• Dosage of Strok ROK in details
• Strok ROK interactions
• Strok ROK reviews

Dosage of Strok ROK in details

Strok ROK Dosage

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

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

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

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

Hypertensive Patients with Left Ventricular Hypertrophy

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

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What other drugs will affect Strok ROK?

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

Strok ROK interactions

Agents Increasing Serum Potassium

Coadministration of Losartan (Strok ROK) 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 Strok ROK and lithium.

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

Losartan (Strok ROK) 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 (Strok ROK)) 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 (Strok ROK) and NSAID therapy.

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

Hydrochlorothiazide (Strok ROK)

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

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

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