Vasotenz N
Vazotenz N: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. H, Method of administration and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. For violations of liver function
- 13. Use in the elderly
- 14. Drug interactions
- 15. Analogs
- 16. Terms and conditions of storage
- 17. Terms of dispensing from pharmacies
- 18. Reviews
- 19. Price H in pharmacies
Latin name: Vasotenz H
ATX code: C09DA01
Active ingredient: losartan (Losartan) + hydrochlorothiazide (Hydrochlorothiazide)
Manufacturer: Actavis hf. (Iceland); Actavis, Ltd. (Malta)
Description and photo update: 2019-11-07
Prices in pharmacies: from 229 rubles.
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Vasotens N is a combined antihypertensive agent.
Release form and composition
Dosage form - film-coated tablets: round, biconvex, with lateral risks and a risk on both sides of the tablet, on one side of the risk there is a marking "LH", on the other - "1" (dosage 50 mg + 12.5 mg) or "2" (dosage 100 mg + 25 mg) (in a blister 7, 10 or 14 pcs., in a cardboard box 2 or 4 blisters of 7 tablets, or 1, 3, 9 or 10 blisters of 10 tablets, or 1 or 2 blisters of 14 tablets and instructions for the use of Vazotenza N).
Composition of 1 tablet:
- active ingredients: losartan potassium - 50 or 100 mg, hydrochlorothiazide - 12.5 or 25 mg, respectively;
- excipients: sodium croscarmellose, microcrystalline cellulose, mannitol, magnesium stearate, povidone, Opadrai white (hypromellose 50cP, hypromellose 3cP, titanium dioxide, macrogol, hydroxypropylcellulose).
Pharmacological properties
Pharmacodynamics
Vasotens N is a combined antihypertensive agent.
Properties of active ingredients:
- Losartan is a specific angiotensin II receptor antagonist (AT1 subtype). Reduces blood pressure (BP), total peripheral vascular resistance (OPSS), pressure in the pulmonary circulation, the concentration of adrenaline and aldosterone in the blood, reduces afterload, has a diuretic effect. In patients with chronic heart failure, it prevents the development of myocardial hypertrophy and increases exercise tolerance. Does not inhibit kinase II, an enzyme that degrades bradykinin;
- hydrochlorothiazide is a thiazide diuretic. Reduces the reabsorption of sodium ions, increases the urinary excretion of bicarbonate, phosphates and potassium ions.
Thus, Vasotens N reduces the volume of circulating blood, changes the reactivity of the vascular wall, enhances the depressive effect on the ganglia, reduces the pressor effect of vasoconstrictor substances, thereby lowering blood pressure.
Pharmacokinetics
After oral administration, Losartan is rapidly absorbed in the gastrointestinal tract (GIT). It is characterized by low bioavailability, amounting to ~ 33%. Has the effect of the first passage through the liver. It is metabolized by carboxylation, resulting in the formation of inactive metabolites and the main pharmacologically active metabolite (E-3174). About 99% of the dose binds to plasma proteins. After taking Vazotenza N inside, the maximum concentration of losartan is reached within 1 hour, the active metabolite is 3-4 hours. The half-life (T ½) of losartan is 1.5-2 hours, E-3174 is 3-4 hours. It is excreted through the intestines. - 60% of the dose, kidneys - 35%.
Hydrochlorothiazide after oral administration is rapidly absorbed in the gastrointestinal tract. It is not metabolized in the liver. T ½ - 5.8-14.8 hours. Most (~ 61%) is excreted unchanged in the urine.
Indications for use
- arterial hypertension - to reduce high blood pressure in cases where the appointment of combination therapy is optimal;
- arterial hypertension and left ventricular hypertrophy - to reduce the risk of developing cardiovascular diseases.
Contraindications
Absolute:
- severe arterial hypotension;
- severe renal dysfunction [CC (creatinine clearance) ≤ 30 ml / min];
- severe liver dysfunction;
- hypovolemia (including against the background of high doses of diuretics);
- anuria;
- age up to 18 years;
- period of pregnancy and lactation;
- hypersensitivity to losartan, hydrochlorothiazide, other sulfonamide derivatives or any auxiliary component of the drug.
Relative (Vasotens N should be used with caution):
- violations of the water and electrolyte balance of the blood (dehydration, hypochloremic alkalosis, hyponatremia, hypokalemia, hypomagnesemia);
- bilateral stenosis of the renal arteries or stenosis of an artery of a solitary kidney;
- hypercalcemia, hyperuricemia, and / or gout;
- diabetes;
- systemic connective tissue diseases (including systemic lupus erythematosus);
- burdened allergic history;
- bronchial asthma;
- simultaneous use of non-steroidal anti-inflammatory drugs (NSAIDs), including inhibitors of COX-2 (cyclooxygenase-2).
Vasotenz N, instructions for use: method and dosage
The drug can be used as monotherapy or in combination with other antihypertensive drugs. It is prescribed in cases when losartan or hydrochlorothiazide with monotherapy failed to achieve target blood pressure values. Initially, it is recommended to titrate the doses of active ingredients separately, and then start taking Vazotenza N.
Vazotenz N tablets are taken orally with plenty of water (200–250 ml). Meal time does not matter.
In most cases, 1 tablet is prescribed containing 50 mg of losartan and 12.5 mg of hydrochlorothiazide, once a day. If the severity of the effect is not enough, it is possible to increase the daily dose to 100 mg of losartan and 25 mg of hydrochlorothiazide (2 tablets of Vazotens N 50 mg + 12.5 mg or 1 tablet of Vazotens N 100 mg + 25 mg). Further increase in the dose is inappropriate.
The maximum hypotensive effect usually develops within 3-4 weeks of regular use of the drug.
With a reduced volume of circulating blood (for example, due to taking high doses of diuretics), the initial recommended daily dose of losartan is 25 mg. Vasotens N can be prescribed only after discontinuation of diuretics and correction of hypovolemia.
To reduce the risk of cardiovascular disease and mortality, the recommended dose of losartan for patients with arterial hypertension and left ventricular hypertrophy is 50 mg once a day. If this dose does not allow reaching the target blood pressure values, hydrochlorothiazide is added to the therapy at a low dose (12.5 mg). The two drugs can be replaced with Vazotenz N 50 mg + 12.5 mg. If necessary, further increase the dose of losartan to 100 mg, and hydrochlorothiazide to 25 mg (1 tablet of Vazotens N 100 mg + 25 mg or 2 tablets of 50 mg + 12.5 mg) once a day.
Side effects
When using Vasotenza N, side effects may occur that are observed when taking losartan potassium and / or hydrochlorothiazide.
Possible adverse reactions:
- on the part of the cardiovascular system: a pronounced decrease in blood pressure;
- from the digestive tract: rarely (1%; due to losartan in the composition of the drug) - diarrhea, hepatitis;
- from the respiratory system: cough (due to the action of losartan);
- skin and allergic reactions: urticaria, angioedema (including swelling of the lips, pharynx, larynx and / or tongue), which can lead to airway obstruction; extremely rarely (due to the action of losartan) - vasculitis, including Shenlein-Henoch disease;
- laboratory parameters: rarely - hyperkalemia (serum potassium> 5.5 mmol / l), an increase in the activity of liver enzymes.
In essential hypertension, the most common side effect is dizziness.
Overdose
In case of an overdose, losartan can cause the following disorders: a pronounced decrease in blood pressure, bradycardia, tachycardia.
An overdose of hydrochlorothiazide can be manifested by loss of electrolytes (hyperchloremia, hypokalemia, hyponatremia), as well as dehydration, which is a consequence of excessive diuresis.
If a little time has passed since taking Vazotenza N, it is recommended to perform gastric lavage. Symptomatic and supportive treatment is prescribed; correction of water-electrolyte disturbances is required. If necessary, hemodialysis is performed to remove losartan and its active metabolite from the body.
special instructions
Losartan
Before prescribing the drug, it is necessary to correct the reduced BCC. Treatment in this case should start with a lower dose.
During the period of taking losartan, regular monitoring of the level of potassium in the blood is required, especially with impaired renal function and in old age.
Hydrochlorothiazide
During therapy, it is necessary to monitor the patient's condition in order to timely identify clinical signs of a possible violation of the water-electrolyte balance, which may occur against the background of intercurrent diarrhea or vomiting. In such patients, serum electrolyte levels should also be monitored.
Thiazide diuretics can interfere with glucose tolerance, which may require a dose adjustment of the hypoglycemic agent or insulin.
Hydrochlorothiazide can reduce the excretion of calcium in the urine, as well as cause a slight episodic increase in serum calcium levels. If severe hypercalcemia is detected, the presence of latent hyperparathyroidism should be assumed.
Thiazides affect calcium metabolism, therefore, they can distort the results of the study of the function of the parathyroid glands. In this regard, on the eve of the test, the drug must be canceled.
Hydrochlorothiazide can raise blood triglyceride and cholesterol levels.
During therapy, exacerbation or progression of systemic lupus erythematosus is possible.
Hydrochlorothiazide may cause hyperuricemia and / or gout. However, losartan, the second active component of Vazotenza N, reduces uric acid levels, therefore, reduces the severity of diuretic-induced hyperuricemia.
Against the background of diuretic therapy, hypersensitivity reactions may occur, even in patients with no history of bronchial asthma or allergies.
Influence on the ability to drive vehicles and complex mechanisms
Special clinical studies to study the effect of Vasotenza N on human cognitive and psychomotor functions have not been conducted. However, during the period of therapy, dizziness and drowsiness may appear. For this reason, it is recommended to exercise caution when performing work requiring increased attention and speed of reactions, especially at the initial stage of therapy and during the period of increasing the dose of the drug.
Application during pregnancy and lactation
When used in the II and III trimesters of pregnancy, losartan, like other drugs that affect the renin-angiotensin-aldosterone system (RAAS), can cause a developmental defect and even fetal death.
Hydrochlorothiazide crosses the placental barrier, is determined in the blood of the umbilical cord. When used during pregnancy, it increases the risk of developing jaundice in the fetus or newborn, as well as thrombocytopenia and electrolyte imbalance in the mother.
Vazotenz N tablets are contraindicated during pregnancy. If pregnancy is detected during treatment with the drug, it should be canceled as soon as possible.
Thiazide diuretics pass into breast milk. A woman is advised to stop breastfeeding if drug therapy during lactation is clinically justified.
Pediatric use
In patients under 18 years of age, the efficacy and safety of Vasotenza N have not been established.
With impaired renal function
Vasotens N is contraindicated in severe renal impairment (creatinine clearance ≤ 30 ml / min). It should be used with caution in patients with bilateral renal artery stenosis or stenosis of a solitary kidney artery.
For violations of liver function
Vasotenz H is contraindicated in severe liver dysfunction.
Use in the elderly
Tablets Vazotenz N for the elderly are prescribed in the usual doses used to treat adult patients.
Drug interactions
Losartan
Losartan can be used in combination with other antihypertensive drugs (diuretics, sympatholytics, beta-blockers). In this case, a mutual enhancement of the effect is noted.
There are no clinically significant drug interactions with the simultaneous use of hydrochlorothiazide, erythromycin, cimetidine, ketoconazole, phenobarbital, warfarin, digoxin.
In patients with reduced BCC due to previous treatment with large doses of diuretics, the drug can cause a pronounced decrease in blood pressure.
With the joint administration of potassium-sparing diuretics (amiloride, triamterene, spironolactone), potassium-containing salts or potassium preparations, an increase in the level of potassium in the blood serum is possible.
Fluconazole and rifampicin decrease the plasma level of the active metabolite of losartan. The clinical significance of these interactions has not been established.
Losartan is able to increase the blood plasma lithium content. In this regard, lithium preparations can be prescribed only after a careful assessment of the expected benefits and possible risks. When using this combination, the plasma concentration of lithium should be carefully monitored.
The effect of losartan can be reduced by NSAIDs, including selective COX-2 inhibitors. In patients with impaired renal function, in some cases, this combination can contribute to a further deterioration in renal function, up to the development of acute renal failure. This effect is usually reversible.
Hydrochlorothiazide
With the joint administration of drugs, ethanol or barbiturates, the risk of developing orthostatic hypotension increases.
Thiazides are capable of impairing glucose tolerance, which may require a dose adjustment of the hypoglycemic agent or insulin.
An additive effect is observed while taking other antihypertensive drugs.
The absorption of hydrochlorothiazide is reduced by colestipol and colestyramine.
Diuretics decrease the renal clearance of lithium and increase the likelihood of developing its toxic effects. This combination is not recommended.
Hydrochlorothiazide can reduce the severity of the response to the introduction of pressor amines (epinephrine, norepinephrine), but does not exclude the possibility of their use. Able to enhance the effects of non-depolarizing muscle relaxants (for example, tubocurarine).
With the combined use of corticosteroids or adrenocorticotropic hormone, a pronounced decrease in electrolyte levels is possible, which leads to hypokalemia.
NSAIDs can reduce the diuretic, hypotensive and natriuretic effects of hydrochlorothiazide.
Analogs
Analogues of Vazotenza N are: Atakand Plus, Blocktran GT, Valz N, Duopress, Valsartan + Hydrochlorothiazide, Gizaar, Gizaar Forte, Ibertan Plus, Co-Diovan, Coaprovel, Lozarel Plus, Losartan N, Lorista N, Oregon Preszart, Nlusart, Simartan-N, Telpres Plus, Telsartan N, etc.
Terms and conditions of storage
Store at temperatures up to + 30 ° С out of reach of children.
The shelf life is 3 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Vasotense N
There are no reviews on Vazotense N in social networks and on specialized medical forums that would allow evaluating the drug from the point of view of the consumer.
Price for Vazotenz N in pharmacies
The price of Vazotenz N depends on the dosage of the tablets and the pharmacy chain selling the drug. The approximate cost of a package of 30 tablets of 50 mg + 12.5 mg is 202-269 rubles, for 100 mg + 25 mg - 387-474 rubles.
Vazotenz N: prices in online pharmacies
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Drug name Price Pharmacy |
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Vasotenz N 50 mg + 12.5 mg film-coated tablets 30 pcs. 229 r Buy |
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!