Hydrochlorothiazide and losartan

What is the most important information I should know about hydrochlorothiazide and losartan?

Do not use this medication if you are allergic to hydrochlorothiazide or losartan, or if you are unable to urinate.

Do not use this medication without telling your doctor if you are pregnant. Losartan may cause injury and even death to the unborn baby if you take it during the second and third trimesters of pregnancy. Use an effective form of birth control. Stop using this medication and tell your doctor right away if you become pregnant during treatment.

Before using hydrochlorothiazide and losartan, tell your doctor if you have congestive heart failure, kidney or liver disease, asthma, low or high blood levels of potassium, gout, lupus, diabetes, or an allergy to sulfa drugs.

Hydrochlorothiazide and losartan can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Avoid drinking alcohol. It can lower your blood pressure and may increase some of the side effects of hydrochlorothiazide and losartan.

Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

Do not use potassium supplements or salt substitutes while you are taking hydrochlorothiazide and losartan, unless your doctor has told you to.

What is hydrochlorothiazide and losartan?

Hydrochlorothiazide is a thiazide diuretic (water pill) that helps prevent your body from absorbing too much salt, which can cause fluid retention.

Losartan is in a group of drugs called angiotensin II receptor antagonists. Losartan keeps blood vessels from narrowing, which lowers blood pressure improves blood flow.

The combination of hydrochlorothiazide and losartan is used to treat high blood pressure (hypertension) and to reduce the risk of stroke in people with hypertension.

Hydrochlorothiazide and losartan may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking hydrochlorothiazide and losartan?

Do not use this medication if you are allergic to hydrochlorothiazide or losartan, or if you are unable to urinate.

Before using hydrochlorothiazide and losartan, tell your doctor if you have:

• kidney disease;
• liver disease;
• congestive heart failure;
• asthma or allergies;
• low or high levels of potassium in your blood;
• gout;
• lupus;
• diabetes; or
• an allergy to sulfa drugs.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take hydrochlorothiazide and losartan.

FDA pregnancy category D. This medication can cause harm to an unborn baby. Do not use this medication without telling your doctor if you are pregnant. Losartan may cause injury and even death to the unborn baby if you take it during the second and third trimesters of pregnancy. Use an effective form of birth control. Stop using this medication and tell your doctor right away if you become pregnant during treatment.

It is not known whether hydrochlorothiazide and losartan passes into breast milk. Do not take this medication without first talking to your doctor if you are breast-feeding a baby.

How should I take hydrochlorothiazide and losartan?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results from this medication.

Take this medication with a full glass (8 ounces) of water.

To be sure this medication is helping your condition, your blood pressure will need to be checked on a regular basis. Your kidney function may also need to be tested. Do not miss any scheduled appointments.

Hydrochlorothiazide can interfere with the results of a thyroid test. Tell any doctor who treats you that you are using this medication.

If you are being treated for high blood pressure, keep using this medication even if you feel fine. High blood pressure often has no symptoms.

Store hydrochlorothiazide and losartan at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include fast or slow heartbeat, feeling light-headed, or fainting.

What should I avoid while taking hydrochlorothiazide and losartan?

Hydrochlorothiazide and losartan can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Avoid drinking alcohol. It can lower your blood pressure and may increase some of the side effects of hydrochlorothiazide and losartan.

Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

Do not use potassium supplements or salt substitutes while you are taking hydrochlorothiazide and losartan, unless your doctor has told you to.

What are the possible side effects of hydrochlorothiazide and losartan?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using this medication and call your doctor at once if you have a serious side effect such as:

• feeling light-headed, fainting;
• swelling, rapid weight gain;
• fast or pounding heartbeats;
• urinating more or less than usual, or not at all;
• jaundice (yellowing of the skin or eyes); or
• dry mouth, increased thirst, drowsiness, restless feeling, confusion, nausea, vomiting, increased urination, muscle pain or weakness, fast heart rate, feeling light-headed, fainting, or seizure (convulsions).

Less serious side effects may include:

• stomach pain;
• back pain;
• dizziness;
• skin rash;
• runny or stuffy nose, sore throat; or
• dry cough.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

What other drugs will affect hydrochlorothiazide and losartan?

Before taking hydrochlorothiazide and losartan, tell your doctor if you are using any of the following drugs:

• any other blood pressure medications;
• steroids (prednisone and others);
• lithium (Eskalith, Lithobid);
• celecoxib (Celebrex) or valdecoxib (Bextra);
• cholestyramine (Prevalite, Questran) or colestipol (Colestid);
• rifampin (Rifadin, Rimactane, Rifater);
• a barbiturate such as amobarbital (Amytal), butabarbital (Butisol), mephobarbital (Mebaral), secobarbital (Seconal), or phenobarbital (Luminal, Solfoton);
• any other diuretics, such as amiloride (Midamor), bumetanide (Bumex), chlorthalidone (Hygroton, Thalitone), ethacrynic acid (Edecrin), furosemide (Lasix), hydrochlorothiazide (HCTZ, HydroDiuril), indapamide (Lozol), metolazone (Mykrox, Zarxolyn), spironolactone (Aldactone), triamterene (Dyrenium, Maxzide, Dyazide), torsemide (Demadex), and others;
• aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Motrin, Advil), diclofenac (Voltaren), diflunisal (Dolobid), etodolac (Lodine), flurbiprofen (Ansaid), indomethacin (Indocin), ketoprofen (Orudis), ketorolac (Toradol), mefenamic acid (Ponstel), meloxicam (Mobic), nabumetone (Relafen), naproxen (Aleve, Naprosyn), piroxicam (Feldene), and others;
• a muscle relaxer such as baclofen (Lioresal), carisoprodol (Soma), cyclobenzaprine (Flexeril), dantrolene (Dantrium), metaxalone (Skelaxin), or methocarbamol (Robaxin), orphenadrine (Norflex), or tizanidine (Zanaflex);
• a narcotic medication such as hydrocodone (Lortab, Vicodin), hydromorphone (Dilaudid, Palladone), levorphanol (Levo-Dromoran), meperidine (Demerol), methadone (Methadose), morphine (Kadian, MS Contin), oxycodone (OxyContin), oxymorphone (Numorphan), or propoxyphene (Darvon, Darvocet).

This list is not complete and there may be other drugs that can interact with hydrochlorothiazide and losartan. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about hydrochlorothiazide and losartan.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2003 Cerner Multum, Inc. Version: 5.06. Revision date: 11/15/2007.