Lostad Uses

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• Lostad indications
• Uses of Lostad in details
• Lostad description
• Lostad dosage
• Lostad interactions
• Lostad side effects
• Lostad contraindications

What is Lostad?

Lostad is used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. Lowering blood pressure may reduce the risk of strokes and heart attacks.

Lostad is an angiotensin II receptor blocker (ARB). It works by blocking a substance in the body that causes blood vessels to tighten. As a result, Lostad relaxes the blood vessels. A lower blood pressure will increase the supply of the blood and oxygen to the heart.

Lostad is also used to decrease the risk of stroke in patients with high blood pressure and enlargement of the heart. It is also used to treat kidney problems in patients with type 2 diabetes and a history of hypertension.

Lostad is available only with your doctor's prescription.

Lostad indications

Lostad is used to treat high blood pressure (hypertension). High blood pressure adds to the work load of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled.

Lostad works by blocking the action of a substance in the body that causes blood vessels to tighten. As a result, Lostad relaxes blood vessels. This lowers blood pressure.

Lostad is also used to decrease the risk of stroke in patients with high blood pressure and a condition called left ventricular hypertrophy (LVH). LVH is an enlargement of the left pumping chamber of the heart and can cause problems with the way the heart pumps blood.

Lostad is also used to treat a condition called diabetic nephropathy. Diabetic nephropathy is a complication of type 2 diabetes which causes the kidneys to not work properly.

How should I use Lostad?

Use Lostad as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• An extra patient leaflet is available with Lostad. Talk to your pharmacist if you have questions about this information.
• Take Lostad by mouth with or without food.
• If you cannot swallow tablets, ask your doctor or pharmacist about preparing a suspension of Lostad.
• Take Lostad on a regular schedule to get the most benefit from it. Taking Lostad at the same time each day will help you remember to take it.
• Continue to take Lostad even if you feel well. Do not miss any doses.
• If you miss a dose of Lostad, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Lostad.

Uses of Lostad in details

Use: Labeled Indications

Hypertension: Management of hypertension in adults and children ≥6 years of age

Proteinuric chronic kidney disease, diabetic: Treatment of diabetic nephropathy with an elevated serum creatinine and proteinuria (urinary albumin to creatinine ratio ≥300 mg/g) in patients with type 2 diabetes and a history of hypertension

Off Label Uses

Heart failure with reduced ejection fraction

Data from a randomized, double-blind, dose comparison study in patients with New York Heart Association (NYHA) class II to IV heart failure support the use of Lostad at higher doses to reduce the rate of death or admission for heart failure in patients with heart failure.

Proteinuric chronic kidney disease, nondiabetic

Based on the 2012 Kidney Disease Improving Global Outcomes guidelines, the use of an ACE inhibitor or an ARB is recommended in patients with proteinuric CKD to prevent progression of CKD.

ST-elevation myocardial infarction

Based on the 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infraction, an ARB is recommended and effective in patients who have indications for but are intolerant of ACE inhibitors.

Lostad description

Lostad POTASSIUM (Lostad), the first of a new class of agents for the treatment of hypertension, is an angiotensin II receptor (type AT1) antagonist. Lostad POTASSIUM (Lostad) also provides a reduction in the combined risk of cardiovascular death, stroke, and myocardial infarction in hypertensive patients with left ventricular hypertrophy and renal protection for type 2 diabetic patients with proteinuria.

Lostad potassium, a non-peptide molecule, is chemically described as 2-butyl-4-chloro-1-[[2'-(1H-tetrazol-5-yl)[1,1'-biphenyl]-4-yl]methyl]-1H-imidazole-5-methanol monopotassium salt.

Its empirical formula is C₂₂H₂₂ClKN₆O.

Lostad potassium is a white to off-white free-flowing crystalline powder with a molecular weight of 461.01. It is freely soluble in water, soluble in alcohols, and slightly soluble in common organic solvents, such as acetonitrile and methyl ethyl ketone.

Oxidation of the 5-hydroxymethyl group on the imidazole ring results in the active metabolite of Lostad.

Lostad dosage

Hypertension: The usual starting and maintenance dose is 50 mg once daily for most patients. The maximal antihypertensive effect is attained 3-6 weeks after initiation of therapy. Some patients may receive an additional benefit by increasing the dose to 100 mg once daily.

For patients with intravascular volume-depletion (e.g., those treated with high-dose diuretics), a starting dose of 25 mg once daily should be considered.

No initial dosage adjustment is necessary for elderly patients or for patients with renal impairment, including patients on dialysis. A lower dose should be considered for patients with a history of hepatic impairment.

Reduction in the Risk of Cardiovascular Morbidity and Mortality in Hypertensive Patients with Left Ventricular Hypertrophy: The usual starting dose is 50 mg of Lostad POTASSIUM (Lostad) once daily. A low dose of hydrochlorothiazide should be added and/or the dose of Lostad POTASSIUM (Lostad) should be increased to 100 mg once daily based on blood pressure response.

Renal Protection in Type 2 Diabetic Patients with Proteinuria: The usual starting dose is 50 mg once daily. The dose may be increased to 100 mg once daily based on blood pressure response. Lostad POTASSIUM (Lostad) may be administered with other antihypertensive agents (e.g., diuretics, calcium channel blockers, alpha- or beta-blockers, and centrally acting agents) as well as with insulin and other commonly used hypoglycemic agents (e.g., sulfonylureas, glitazones and glucosidase inhibitors).

Administration: Lostad POTASSIUM (Lostad) may be administered with or without food.

Lostad POTASSIUM (Lostad) may be administered with other antihypertensive agents.

Lostad interactions

See also:
What other drugs will affect Lostad?

Concomitant use of Lostad with fenofibrate is beneficial in the treatment of patients with gout and hypertriglyceridemia.

Lostad shows no effect on the pharmacokinetics of warfarin and digoxin.

Administration of Lostad with fluconazole, phenytoin and grapefruit juice inhibits the metabolism of Lostad to its active metabolite. Although not yet established, the possibility of decreased therapeutic effect of Lostad may be considered.

Rifampicin was found to induce the metabolism of Lostad to its active metabolite, E3174 thereby, reducing levels of both Lostad and E3174 in the circulation.

Lostad does not affect the pharmacokinetic properties of phenytoin and orlistat.

Administration of Lostad with spironolactone and other potassium-sparing diuretics may lead to the occurrence of hyperkalemia. Physicians are advised to monitor patient's serum potassium level.

The use of Lostad with ACE inhibitors and β-blockers potentiates the antihypertensive effects of Lostad.

There have been reports of lithium intoxication when Lostad was given to patients treated with lithium.

Lostad side effects

See also:
What are the possible side effects of Lostad?

Lostad POTASSIUM (Lostad) has been found to be generally well tolerated in controlled clinical trials for hypertension; side effects have usually been mild and transient in nature and have not required discontinuation of therapy. The overall incidence of side effects reported with Lostad POTASSIUM (Lostad) was comparable to placebo.

In controlled clinical trials for essential hypertension, dizziness was the only side effect reported as drug related that occurred with an incidence greater than placebo in one percent or more of patients treated with Lostad POTASSIUM (Lostad). In addition, dose-related orthostatic effects were seen in less than one percent of patients. Rarely, rash was reported, although the incidence in controlled clinical trials was less than placebo.

In these double-blind controlled clinical trials for essential hypertension, the following adverse experiences reported with Lostad POTASSIUM (Lostad) occurred in ≥1 percent of patients, regardless of drug relationship:

Lostad POTASSIUM (Lostad) was generally well tolerated in a controlled clinical trial in hypertensive patients with left ventricular hypertrophy. The most common drug-related side effects were dizziness, asthenia/fatigue, and vertigo.

In the LIFE study, among patients without diabetes at baseline, there was a lower incidence of new onset diabetes mellitus with Lostad POTASSIUM (Lostad) as compared to atenolol (242 patients versus 320 patients, respectively, p<0.001). Because there was no placebo group included in the study, it is not known if this represents a beneficial effect of Lostad POTASSIUM (Lostad) or an adverse effect of atenolol.

Lostad POTASSIUM (Lostad) was generally well tolerated in a controlled clinical trial in type 2 diabetic patients with proteinuria. The most common drug-related side effects were asthenia/fatigue, dizziness, hypotension and hyperkalemia.

The following additional adverse reactions have been reported in post-marketing experience: Hypersensitivity: Anaphylactic reactions, angioedema including swelling of the larynx and glottis causing airway obstruction and/or swelling of the face, lips, pharynx and/or tongue has been reported rarely in patients treated with Lostad; some of these patients previously experienced angioedema with other drugs including ACE inhibitors. Vasculitis, including Henoch-Schoenlein purpura, has been reported rarely.

Gastrointestinal: Hepatitis (reported rarely), liver function abnormalities, vomiting.

General Disorders and Administration Site Conditions: Malaise.

Hematologic: Anemia, thrombocytopenia (reported rarely).

Musculoskeletal: Myalgia, arthralgia.

Nervous System/Psychiatric: Migraine, dysgeusia.

Reproductive System and Breast Disorders: Erectile dysfunction/impotence.

Respiratory: Cough.

Skin: Urticaria, pruritus, erythroderma, photosensitivity.

Laboratory Test Findings: In controlled clinical trials for essential hypertension, clinically important changes in standard laboratory parameters were rarely associated with administration of Lostad POTASSIUM (Lostad). Hyperkalemia (serum potassium >5.5 mEq/L) occurred in 1.5% of patients in the hypertension clinical trials. In a clinical study conducted in type 2 diabetic patients with proteinuria, 9.9% of patients treated with Lostad POTASSIUM (Lostad) and 3.4% of patients treated with placebo developed hyperkalemia. Elevations of ALT occurred rarely and usually resolved upon discontinuation of therapy.

Lostad contraindications

See also:
What is the most important information I should know about Lostad?

Do not use if you are pregnant. Stop using and tell your doctor right away if you become pregnant. Lostad can cause injury or death to the unborn baby if you take the medicine during your second or third trimester. Use effective birth control.

You should not use this medication if you are allergic to Lostad.

Before you use Lostad, tell your doctor about all your other medical conditions and allergies. Also make sure your doctor knows if you are pregnant or breast-feeding. In some cases, you may not be able to use Lostad, or you may need a dose adjustment or special precautions.

Certain other drugs may interact with Lostad or should not be used at the same time. Tell each of your healthcare providers about all medicines you use now, and any medicine you start or stop using.

Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking this medicine, which can lead to severely low blood pressure or a serious electrolyte imbalance.

In rare cases, Lostad can cause a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, and dark colored urine.

Active ingredient matches for Lostad:

Losartan in Vietnam.

Omeprazole in Austria.

References

1. DailyMed. "OMEPRAZOLE MAGNESIUM: 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. PubChem. "omeprazole". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology