Lorista

Lorista is an angiotensin II receptor antagonist, an antihypertensive agent.

Release form and composition

Dosage form Loristy - tablets:

• 12.5 mg: oval, slightly biconvex, film-coated from light yellow to yellow, with a bevel;
• 25 mg: oval, slightly biconvex, film-coated yellow, with a chamfer, with a risk on one side;
• 50 mg: round, slightly biconvex, film-coated white, chamfered, with a risk on one side;
• 100 mg: oval, slightly biconvex, film-coated white.

Available in 10 tablets in blisters, 3, 6 or 9 packs in a carton.

The active ingredient of the drug is potassium losartan. 1 tablet contains 12.5 mg, 25 mg, 50 mg or 100 mg.

Auxiliary components: cellactose (a mixture of cellulose and lactose monohydrate), anhydrous colloidal silicon dioxide, microcrystalline cellulose, magnesium stearate, corn starch and pregelatinized starch.

Shell composition: propylene glycol, talc, titanium dioxide (E171), hypromellose and quinoline yellow dye (E104).

Indications for use

• Treatment of arterial hypertension;
• Combination therapy of chronic heart failure in case of intolerance or failure of treatment with angiotensin-converting enzyme (ACE) inhibitors.

In addition, Lorista is used for such purposes:

• Reducing the risk of stroke in patients diagnosed with left ventricular hypertrophy and arterial hypertension;
• Protection of kidney function in patients with type 2 diabetes mellitus, accompanied by proteinuria. The goal of therapy is to reduce proteinuria, slow the progression of kidney damage, reduce the risk of end-stage development (prevent the likelihood of an increase in serum creatinine levels and prevent the need for dialysis) or death.

Contraindications

Absolute:

• Galactosemia or glucose impaired glucose / galactose syndrome;
• Lactose intolerance;
• Hypotension;
• Dehydration;
• Hyperkalemia;
• Age up to 18 years;
• Pregnancy;
• Lactation;
• Hypersensitivity to the drug.

Relative (special caution required):

• Renal / hepatic impairment;
• Decreased circulating blood volume (BCC);
• Violations of water and electrolyte balance;
• Bilateral renal artery stenosis or single kidney artery stenosis.

Dosing and Administration

Lorista should be taken orally once a day, regardless of meals.

The average daily dose for hypertension is 50 mg. The maximum hypotensive effect is achieved within 3-6 weeks of taking the drug. If necessary, you can achieve a more pronounced effect by taking the drug in a daily dose of up to 100 mg in 1-2 doses.

In the case of the concomitant appointment of diuretics, the dose of Loristy should not take 25 mg per day in 1 dose.

Patients with impaired liver function prescribed lower doses of the drug.

Treatment of chronic heart failure begins with a daily dose of 12.5 mg in 1 reception. Then, at 1-week intervals, the dose is gradually increased: first to 25 mg, then to the usual maintenance dose of 50 mg. In this disease, Lorista is usually prescribed in combination with cardiac glycosides and diuretics.

In order to reduce the risk of stroke, Lorista is prescribed in a daily dose of 50 mg. In the future, if necessary, add hydrochlorothiazide in low doses and / or increase the dose of losartan potassium to 100 mg.

To protect the kidneys in diabetics, the drug is taken in a dose of 50 mg. If necessary, taking into account the reduction in blood pressure, it is increased to 100 mg.

Side effects

In most cases, Lorista is well tolerated. Undesirable reactions, if they occur, are weakly expressed, are transient in nature and do not require discontinuation of the drug.

Possible side effects:

• Central and peripheral nervous system: ≥1% - asthenia, fatigue, headache, insomnia, dizziness; <1% - drowsiness, sleep disturbance, memory disorders, anxiety, migraine, hypostezia, tremor, paresthesia, ataxia, syncope, peripheral neuropathy, depression;
• Cardiovascular system: dose-dependent orthostatic hypotension, bradycardia, tachycardia, arrhythmias, vasculitis, palpitations, stenocardia;
• Metabolism: hyperkalemia, gout;
• Digestive system: ≥1% - nausea, diarrhea, abdominal pain, dyspeptic symptoms; <1% - toothache, dry mouth, vomiting, anorexia, flatulence, constipation, gastritis, abnormal liver function, hepatitis; very rarely - hyperbilirubinemia, increased activity of liver enzymes;
• Urinary system: <1% - urinary tract infections, urgency to urinate, impaired renal function; sometimes a moderate increase in serum creatinine and urea;
• Respiratory system: ≥1% - swelling of the nasal mucosa, cough, pharyngitis, bronchitis, nasal congestion, dyspnea, infections of the upper respiratory tract;
• Musculoskeletal system: pain in the chest, back and legs, myalgia, cramps; <1% - pain in the shoulder and knee, arthritis, fibromyalgia, arthralgia;
• The reproductive system: <1% - decreased libido, impotence;
• Hematopoietic system: rarely - anemia, Schoenlein – Genoch purpura;
• Sense organs: <1% - conjunctivitis, visual and taste impairment, tinnitus;
• Dermatological reactions: <1% - photosensitivity, erythema, alopecia, increased sweating, dry skin;
• Allergic reactions: <1% - skin rash, itching, urticaria, angioedema (including swelling of the face, lips and pharynx and / or swelling of the tongue and larynx, causing swelling of the respiratory tract).

In the case of receiving an excessive dose, a pronounced decrease in blood pressure and tachycardia are possible. In some cases, bradycardia may develop (as a result of parasympathetic stimulation). Treatment involves conducting forced diuresis and symptomatic therapy. Hemodialysis is ineffective.

special instructions

In patients with cirrhosis of the liver, mild and moderate, the concentration of losartan and its active metabolite in the blood plasma is higher than in healthy patients, so they are recommended to prescribe the drug in lower doses.

Since patients with reduced BCC (for example, as a result of taking diuretics in high doses) have a risk of developing symptomatic arterial hypotension, it is necessary to eliminate the disorders before starting Loristoy or start treatment with low doses.

Patients with impaired renal function often develop hyperkalemia. Although treatment is therefore rarely stopped, these data should be kept in mind. The entire period of treatment is recommended to regularly monitor the concentration of potassium in the blood, especially in the elderly.

Drugs that affect the renin-angiotensin system may contribute to an increase in serum creatinine and urea in patients with renal artery stenosis. Changes in kidney function may be reversible after stopping Loristy. During treatment, it should be periodically - at regular intervals - to monitor the concentration of creatinine in the serum.

Data on the effect of losartan on the rate of psychophysical activity and the ability to concentrate are not available.

Drug interaction

With the simultaneous use of ketoconazole, erythromycin, cimetidine, phenobarbital, digoxin, hydrochlorothiazide, indirect anticoagulants, no clinically significant interaction was noted.

In the combined use of Loristy with fluconazole and rifampicin, a decrease in the concentration of the active metabolite of losartan potassium was noted, however, the clinical consequences of this phenomenon have not yet been established.

In the case of the simultaneous use of nonsteroidal anti-inflammatory drugs (including selective COX-2 inhibitors), the effectiveness of diuretics and other antihypertensive drugs may decrease.

Concurrently taken potassium-sparing diuretics and potassium preparations increase the risk of hyperkalemia.

When combined with other antihypertensive drugs (beta-blockers, diuretics, sympatholytics), mutual reinforcement of action is noted.

In the case of taking Loristy in combination with thiazide diuretics, a decrease in blood pressure is approximately additive.

Terms and conditions of storage

Keep out of reach of children, protected from moisture at a temperature not exceeding 30 ° C.

Shelf life - 5 years.