📋 Indications & Clinical Dosage
*Hypertension not adequately controlled with losartan alone:*
Adults: Initially 1 tab daily, increased to max 100 mg losartan daily if necessary.
CHILDREN: Not recommended.
⛔ Contraindications
Hepatic impairment, anuria, moderate to severe renal impairment, dialysis, intravascular volume depletion.
⚠️ Precautions & Warnings
Hepatic impairment, renal impairment, intravascular volume depletion, renal artery stenosis, obstructive valvular disease, aortic stenosis, outflow obstruction, cardiomyopathy, SLE, gout, obstructive valvular disease. Monitor serum electrolytes
🔄 Drug Interactions
Barbiturates, narcotics, antidiabetic agents, cholestyramine, colestipol, corticosteroids, ACTH, adrenaline, muscle relaxants, lithium, NSAIDs, K+-sparing diuretics, rifampicin, fluconazole.
⚠️ Adverse Reactions / Side Effects
Hyperkalaemia, angioedema, symptomatic hypotension including dizziness particularly in patients with intravascular volume depletion, e.g. those taking high-dose diuretics,, arthralgia, rhinitis, flatulence, orthostatic effects, diarrhoea, liver function abnormalities, myalgia,
hypertriglyceridaemia, migraine, urticaria, pruritus, rash. Rare: Anaphylactic reactions, angioedema, vasculitis, hepatitis, cough, anaemia
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Contraindicated in pregnancy.
Lactation / Breastfeeding:
Not recommended.
📚 Official Regulatory & Clinical References
- Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
- World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
- Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.