Lopaz plus tablets (12.5, 50 and 100 mg): instructions, price and analogues

width = For the most effective treatment of hypertension, it is recommended to use combination medications.

Lozap plus combines two active components, which have a powerful hypotensive effect without risk development of serious side effects, which distinguishes this drug from other antihypertensive means.

However, despite the high level of safety of the application, the dosage and the regimen should be exclusively by the attending physician or other qualified specialist.

Clinical and pharmacological group

Antihypertensive drug.

Conditions of leave from pharmacies

It is released on prescription.

Price list

How much is Lopaz plus? The average price in pharmacies is at the level of400 rubles.

Form of issue and composition

Medication Lopaz, the indications for the use of which will be described below, has its own dosage form:

Tablets of 12.5 mg of white or cream shade, elongated form, in a membrane in the form of a film.
Tablets of 50 mg of white or cream shade, elongated, in a sheath with a notch for ease of division.

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Tablets of 100 mg of white or cream-colored, elongated, in a shell, with a notch for correction of the dose.

The active ingredient is potassium losartan and additional components that do not have a therapeutic effect. The envelope consists of white sepilafilm, hypromelose, macrogol, MCC and titanium dioxide.

Pharmacological effect

Losartan - a specific antagonist of angiotensin II receptors (subtype AT1) inactivating bradykinin and non-inhibitory enzyme kinase II. Reduces OPSS (total peripheral vascular resistance), the concentration of aldosterone and adrenaline in the blood, blood pressure (blood pressure), pressure in the vessels of the small circle of blood circulation; reduces afterload, has a diuretic act. Prevents the appearance of hypertrophy of the myocardium, improves the tolerance to physical exertion of patients with CHF (chronic heart failure).

Hydrochlorothiazide - thiazide diuretic inhibits the reabsorption of sodium ions, increases the release of bicarbonate, potassium ions and phosphate in the urine. Reduces blood pressure by reducing the BCC (the volume of circulating blood), suppression of pressor influence vasoconstrictor substances, changes in the reactivity of the vascular wall and an increase in the inhibitory effect on ganglia.

Indications for use

What helps? Lopaz plus is recommended for use in the presence of the following diseases:

chronic heart failure (within the framework of complex therapy, with ineffectiveness or intolerance of treatment with inhibitors);
arterial hypertension, - to reduce the risk of heart disease;
diabetic nephropathy, which is accompanied by proteinuria and hypercreatininaemia in diabetics with concomitant arterial hypertension.

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Contraindications

Contraindications for treatment are:

anuria;
pregnancy;
the period of breastfeeding;
age under 18 years (effectiveness and safety not established);
resistant to hypokalemia or hypercalcemia;
severe liver dysfunction;
obturative diseases of the biliary tract;
refractory hyponatremia;
hyperuricemia and / or gout;
severe renal dysfunction (KK≤30 ml / min);
hypersensitivity to any of the components of the drug or to other drugs that are derivatives of sulfonylamide.

With caution appoint patients with bilateral stenosis of the renal arteries or stenosis of the artery of a single kidney, hypovolemic conditions (including diarrhea, vomiting), hyponatremia (an increased risk of developing hypotension in patients on a low-salt or salt-free diet), hypochloraemic alkalosis, hypomagnesemia, connective tissue diseases (including SLE), patients with impaired liver function or with progressive liver disease, diabetes mellitus, bronchial asthma (including in the anamnesis), weighed down by an allergic anamnesis, simultaneously with NSAIDs, incl. inhibitors of COX-2, as well as representatives of Negroid race.

Use in pregnancy and lactation

Information about the admission of Lozapa Plus during pregnancy is not available, but it is known that drugs that affect on the renin-angiotensin system, in the 2nd and 3rd trimester of pregnancy can provoke developmental defects and even death the fetus.

For this reason, taking the drug is recommended to stop immediately when pregnancy occurs.

If breastfeeding should be abandoned or discontinued treatment.

Dosage and route of administration

The instructions for use indicate that Lopaz plus is taken internally, regardless of food intake.

At an elevated pressure (arterial hypertension) the usual initial and maintenance dose is 1 tab. / Day. If, when using the drug in this dose, it is not possible to achieve adequate control of blood pressure, the dose of Lozap Plus can be increased to 2 tab. 1 time / day.
The maximum dose is 2 tablets. 1 time / day. In general, the maximum hypotensive effect is achieved within 3 weeks after the start of treatment.
There is no need for a special selection of the initial dose in elderly patients.

In order to reduce the risk of developing cardiovascular diseases and mortality in patients with arterial hypertension and hypertrophy of the left ventricle appoint losartan (Lozap) in a standard initial dose of 50 mg / day. Patients who failed to achieve the target level of blood pressure on the background of losartan in a dose of 50 mg / day, a selection is required therapy by a combination of losartan with hydrochlorothiazide at a low dose (12.5 mg), which is ensured by the appointment of the drug Lozap A plus.

If necessary, the dose of Lozap Plus can be increased to 2 tab. (100 mg of losartan and 25 mg of hydrochlorothiazide) 1 time / day.

Side effects

Controlled clinical trials of the treatment of essential hypertension with losartan and hydrochlorothiazide in combinations showed the development of a single adverse reaction with a frequency of 1% or more in comparison with placebo - dizziness. Other side effects reported during joint therapy with losartan and hydrochlorothiazide on the part of systems and organs:

liver and biliary tract: rarely - hepatitis;
nervous system: with an uncertain frequency - dysgeusia;
vessels: with indeterminate frequency - orthostatic effect, dose-dependent;
skin and subcutaneous tissues: with an uncertain frequency - cutaneous form of systemic lupus erythematosus;
instrumental and laboratory studies: rarely - increased activity of hepatic transaminases, hyperkalemia.

Also, the use of Lozap plus can cause side reactions, characteristic of each of the active components of the drug alone.

Side effects associated with the use of hydrochlorothiazide:

organ of vision: infrequently xanthopsia, temporary decrease in visual acuity;
gastrointestinal tract: infrequently - nausea / vomiting, constipation, diarrhea, gastritis, spasms, sialadenitis;
cardiovascular system: infrequently - cutaneous vasculitis, necrotizing vasculitis;
skin and subcutaneous tissues: infrequently - hives, photosensitivity, toxic epidermal necrolysis;
liver and biliary tract: infrequently - pancreatitis, cholecystitis, cholestatic jaundice;
respiratory system, chest and mediastinal organs: infrequently - respiratory distress syndrome (RDS), including non-cardiogenic pulmonary edema and pneumonitis;
blood and lymphatic system: infrequently - hemolytic anemia, aplastic anemia, leukopenia, thrombocytopenia, purpura, agranulocytosis;
metabolism: infrequently - hypokalemia, hyperuricemia, hyponatremia, hyperglycemia, anorexia;
immune system: rarely - anaphylactic reactions up to shock;
nervous system: often - headache;
psyche: infrequently - insomnia;
kidney and urinary tract: infrequent - renal failure, interstitial nephritis, glycosuria;
skeletal-muscular system and connective tissue: infrequently - muscle cramps;
general disorders: infrequent - dizziness, fever.

Side effects associated with the use of losartan:

the immune system: rarely - the emergence of hypersensitivity, including anaphylactic reactions, angioedema, edema of the glottis and larynx with the onset of airway obstruction, edema of the face, pharynx, tongue, lips;
genital organs and mammary gland: infrequently - erectile dysfunction, decreased libido;
organ of vision: infrequent - a burning sensation in the eyes, decreased visual acuity, conjunctivitis, blurred vision;
the organ of hearing and labyrinthine disturbances: infrequently - vertigo, ringing in the ears;
skin and subcutaneous tissues: infrequently - dermatitis, hyperemia, rash, itching, sweating, photosensitivity, dry skin, alopecia;
liver and biliary tract: with an uncertain frequency - liver failure;
general disorders: often - chest pain, asthenia, fatigue; infrequently - fever, swelling of the face; with an uncertain frequency - weakness, flu-like symptoms;
gastrointestinal tract: often - diarrhea, nausea, dyspepsia, abdominal pain; infrequently - vomiting, gastritis, dry mouth, constipation, flatulence, toothache;
metabolism: infrequently - gout, anorexia;
musculoskeletal system and connective tissue: often - pain in the back, legs, sciatica, muscle cramps; infrequently - pain in the muscles and bones, swelling of the joints, muscle weakness, fibromyalgia, arthritis, arthralgia, joint stiffness; with an uncertain frequency - rhabdomyolysis;
psyche: often - insomnia; infrequently - memory impairment, depression, confusion, sleep disturbance, unusual dreams, drowsiness, panic attacks, anxiety, anxiety;
respiratory system, chest and mediastinal organs: often - sinusitis, nasal congestion, infection upper respiratory tract, cough; infrequently - rhinitis, nosebleeds, bronchitis, dyspnoea, laryngitis, pharyngitis;
blood and lymphatic system: infrequently - hemolysis, anemia, ecchymosis, Shenlaine-Henoch disease; with an uncertain frequency - thrombocytopenia;
nervous system: often - dizziness, headache; infrequently - paresthesia, increased excitability, syncopal conditions, migraine, tremor, peripheral neuropathy;
cardiovascular system: infrequently - vasculitis, atrioventricular blockade of degree II, angina pectoris, pain in the sternum, orthostatic hypotension, decreased blood pressure, arrhythmias (tachycardia, sinus bradycardia, ventricular tachycardia, atrial fibrillation, ventricular fibrillation), palpitation, heart attack myocardium;
kidney and urinary tract: often - impaired renal function; infrequently - infectious diseases of the urinary tract, imperative calls for urination, nocturia;
laboratory and instrumental studies: often - hyperkalemia, insignificant decrease in hemoglobin and hematocrit; infrequently - slight increase the content of creatinine and urea in blood plasma; very rarely - increased activity of bilirubin and hepatic transaminases; with an uncertain frequency - hyponatremia.

Overdose

When an overdose of the drug Lozap plus, the following symptoms are observed: conditioned by the content of losartan - bradycardia, tachycardia, reduction of blood pressure; the content of hydrochlorothiazide - the loss of electrolytes and dehydration.

Treatment of an overdose is symptomatic. It is necessary to stop taking the drug, rinse the stomach and carry out activities aimed at restoring the water-electrolyte balance. With excessive reduction in blood pressure, supportive infusion therapy is indicated. Hemodialysis for the removal of losartan is not effective. The degree of removal of hydrochlorothiazide by hemodialysis is not established.

special instructions

Patients with cases of angioedema development in the past should be treated with caution and under strict medical supervision.

With cirrhosis of the liver or moderate violations of the function of the body, drug treatment should be administered under the supervision of specialists, since it is possible an increase in the concentration of active components of the drug in the blood plasma, which increases the likelihood of overdose and serious adverse effects.

Lopaz and Lopaz Plus can cause dizziness, drowsiness and fainting, which negatively affects the ability to control mechanisms, so against the background of the use of these drugs it is recommended to abandon any activities that require high concentration and speed reactions.

Drug Interactions

The drug has the property of enhancing the action of other antihypertensive medications. There is also an increase in the effect of nondepolarizing muscle relaxants. Simultaneous use of NSAIDs can provoke a weakening of the action of hydrochlorothiazide. The use of Lozap plus with lithium drugs increases the risk of intoxication. Kolestyramin helps reduce the absorption of hydrochlorothiazide.

With simultaneous use of Lozap plus and hypoglycemic medications, dosage adjustment is required.

Reviews

We picked up some reviews of people taking the drug Lopaz plus:

Olga. I drank only one pill Lozap + (a doctor appointed). Every five minutes she began to run to the toilet, and in about 20 minutes my back ached (apparently not my back, but my kidneys). I could not even turn in bed in pain. It's past by morning. I did not drink any more. But from simple Lozap nothing hurts.
Valentina. For the fourth year I have been taking drugs that reduce blood pressure. First, Enap took, but from him there was a strong cough. The doctor advised Lozap. I helped you well. The pressure became 120/70. But recently I began to drink Lozap + and the pressure sharply went up. Today it jumped to 180/110. I had to drink a second pill, but already Lozap. The pressure after an hour is 135/87. Was it anyone's aggravation from Lozap +? From what it can be?
Elena. At me arterial pressure rises extremely seldom, more often, when strongly I perenervnichaju. Once jumped to 170 per 100, I even had to call a doctor (I do not like to engage in self-medication). The doctor advised "Lopaz plus to normalize my blood pressure, only half of the tablet was enough, and the pressure dropped quite quickly. Now in my supplies of medicines there are always tablets "Lopaz plus".
Tatyana. Saw a lot of everything from constantly increased pressure, in my 26 years it is always 140-150... That only I was not discharged. have written out Lozap, has started to drink... And all has become covered by a terrible eruption, blisters and it is direct what what pustules. The husband has forbidden to drink, after I before a dream if 20 minutes was scratched, did not fall asleep. I stopped drinking them and everything went away. That now I do not know.

Reviews of doctors about Lozap plus differ. So, doctors consider preparations good and, accordingly, positively about them respond only with reference to cases of not serious hypertonic illness. That is, if a person has not severe hypertension, then Lopaz or Lopaz plus is effective and can be successfully used for long-term therapy.

If the hypertensive disease is severe and is combined with heart disease, then the effectiveness of Lozap is very low. The action of the drug is sufficient only for 5 to 8 hours, as a result of which people have to take additional, more powerful medicines. Accordingly, in such situations it is irrational to take Lozap, because you need to immediately focus on other more powerful antihypertensives, for example, beta-blockers.