HYZAAR Rx

Indications for HYZAAR:

Hypertension (not for initial therapy unless HTN is severe). To reduce stroke in hypertensive patients with left ventricular hypertrophy (LVH); this benefit may not apply to black patients.

Adult:

Initially 50/12.5mg once daily (100/12.5mg if BP not controlled on losartan 100mg alone); may increase after 3 weeks as needed to max 100/25mg daily. HTN with LVH (BP not controlled on losartan alone): initially 50/12.5mg once daily; increase as needed to 100/12.5mg, then to max 100/25mg daily.

Children:

Not established.

Contraindications:

Anuria. Sulfonamide allergy. Concomitant aliskiren in patients with diabetes.

Boxed Warning:

Fetal toxicity.

Warnings/Precautions:

Fetal toxicity may develop; discontinue if pregnancy is detected. Correct salt/volume depletion before starting therapy, or reduce initial dose. Hepatic impairment: initial therapy not recommended. Severe renal impairment (CrCl<30mL/min): not established. Severe CHF. Renal artery stenosis. Asthma. SLE. Gout. Diabetes. Postsympathectomy. Acute myopia. Secondary angle-closure glaucoma. Monitor BP, electrolytes, calcium, renal function periodically. Pregnancy (Cat.D). Nursing mothers: not recommended.

Pharmacological Class:

Angiotensin II receptor blocker (ARB) + thiazide diuretic.

Interactions:

See Contraindications. Hyperkalemia with K⁺ supplements, K⁺ sparing diuretics, K⁺ containing salt substitutes. Dual inhibition of the renin-angiotensin system with ARBs, ACEIs, or aliskiren may increase risk of hypotension, hyperkalemia, renal function changes; monitor closely. Avoid concomitant aliskiren in renal impairment (CrCl <60mL/min). May be antagonized by, and renal toxicity potentiated by NSAIDs, including selective COX-2 inhibitors (monitor renal function periodically in elderly and/or volume-depleted). May increase lithium toxicity (monitor). Orthostatic hypotension with alcohol, other CNS depressants. Adjust antihyperglycemics. Hypokalemia with corticosteroids, ACTH. Potentiates other antihypertensives, skeletal muscle relaxants. Concomitant cholestyramine, colestipol; administer at least 4hrs before or 4–6hrs after resin administration.

Adverse Reactions:

Dizziness, upper respiratory infection, cough, back pain; hypersensitivity reactions, renal impairment, electrolyte abnormalities.

Metabolism:

Hepatic (CYP2C9, 3A4).

Elimination:

Fecal, renal.

Generic Availability:

YES

How Supplied:

Tabs—30, 90, 1000