• Dosage of Hyzaar DS in details
• Hyzaar DS interactions
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Dosage of Hyzaar DS in details

Hyzaar DS Dosage

Generic name: Losartan (Hyzaar DS) potassium 50mg, Hydrochlorothiazide (Hyzaar DS) 12.5mg

Dosage form: tablet, film coated

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Hypertension

The usual starting dose of Hyzaar DS is 50/12.5 (Losartan (Hyzaar DS) 50 mg/Hydrochlorothiazide (Hyzaar DS) 12.5 mg) once daily. The dosage can be increased after 3 weeks of therapy to a maximum of 100/25 (Losartan (Hyzaar DS) 100 mg/Hydrochlorothiazide (Hyzaar DS) 25 mg) once daily as needed to control blood pressure.

Initiate a patient whose blood pressure is not adequately controlled with Losartan (Hyzaar DS) 50 mg monotherapy with Hyzaar DS 50/12.5 once daily. If blood pressure remains uncontrolled after about 3 weeks of therapy, the dosage may be increased to two tablets of Hyzaar DS 50/12.5 once daily or one tablet of Hyzaar DS 100/25 once daily.

Initiate a patient whose blood pressure is not adequately controlled with Losartan (Hyzaar DS) 100 mg monotherapy with Hyzaar DS 100/12.5 (Losartan (Hyzaar DS) 100 mg/Hydrochlorothiazide (Hyzaar DS) 12.5 mg) once daily. If blood pressure remains uncontrolled after about 3 weeks of therapy, increase the dose to two tablets of Hyzaar DS 50/12.5 once daily or one tablet of Hyzaar DS 100/25 once daily.

Initiate a patient whose blood pressure is inadequately controlled with Hydrochlorothiazide (Hyzaar DS) 25 mg once daily, or is controlled but who experiences hypokalemia with this regimen, on Hyzaar DS 50/12.5 once daily, reducing the dose of Hydrochlorothiazide (Hyzaar DS) without reducing the overall expected antihypertensive response. Evaluate the clinical response to Hyzaar DS 50/12.5 and, if blood pressure remains uncontrolled after about 3 weeks of therapy, increase the dose to two tablets of Hyzaar DS 50/12.5 once daily or one tablet of Hyzaar DS 100/25 once daily.

Hypertensive Patients with Left Ventricular Hypertrophy

In patients whose blood pressure is not adequately controlled on 50 mg Losartan (Hyzaar DS) potassium, initiate treatment with Hyzaar DS 50/12.5. If additional blood pressure reduction is needed, increase the dose to Hyzaar DS 100/12.5, followed by Hyzaar DS 100/25. For further blood pressure reduction add other antihypertensives.

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What other drugs will affect Hyzaar DS?

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with Hyzaar DS, especially:

• any other blood pressure medications;

• steroids (prednisone and others);

• lithium;

• cholestyramine or colestipol;

• insulin or oral diabetes medicine;

• rifampin;

• a barbiturate--phenobarbital and others;

• any other diuretic or "water pill";

• NSAIDs (non-steroidal anti-inflammatory drugs)--ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others;

• a muscle relaxer--baclofen, carisoprodol, cyclobenzaprine, methocarbamol, tizanidine, and others; or

• narcotic medicine--codeine, fentanyl, hydrocodone, hydromorphone, methadone, morphine, oxycodone, and others.

This list is not complete. Other drugs may interact with Hyzaar DS, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Hyzaar DS interactions

Agents Increasing Serum Potassium

Coadministration of Losartan (Hyzaar DS) with other drugs that raise serum potassium levels may result in hyperkalemia. Monitor serum potassium in such patients.

Lithium

Increases in serum lithium concentrations and lithium toxicity have been reported with concomitant use of angiotensin II receptor antagonists or thiazide diuretics. Monitor lithium levels in patients receiving Hyzaar DS and lithium.

Non-Steroidal Anti-Inflammatory Agents Including Selective Cyclooxygenase-2 Inhibitors

Losartan (Hyzaar DS) Potassium

In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, coadministration of NSAIDs, including selective COX-2 inhibitors, with angiotensin II receptor antagonists (including Losartan (Hyzaar DS)) may result in deterioration of renal function, including possible acute renal failure. These effects are usually reversible. Monitor renal function periodically in patients receiving Losartan (Hyzaar DS) and NSAID therapy.

The antihypertensive effect of angiotensin II receptor antagonists, including Losartan (Hyzaar DS), may be attenuated by NSAIDs, including selective COX-2 inhibitors.

Hydrochlorothiazide (Hyzaar DS)

The administration of a non-steroidal anti-inflammatory agent including a selective COX-2 inhibitor can reduce the diuretic, natriuretic, and antihypertensive effects of loop, potassium-sparing and thiazide diuretics. Therefore, when Hyzaar DS and non-steroidal anti-inflammatory agents including selective COX-2 inhibitors are used concomitantly, observe closely to determine if the desired effect of the diuretic is obtained.

In patients receiving diuretic therapy, coadministration of NSAIDs with angiotensin receptor blockers, including Losartan (Hyzaar DS), may result in deterioration of renal function, including possible acute renal failure. These effects are usually reversible. Monitor renal function periodically in patients receiving Hydrochlorothiazide (Hyzaar DS), Losartan (Hyzaar DS), and NSAID therapy.

Dual Blockade Of The Renin-Angiotensin System (RAS)

Dual blockade of the RAS with angiotensin receptor blockers, ACE inhibitors, or aliskiren is associated with increased risks of hypotension, syncope, hyperkalemia, and changes in renal function (including acute renal failure) compared to monotherapy.

The Veterans Affairs Nephropathy in Diabetes (VA NEPHRON-D) trial enrolled 1448 patients with type 2 diabetes, elevated urinary-albumin-to-creatinine ratio, and decreased estimated glomerular filtration rate (GFR 30 to 89.9 mL/min), randomized them to lisinopril or placebo on a background of Losartan (Hyzaar DS) therapy and followed them for a median of 2.2 years. Patients receiving the combination of Losartan (Hyzaar DS) and lisinopril did not obtain any additional benefit compared to monotherapy for the combined endpoint of decline in GFR, end-stage renal disease, or death, but experienced an increased incidence of hyperkalemia and acute kidney injury compared with the monotherapy group.

Closely monitor blood pressure, renal function, and electrolytes in patients on Hyzaar DS and other agents that affect the RAS.

Do not coadminister aliskiren with Hyzaar DS in patients with diabetes. Avoid use of aliskiren with Hyzaar DS in patients with renal impairment (GFR < 60 mL/min).

The Use Of Hydrochlorothiazide (Hyzaar DS) With Other Drugs

When administered concurrently, the following drugs may interact with thiazide diuretics :

Antidiabetic drugs (oral agents and insulin) — dosage adjustment of the antidiabetic drug may be required.

Cholestyramine and colestipol resins — Absorption of Hydrochlorothiazide (Hyzaar DS) is impaired in the presence of anionic exchange resins. Single doses of either cholestyramine or colestipol resins bind the Hydrochlorothiazide (Hyzaar DS) and reduce its absorption from the gastrointestinal tract by up to 85 and 43 percent, respectively. Stagger the dosage of Hydrochlorothiazide (Hyzaar DS) and the resin such that Hydrochlorothiazide (Hyzaar DS) is administered at least 4 hours before or 4 to 6 hours after the administration of the resin.

References

1. DailyMed. "AMLODIPINE BESYLATE; HYDROCHLOROTHIAZIDE; OLMESARTAN MEDOXOMIL: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
2. DailyMed. "LOSARTAN POTASSIUM: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
3. FDA/SPL Indexing Data. "JMS50MPO89: The UNique Ingredient Identifier (UNII) is an alphanumeric substance identifier from the joint FDA/USP Substance Registration System (SRS).". https://www.fda.gov/ForIndustry/Data... (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology