Losartan + hydrochlorothiazide

Hypersensitivity to losartan, hydrochlorothiazide or sulfonamide-derived drugs. Anuria, intravascular volume depletion. Pregnancy. Concomitant use with aliskiren in patients with diabetes mellitus or renal impairment (GFR <60 mL/min).

Patient with significant aortic/mitral stenosis, prediabetes or diabetes mellitus, history of gout, SLE, moderate or high cholesterol concentrations, unstented unilateral/bilateral renal artery stenosis, or those undergoing surgery. Black patients. Hepatic and severe renal impairment. Lactation. Monitoring Parameters Monitor blood pressure, serum electrolytes and renal function at baseline and periodically. Observe for clinical signs of fluid or electrolyte imbalance.

Significant: Hypersensitivity reactions, electrolyte disturbance (e.g. hyperkalaemia, hypokalaemia, hypochloraemic alkalosis, hyponatraemia, hypomagnesaemia), symptomatic hypotension, acute transient myopia, acute angle-closure glaucoma, exacerbation of SLE, photosensitivity, renal function deterioration. Rarely, angioedema. Blood and lymphatic system disorders: Anaemia, agranulocytosis, leucopenia. Cardiac disorders: Tachycardia, palpitations, chest pain. Eye disorders: Transient blurred vision, xanthopsia. Gastrointestinal disorders: Abdominal pain, nausea, vomiting, dyspepsia, gastric irritation, cramping, pancreatitis, sialoadenitis, dysgeusia. General disorders and administration site conditions: Asthenia, malaise, weakness. Hepatobiliary disorders: Jaundice. Investigations: Liver function abnormalities. Metabolism and nutrition disorders: Anorexia, hyperglycaemia, hyperuricaemia. Musculoskeletal and connective tissue disorders: Back pain, leg pain, myalgia, muscle cramps or spasms. Nervous system disorders: Dizziness, headache, paraesthesia, migraine. Psychiatric disorders: Restlessness, insomnia. Renal and urinary disorders: Glycosuria, renal dysfunction, interstitial nephritis. Reproductive system and breast disorders: Impotence, erectile dysfunction. Respiratory, thoracic and mediastinal disorders: Nasal congestion, cough, upper respiratory infection, sinusitis, sinus disorder. Skin and subcutaneous tissue disorders: Rash, urticaria, pruritus, purpura. Vascular disorders: Orthostatic effects (dose-related), necrotising angiitis (vasculitis, cutaneous vasculitis).

May increase serum K with K-sparing diuretics (e.g. spironolactone, triamterene, amiloride), K supplements, K-containing salt substitutes. May increase serum lithium concentration and toxicity.

Angiotensin II Antagonists / Diuretics

C03AA03 - hydrochlorothiazide ; Belongs to the class of low-ceiling thiazide diuretics.
C09CA01 - losartan ; Belongs to the class of angiotensin II antagonists. Used in the treatment of cardiovascular disease.