• Dosage of Lara-H in details
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Dosage of Lara-H in details

Lara-H Dosage

Generic name: Losartan (Lara-H) potassium 50mg, Hydrochlorothiazide (Lara-H) 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 Lara-H is 50/12.5 (Losartan (Lara-H) 50 mg/Hydrochlorothiazide (Lara-H) 12.5 mg) once daily. The dosage can be increased after 3 weeks of therapy to a maximum of 100/25 (Losartan (Lara-H) 100 mg/Hydrochlorothiazide (Lara-H) 25 mg) once daily as needed to control blood pressure.

Initiate a patient whose blood pressure is not adequately controlled with Losartan (Lara-H) 50 mg monotherapy with Lara-H 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 Lara-H 50/12.5 once daily or one tablet of Lara-H 100/25 once daily.

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

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

Hypertensive Patients with Left Ventricular Hypertrophy

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

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What other drugs will affect Lara-H?

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with Lara-H, 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 Lara-H, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Lara-H interactions

Agents Increasing Serum Potassium

Coadministration of Losartan (Lara-H) 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 Lara-H and lithium.

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

Losartan (Lara-H) 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 (Lara-H)) 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 (Lara-H) and NSAID therapy.

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

Hydrochlorothiazide (Lara-H)

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 Lara-H 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 (Lara-H), 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 (Lara-H), Losartan (Lara-H), 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 (Lara-H) therapy and followed them for a median of 2.2 years. Patients receiving the combination of Losartan (Lara-H) 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 Lara-H and other agents that affect the RAS.

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

The Use Of Hydrochlorothiazide (Lara-H) 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 (Lara-H) is impaired in the presence of anionic exchange resins. Single doses of either cholestyramine or colestipol resins bind the Hydrochlorothiazide (Lara-H) and reduce its absorption from the gastrointestinal tract by up to 85 and 43 percent, respectively. Stagger the dosage of Hydrochlorothiazide (Lara-H) and the resin such that Hydrochlorothiazide (Lara-H) 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