• Some antipsychotics (e.g. Thiazides in high doses causing intense diuresis can inhibit the milk production. Administration of losartan blocks all the physiologically relevant actions of angiotensin II and through inhibition of aldosterone could tend to attenuate the potassium loss associated with the diuretic.Losartan has been shown to have a mild and transient uricosuric effect. If dual blockade therapy is considered absolutely necessary, this should only occur under specialist supervision and subject to frequent close monitoring of renal function, electrolytes and blood pressure.
Haloperidol metabolites are not considered to make a significant contribution to its activity, although for the reduced metabolite of haloperidol, back-conversion to haloperidol cannot be fully ruled out. The toxic potential of the combination of losartan/hydrochlorothiazide was evaluated in chronic toxicity studies for up to six months duration in rats and dogs after oral administration, and the changes observed in these studies with the combination were mainly produced by the losartan component. Therefore, the plasma concentrations of potassium and creatinine clearance values should be closely monitored; especially patients with heart failure and a creatinine clearance between 30-50 ml/min should be closely monitored.The concomitant use of potassium-sparing diuretics, potassium supplements, potassium containing salt substitutes, or other drugs that may increase serum potassium (e.g., trimethoprim-containing products) with losartan/hydrochlorothiazide is not recommended (see section 4.5).Based on pharmacokinetic data which demonstrate significantly increased plasma concentrations of losartan in cirrhotic patients, Cozaar Comp should be used with caution in patients with a history of mild to moderate hepatic impairment. The pharmacokinetics of losartan and its active metabolite are linear with oral losartan potassium doses up to 200 mg.Following oral administration, plasma concentrations of losartan and its active metabolite Both biliary and urinary excretion contribute to the elimination of losartan and its metabolites. �_݊J6�/0IL7�T�D������a1��=���&Ĩ�ء���\�ռ���]�`ϓ��\Ր�wo����v�tZ6��L'��zK�Bǣ����m2�A`�K������d#yW�I��/����-j:��f��h�՛��߄��>6���o�bY�'��e�p:���_H�ڹ@���^o�~Je��;��)�����q��K�1�T��T���%�S�y�����u�w'{�aȠSy���-�=2���v�?��� The use of AIIRAs is contraindicated during the 2Epidemiological evidence regarding the risk of teratogenicity following exposure to ACE inhibitors during the first trimester of pregnancy has not been conclusive; however a small increase in risk cannot be excluded. Dilutional hyponatraemia may occur in oedematous patients in hot weather.Thiazide therapy may impair glucose tolerance. When losartan is administered orally, about 4% of the dose is excreted unchanged in the urine, and about 6% of the dose is excreted in the urine as active metabolite. In general, the antihypertensive effect is attained within three to four weeks after initiation of therapy. Cozaar Comp is indicated for the treatment of essential hypertension in patients whose blood pressure is not adequately controlled on losartan or hydrochlorothiazide alone.Losartan and hydrochlorothiazide is not for use as initial therapy, but in patients whose blood pressure is not adequately controlled by losartan potassium or hydrochlorothiazide alone.Dose titration with the individual components (losartan and hydrochlorothiazide) is recommended.When clinically appropriate direct change from monotherapy to the fixed combination may be considered in patients whose blood pressure is not adequately controlled.The usual maintenance dose of Cozaar Comp is one tablet of Cozaar Comp 50 mg/12.5 mg (losartan 50 mg/HCTZ 12.5 mg) once daily. For temporary relief, use sugarless candy or gum, melt bits of ice in your mouth, or use a saliva substitute.
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