organ’s glomeruli.

Efficacy in hypertension

For patients with arterial hypertension, Lozap Plus will bring relief, because its effectiveness is due to the fact that:

the resistance of the vascular walls decreases;
pressure in the pulmonary circulation decreases;
barriers are created for the formation of hypertrophy of cardiac muscle tissue;
resistance to physical activity increases;
blood pressure levels decrease due to a decrease in the volume of blood circulating in the vessels.

The main substance of the product undergoes rapid absorption into the blood and is metabolized in the liver. 1 hour after taking the tablet, a decrease in blood pressure occurs. It takes 1.5-2 hours to remove losartan from the body, and 3-4 hours for its metabolites. Regarding the excretion of the diuretic hydrochlorothiazide, it is noted that 60% occurs in the kidneys, while the substance remains unchanged.

The maximum hypotensive effect can be achieved after 3 weeks with regular tablet intake.

Rules for administration and dosage

A special feature of the drug is that its absorption is independent of food intake. Therefore, you can take it orally once a day before or after meals with an optimal amount of water.

Typically, the maintenance dosage of Lozap Plus consists of 1 tablet of 50 milligrams to block high blood pressure. When it is not possible to control blood pressure with such doses of the drug, they switch to a 2-fold increase – 100 milligrams.

For adults

Hypertensive patients are prescribed a drug with the active ingredient losartan, regardless of age, 1 tablet in a single dose. A dose of 50 milligrams can restore normal blood pressure values for a long time.

If the goal of therapy is to eliminate the risk of developing pathological changes in the heart and blood vessels with left ventricular hypertrophy, then the initial dosage will be 50 milligrams, followed by a 2-fold increase if the therapeutic effect is insufficient.

When the target blood pressure level is not achieved while using the medication, it is better for a patient with hypertension to combine 50 milligrams of losartan with the diuretic hydrochlorothiazide in an amount of 12.5 milligrams. By increasing the dose of the main substance, the amount of diuretic is also increased to 25 milligrams.

Adults who suffer from low blood pressure should not take the medicine. Kidney and liver disorders lead to the fact that the main substance is retained in the body and has a negative effect on a person. A high dosage of diuretics causes a sharp decrease in circulating blood volumes. This has an adverse effect on the condition of the heart muscle.

The drug should be included in the treatment of hypertension with caution for those who have symptoms associated with renal artery stenosis. Side effects may occur when treated with an antihypertensive drug in those whose hypertensive condition is aggravated by bronchial asthma, lupus erythematosus, diabetes mellitus, and gout. This requires mandatory supervision by a specialist.

For children

An absolute contraindication for taking antihypertensive tablets is age under 18 years. The ban is due to the fact that there is no data on the effectiveness of losartan and its safety for the child’s body. If Lozap is prescribed by a doctor to a child with arterial hypertension, then it must be justified.

During pregnancy and lactation

The period of pregnancy of a woman and the feeding of a newborn is associated with a ban on Lozap Plus, as stated in the instructions. The negative effect of the drug on the development of the human embryo has been experimentally proven.

Taking an antihypertensive drug in the second half of pregnancy, the expectant mother risks losing her child. Drug therapy can lead to fetal abnormalities and pathologies. Fetal and newborn jaundice often occurs. And the woman suffers from thrombocytopenia, accompanied by increased bleeding. A diuretic in the medicine will not help prevent developing toxicosis in pregnant women.

During lactation, when the life of a young mother is at risk due to high blood pressure, Lozap Plus can be prescribed, but without stopping feeding the baby.

Interaction with other drugs

The antihypertensive drug Lozap enhances the level of blood pressure reduction if it is combined with drugs of similar action. The diuretic hydrochlorothiazide contained in Lozapa prevents the excretion of potassium from the body. Taking additional potassium-sparing diuretics leads to a high content of the element in the blood plasma. And this condition is dangerous, as it can lead to serious pathologies of the heart and kidneys.

When taking Lozap Plus with:

barbiturate drugs cause signs of orthostatic hypotension associated with the appearance of fainting and loss of consciousness;
drugs that lower blood sugar levels, insulin - it is necessary to adjust the dose;
corticosteroids - there is an increase in the loss of electrolytes, especially potassium, by the body;
muscle relaxants – their effect is enhanced;
medications containing lithium – increases the risk of poisoning the body with the element;
non-steroidal anti-inflammatory drugs - the diuretic and hypotensive effect of hydrochlorothiazemide becomes significantly less.

You cannot undergo examination of the functions of the parathyroid glands during a course of taking Lozap, as the results will be inaccurate.

Side effects and overdose

Among the side effects of taking Lozap, the most pronounced are dizziness. The substance losartan can cause allergic reactions in some patients, resulting in swelling of the oral mucosa and facial tissues. Such reactions are extremely rare, but they lead to obstructive changes in the airways.

Rare reactions to the main substance of the drug may include diarrhea and cough. Urticaria occurs in less than 1% of patients.

When examining blood serum in hypertensive patients undergoing therapy with Lozap, a slight increase in potassium levels is sometimes encountered.

Increased doses of losartan cause increased or slowed heart rate.

An overdose of a diuretic leads to the body losing electrolytes, which affects a sharp decrease in sodium, potassium, and chlorine in the blood. Excessive urine production contributes to dehydration.

It is known that it is impossible to remove losartan and its metabolites from the body by hemodialysis.

Analogs

You can replace Lozap Plus with drugs similar in effect:

Vasotensom, to control the action and amount of thyroid hormones in the blood.
Losartan, with a therapeutic effect after 1-1.5 months of daily use.
Losarel, which has the same composition with the main substance classified as an angiotensin II antagonist. But the remedy is used not only for high blood pressure in hypertensive patients. It is prescribed to significantly reduce the occurrence of nephropathies.
Presartan. The drug has few contraindications. The ban applies only to persons under 18 years of age and women during pregnancy and lactation. There are people whose body cannot tolerate some of the components of the drug; they cause a severe allergic reaction in them.

The selection of a drug for hypertension is made only by a highly qualified doctor, who takes into account the characteristics of the course of the disease in a particular patient, the condition of his heart and blood vessels.

Lozap (active ingredient - losartan) is an antihypertensive drug that is a specific antagonist (blocker) of angiotensin II receptors. This drug is produced by the Slovak pharmaceutical company Zentiva and is the first European generic of losartan.

According to modern concepts, a truly effective antihypertensive drug must meet a wider range of criteria than previously thought, among which, in addition to reliable control of blood pressure, a minimum number of negative side reactions, and duration of action, there is also such a qualification requirement as the prevention of target organ damage . Thus, one of the key advantages of such an ideal drug is the ability to prevent or reduce the severity of left ventricular hypertrophy, which develops in 70% of hypertensive patients over 45 years of age and significantly worsens the prognosis for arterial hypertension. In the development of this pathology, the renin-angiotensin-aldosterone system (abbreviated as RAAS) plays an important (if not the main) role. Its main regulatory instrument, the hormone angiotensin II, controls the synthesis of collagen by myocardial connective tissue cells and promotes the development of left ventricular fibrosis. Drugs from the group of angiotensin II blockers (ARBs) prevent the effects of this hormone at the receptor level, regardless of the route of its formation, which, in fact, is the key difference between their mechanism of action and that of angiotensin-converting enzyme inhibitors (ACEIs). Today, ARBs are considered as the drugs of choice in patients with arterial hypertension and left ventricular hypertrophy. Losartan (Lozap) was the first ARB to be shown to be more effective in increasing survival in these patients.

The proven cardioprotective effect is not the only advantage of lozap. In addition, the drug has cerebro- and nephroprotective effects, which greatly expands the range of its use. Thus, the nephroprotective effect of lozap helps reduce the incidence of cardiovascular events and patient mortality. As for the cerebroprotective effect of the drug, it reduces the likelihood of cerebral strokes and their disabling consequences. Lozap is also used in the treatment of arrhythmias, reducing the risk of developing the most dangerous heart rhythm disorders. The drug is characterized by uniformity of action, which is important in preventing the so-called. cardiovascular accidents, which usually occur in the morning, when the effect of a previously taken antihypertensive drug wears off. Another undeniable advantage of the lozap is the absence of the so-called. withdrawal syndrome when the drug course is interrupted.

Lozap is available in tablet form. For arterial hypertension, the drug is taken 50 mg 1 time per day; the maximum daily dose is 100 mg. Patients with heart failure begin taking lozap with a dose of 12.5 mg once a day. Subsequently, every week (but not more often), the dose can be increased stepwise until the 50-mg daily “ceiling” is reached. Elderly patients take the drug on a general basis; dose adjustment is not required in this case. Another thing is for patients with impaired liver function: for them, the dose of Lozap should be lower than the standard recommended.

Pharmacology

Antihypertensive drug. Specific antagonist of angiotensin II receptors (subtype AT 1). Does not inhibit kininase II, an enzyme that catalyzes the conversion of angiotensin I to angiotensin II. Reduces peripheral vascular resistance, blood concentrations of adrenaline and aldosterone, blood pressure, pressure in the pulmonary circulation; reduces afterload and has a diuretic effect. Prevents the development of myocardial hypertrophy, increases exercise tolerance in patients with chronic heart failure. Losartan does not inhibit ACE kininase II and, accordingly, does not prevent the destruction of bradykinin, so side effects indirectly associated with bradykinin (for example, angioedema) occur quite rarely.

In patients with arterial hypertension without concomitant diabetes mellitus with proteinuria (more than 2 g/day), the use of the drug significantly reduces proteinuria, albumin and immunoglobulin G excretion.

Stabilizes the level of urea in blood plasma. Does not affect autonomic reflexes and does not have a long-term effect on the concentration of norepinephrine in the blood plasma. Losartan at a dose of up to 150 mg/day does not affect the levels of triglycerides, total cholesterol and HDL cholesterol in the blood serum in patients with arterial hypertension. At the same dose, losartan does not affect fasting blood glucose levels.

After a single oral dose, the hypotensive effect (systolic and diastolic blood pressure decreases) reaches a maximum after 6 hours, then gradually decreases over 24 hours.

The maximum hypotensive effect develops 3-6 weeks after starting the drug.

Pharmacokinetics

Suction

When taken orally, losartan is well absorbed and undergoes first-pass metabolism through the liver by carboxylation with the participation of the cytochrome CYP2C9 isoenzyme to form an active metabolite. Systemic bioavailability of losartan is about 33%. Cmax of losartan and its active metabolite is achieved in the blood serum approximately 1 hour and 3-4 hours after oral administration, respectively. Food intake does not affect the bioavailability of losartan.

Distribution

More than 99% of losartan and its active metabolite are bound to plasma proteins, mainly albumin. V d of losartan - 34 l. Losartan practically does not penetrate the BBB.

Metabolism

Approximately 14% of losartan administered to a patient intravenously or taken orally is converted into an active metabolite.

Removal

Plasma clearance of losartan is 600 ml/min, and the active metabolite is 50 ml/min. The renal clearance of losartan and its active metabolite is 74 ml/min and 26 ml/min, respectively. When taken orally, approximately 4% of the dose taken is excreted unchanged by the kidneys and about 6% is excreted by the kidneys in the form of an active metabolite. Losartan and its active metabolite exhibit linear pharmacokinetics when administered orally in doses up to 200 mg.

After oral administration, plasma concentrations of losartan and its active metabolite decrease polyexponentially with a final T1/2 of losartan of about 2 hours, and of the active metabolite - about 6-9 hours. When taking the drug at a dose of 100 mg/day, neither losartan nor the active metabolite significantly accumulate in blood plasma. Losartan and its metabolites are excreted from the body through the intestines and kidneys. In healthy volunteers, after oral administration of losartan labeled with the 14 C isotope, about 35% of the radioactive label is found in the urine and 58% in the feces.

Pharmacokinetics in special clinical situations

In patients with mild to moderate alcoholic cirrhosis, the concentration of losartan was 5 times higher, and the active metabolite was 1.7 times higher than in healthy male volunteers.

When CC >10 ml/min, the concentration of losartan in the blood plasma does not differ from that with normal renal function. In patients who require hemodialysis, the AUC is approximately 2 times higher than in patients with normal renal function.

Neither losartan nor its active metabolite is removed from the body by hemodialysis.

Plasma concentrations of losartan and its active metabolite in elderly men with arterial hypertension do not differ significantly from the values of these parameters in young men with arterial hypertension.

The plasma concentrations of losartan in women with arterial hypertension are 2 times higher than the corresponding values in men with arterial hypertension. Concentrations of the active metabolite do not differ between men and women. This pharmacokinetic difference is not clinically significant.

Release form

White or almost white, film-coated tablets, oblong, biconvex.

Excipients: microcrystalline cellulose, mannitol, crospovidone, colloidal anhydrous silicon dioxide, talc, magnesium stearate.

Film shell composition: sepifilm 752 white (hypromellose, microcrystalline cellulose, macrogol 2000 stearate, titanium dioxide), macrogol 6000.

10 pcs. - blisters (3) - cardboard packs.
10 pcs. - blisters (6) - cardboard packs.
10 pcs. - blisters (9) - cardboard packs.

Dosage

The drug is taken orally, regardless of food intake. Frequency of application - 1 time/day.

For arterial hypertension, the average daily dose is 50 mg. In some cases, to achieve a greater therapeutic effect, the daily dose can be increased to 100 mg in 2 or 1 dose.

The initial dose for patients with chronic heart failure is 12.5 mg 1 time / day. As a rule, the dose is increased at weekly intervals (i.e., 12.5 mg/day, 25 mg/day, 50 mg/day) to an average maintenance dose of 50 mg 1 time/day, depending on tolerability of the drug.

When prescribing the drug to patients receiving diuretics in high doses, the initial dose of Lozap ® should be reduced to 25 mg 1 time / day.

For elderly patients there is no need for dose adjustment.

When prescribing the drug to reduce the risk of cardiovascular diseases (including stroke) and mortality in patients with arterial hypertension and left ventricular hypertrophy, the initial dose is 50 mg/day. In the future, hydrochlorothiazide may be added at a low dose and/or the dose of Lozap ® may be increased to 100 mg/day in 1-2 doses.

For patients with concomitant type 2 diabetes mellitus with proteinuria, the initial dose of the drug is 50 mg 1 time / day, then the dose is increased to 100 mg / day (taking into account the degree of blood pressure reduction) in 1-2 doses.

For patients with a history of liver disease, dehydration, during hemodialysis, as well as patients over 75 years of age, a lower initial dose of the drug is recommended - 25 mg (1/2 tablet of 50 mg) 1 time / day.

Overdose

Symptoms: marked decrease in blood pressure, tachycardia; Bradycardia may occur due to parasympathetic (vagal) stimulation.

Treatment: forced diuresis, symptomatic therapy; hemodialysis is not effective.

Interaction

The drug can be prescribed with other antihypertensive drugs. There is a mutual enhancement of the effects of beta-blockers and sympatholytics. When losartan is used together with diuretics, an additive effect is observed.

There was no pharmacokinetic interaction of losartan with hydrochlorothiazide, digoxin, warfarin, cimetidine, phenobarbital, ketoconazole and erythromycin.

Rifampicin and fluconazole have been reported to reduce plasma concentrations of the active metabolite losartan. The clinical significance of this interaction is not yet known.

As with other drugs that inhibit angiotensin II or its action, concomitant use of losartan with potassium-sparing diuretics (for example, spironolactone, triamterene, amiloride), potassium supplements and potassium-containing salts increases the risk of hyperkalemia.

NSAIDs, including selective COX-2 inhibitors, may reduce the effect of diuretics and other antihypertensive agents.

With the combined use of angiotensin II receptor antagonists and lithium, an increase in the concentration of lithium in the blood plasma is possible. Considering this, it is necessary to weigh the benefits and risks of combined use of losartan with lithium salts. If combined use is necessary, the concentration of lithium in the blood plasma should be regularly monitored.

Side effects

When using losartan for the treatment of essential hypertension in controlled studies, among all side effects, only the incidence of dizziness differed from placebo by more than 1% (4.1% versus 2.4%).

A dose-dependent orthostatic effect, characteristic of antihypertensive drugs, was observed in less than 1% of patients when using losartan.

Determination of the frequency of side effects: very often (≥ 1/10); often (≥ 1/100, ≤ 1/10); sometimes (≥ 1/1000, ≤ 1/100); rare (≥ 1/10,000, ≤ 1/1000); very rare (≤ 1/10,000, including isolated reports).

Side effects occurring with a frequency greater than 1%

Side effects	Losartan (n=2085)	Placebo (n=535)
General reactions
Asthenia, fatigue	3.8	3.9
Chest pain	1.1	2.6
Peripheral edema	1.7	1.9
From the cardiovascular system
Heartbeat	1.0	0.4
Tachycardia	1.0	1.7
From the digestive system
Abdominal pain	1.7	1.7
Diarrhea	1.9	1.9
Dyspeptic phenomena	1.1	1.5
Nausea	1.8	2.8
From the musculoskeletal system
Pain in back, legs	1.6	1.1
Calf muscle cramps	1.0	1.1
From the side of the central nervous system
Dizziness	4.1	2.4
Headache	14.1	17.2
Insomnia	1.1	0.7
From the respiratory system
Cough, bronchitis	3.1	2.6
Nasal congestion	1.3	1.1
Pharyngitis	1.5	2.6
Sinusitis	1.0	1.3
Upper respiratory tract infections	6.5	5.6

Side effects of losartan are usually transient and do not require discontinuation of the drug.

Side effects occurring with an incidence of less than 1%

From the cardiovascular system: orthostatic hypotension (dose-dependent), epistaxis, bradycardia, arrhythmias, angina pectoris, vasculitis, myocardial infarction.

From the digestive system: anorexia, dry oral mucosa, toothache, vomiting, flatulence, gastritis, constipation, hepatitis, liver dysfunction; very rarely - moderate increase in AST and ALT activity, hyperbilirubinemia.

Dermatological reactions: dry skin, erythema, ecchymosis, photosensitivity, increased sweating, alopecia.

Allergic reactions: urticaria, skin rash, itching, angioedema (including swelling of the larynx and tongue, causing airway obstruction and/or swelling of the face, lips, pharynx).

From the hematopoietic system: sometimes - anemia (slight decrease in hemoglobin concentration and hematocrit, on average by 0.11 g% and 0.09 volume%, respectively, rarely - of clinical significance), thrombocytopenia, eosinophilia, Henoch-Schönlein purpura.

From the musculoskeletal system: arthralgia, arthritis, shoulder pain, knee pain, fibromyalgia.

From the central nervous system and peripheral nervous system: anxiety, sleep disturbance, drowsiness, memory disorders, peripheral neuropathy, paresthesia, hypoesthesia, tremor, ataxia, depression, fainting, migraine.

From the senses: ringing in the ears, taste disturbances, visual disturbances, conjunctivitis.

From the urinary system: imperative urge to urinate, urinary tract infections, impaired renal function; sometimes - an increase in the level of urea and residual nitrogen or creatinine in the blood serum.

From the reproductive system: decreased libido, impotence.

Metabolism: often - hyperkalemia (potassium level in blood plasma more than 5.5 mmol/l); gout.

Indications

arterial hypertension;
chronic heart failure (as part of combination therapy, with intolerance or ineffectiveness of therapy with ACE inhibitors);
reducing the risk of developing cardiovascular diseases (including stroke) and mortality in patients with arterial hypertension and left ventricular hypertrophy;
diabetic nephropathy with hypercreatininemia and proteinuria (the ratio of urine albumin to creatinine more than 300 mg/g) in patients with type 2 diabetes mellitus and concomitant arterial hypertension (reducing the progression of diabetic nephropathy to end-stage chronic renal failure).

Contraindications

pregnancy;
lactation period;
age under 18 years (efficacy and safety have not been established);
hypersensitivity to the components of the drug.

The drug should be used with caution in case of arterial hypotension, decreased blood volume, water-electrolyte imbalance, bilateral renal artery stenosis or stenosis of the artery of a single kidney, and renal/liver failure.

Features of application

Use during pregnancy and breastfeeding

There are no data on the use of Lozap ® during pregnancy. However, it is known that drugs that directly affect the RAAS, when used in the second and third trimesters of pregnancy, can cause developmental defects or even death of the developing fetus. Therefore, if pregnancy occurs, the use of Lozap ® should be stopped immediately.

If it is necessary to use Lozap during lactation, a decision should be made either to stop breastfeeding or to stop treatment with the drug.

Use for liver dysfunction

Patients with impaired liver function should be prescribed Lozap in lower doses.

Use for renal impairment

In patients with impaired renal function, including patients on dialysis, there is no need to adjust the initial dose.

During treatment, the concentration of potassium in the blood should be regularly monitored in case of impaired renal function.

Use in children

The drug is contraindicated in children and adolescents under 18 years of age (efficacy and safety have not been established).

Special instructions

It is necessary to correct dehydration before prescribing the drug Lozap ® or begin treatment with the use of the drug at a lower dose.

Drugs that affect the RAAS may increase blood urea and serum creatinine levels in patients with bilateral renal artery stenosis or solitary renal artery stenosis.

In patients with liver cirrhosis, the concentration of losartan in the blood plasma increases significantly, and therefore, in the presence of a history of liver disease, it should be prescribed in lower doses.

During the treatment period, the concentration of potassium in the blood should be regularly monitored, especially in elderly patients with impaired renal function.

Use in pediatrics

The safety and effectiveness of the drug Lozap ® in children and adolescents under 18 years of age have not been established.

Impact on the ability to drive vehicles and operate machinery

Lozap ® does not affect the ability to drive vehicles or operate machinery.