Uses of Angitan Plus: - Hypertension (high blood pressure) Hypertension, Stroke, risk reduction of hypertensive or LVH patients Pregnancy, lactation; intravascular volume depletion.

How to use Hydrochlorothiazide + Losartan Potassium: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Hydrochlorothiazide + Losartan Potassium may be taken with or without food, but it is better to take it at a fixed time. Adult Dose: Hypertension Initial: 50 mg/12.5 mg PO qDay If dose titrated upward, do not to exceed final titration of 100 mg/25 mg PO qDay or 50 mg/12.5 mg PO q12hr Decrease losartan to 25 mg PO qDay initially if volume depleted Child Dose: Safety and efficacy not established Renal Dose: Renal impairment CrCl <30 mL/min: Do not use thiazide-containing products; loop diuretic preferred CrCl >30 mL/min: No dosage adjustment required

Reduced excretion of lithium; effect of diuretic, natriuretic & other antihypertensive w/ NSAIDs including selective COX-2 inhibitors. Do not co-administer w/ aliskiren in patients w/ diabetes & renal impairment. Losartan: Rifampin & fluconazole. Increased serum potassium w/ K-sparing diuretics (eg spironolactone, triamterene, amiloride), K supplements or salt substitutes containing K. Hydrochlorothiazide: Potentiate orthostatic hypotension w/ alcohol, barbiturates or narcotics. Antidiabetic drugs (oral agents, insulin), other antihypertensive drugs. Impaired absorption w/ cholestyramine & colestipol resins. Intensified electrolyte depletion w/ corticosteroids, ACTH, glycyrrhizin (liquorice). Possible decreased response to pressor amines (eg adrenaline); increased response to nondepolarizing skeletal muscle relaxants (eg tubocurarine). May interfere w/ parathyroid function test.

Pregnancy, lactation; intravascular volume depletion.

Common - Nausea - Taste change - Upset stomach - Diarrhea - Headache - Dizziness - Weakness - Decreased blood pressure - Increased blood uric acid - Increased blood lipid level - Glucose intolerance - Electrolyte imbalance >10% Losartan Fatigue (14%),Hypoglycemia (14%),Chest pain (12%),Cough, incidence higher in previous cough related to ACE therapy (3-11%) 1-10% Losartan Diarrhea (2-10%),URI (8%),Hypotension (7%),Dizziness (4%),Nausea (2%) Hydrochlorothiazide Hypotension,Anorexia,Epigastric distress,Hypokalemia,Phototoxicity,Thrombocytopenia Potentially Fatal: Hypersensitivity reactions; hemolytic anaemia; toxic epidermal necrolysis.

Precaution: Existing electrolyte disturbances; hepatic cirrhosis; severe hepatic failure; oedema; elderly (>75 yr); renal impairment; hepatic impairment; diabetes, gout, hyperlipidaemia; hyperuricaemia; ECG: LVH and/or ventricular ectopics extrasystoles); volume depleted patients; patients on diuretics and salt restriction; renal artery stenosis; aortic and mitral stenosis. Monitor potassium concentration. Discontinue before performing tests for parathyroid function. Lactation: Discontinue drug or do not nurse

Hydrochlorothiazide increases renal excretion of sodium and chloride and reduces cardiac load. Losartan is an angiotensin II receptor (type AT1) antagonist antihypertensive which acts by blocking the actions of angiotensin II of renin-angiotensin-aldosterone system. The drug and its active metabolite selectively block the vasoconstrictor and aldosterone secreting effects of angiotensin II. The two drugs exert additive effects in hypertension.