"Lorista" (pills): instruction manual, reviews, analogues
The pharmaceutical market is rich in drugs to reduce blood pressure. Among them there are antagonists of the angiotensin enzyme receptors.
Variety of the drug
The drug "Lorist" is available in severalvarieties: in the form of a one-component preparation "Lorista", combined forms of "Lorist N" and "Lorist ND", which differ in the dosage of active substances. Two-component forms of the drug have antihypertensive effect and have a diuretic effect.
"Lorist" tablets of a single-component preparationare available in three dosages with the active substance content of losartan potassium at 12.5 mg, 25 mg, 50 mg. As auxiliary components, corn and pregelatinized starch, microcrystalline cellulose, a mixture of lactose with cellulose, aerosil, magnesium stearate are used. The film sheath of dosages of 25 mg or 50 mg of potassium losartan consists of hypromellose, talc, propylene glycol, titanium dioxide, and a further yellow quinoline dye is used for a dose of 12.5 mg.
Tablets of preparations "Lorista N" and "Lorista ND"consist of a core and a shell. The core contains two active components: potassium losartan 50 mg (for H form) and 100 mg (for ND forms) and hydrochlorothiazide at 12.5 mg (for "H" form) and 25 mg (for "ND" form). To form the core, additional components are used in the form of pregelatinized starch, microcrystalline cellulose, milk sugar, magnesium stearate.
The tablets "Lorista N" and "Lorista ND" are covered with a film membrane consisting of hypromellose, macrogol 4000, quinoline yellow dye, titanium dioxide and talc.
How the drug works
Combined antihypertensive drug (drug "Lorista") instruction describes the pharmacological action of each active component.
One of the active substances is losartan, acting as a selective antagonist of the enzyme type 2 angiotensin on the receptors of the non-protein structure.
Studies conducted in vitro and onanimal organisms, found that the action of losartan and its carboxyl metabolite is aimed at blocking the effects of angiotensin on angiotensin type 1 receptors. This activates renin in the blood plasma and causes a decrease in the concentration of aldosterone in the blood serum.
Causing an increase in the content of angiotensin type 2, losartan activates the receptors of this enzyme, while at the same time does not change the work of the enzyme kininase type 2, involved in the exchange of bradykinin.
The action of the active component of the drug "Lorista"is aimed at reducing the overall peripheral resistance of the vascular bed, pressure in the vessels of the small circle of blood circulation, postnagruzka, to provide a diuretic effect.
Losartan does not allow the development of a pathological increase in the heart muscle, it increases the resistance to the physical work of the human body, which has chronic heart failure.
Daily use of a single dose of losartancauses a steady decrease in upper (systolic) and lower (diastolic) blood pressure. During the day, under the action of this substance, the blood pressure is uniformly controlled, and the antihypertensive effect coincides with the natural circadian rhythm. The decrease in pressure at the time of completion of dosage of losartan occurs by 80% compared with the peak activity of the active component. With medication, there is no effect on the heart rate, and when you stop taking it, the symptoms of withdrawal do not develop. The effectiveness of losartan extends to the male and female body of all ages.
As part of a combination of actionhydrochlorothiazide as a thiazide diuretic is associated with impaired absorption of chlorine, sodium, magnesium, potassium and water ions in the primary urine back into the blood plasma of the distal kidney nephron. The substance enhances the retention of calcium ion and uric acid. Hydrochlorothiazide exhibits antihypertensive properties due to the expansion of arterioles. The diuretic effect begins after 60-120 minutes, and the maximum diuretic effect lasts from 6 to 12 hours. The optimal antihypertensive effect of drug treatment occurs after 1 month.
The drug "Lorista" tablets, instructions for use recommends the use of:
- for the treatment of arterial hypertension, in which the combined treatment is indicated;
- to reduce the likelihood of diseases of the cardiovascular system and the number of deaths in hypertension and pathological changes in the left ventricle.
Mode of application
This medicine is for oral administration.application. Eating does not affect the action of the drug. Tablets of pressure "Lorista" may be combined with antihypertensive drugs. Eating does not affect the action of the drug.
On the drug "Lorista" (pills) instructions forapplication has recommendations for dosing single-component forms, "H" and "ND" combinations. For all varieties of the drug, the initial and maintenance dose at elevated pressure is 1 tablet 1 time per day. The maximum effect of reducing pressure is observed after 3 weeks from the start of treatment. In order to achieve a significant effect, it is allowed to increase the daily dose of Lorista N to 2 tablets per dose. Per day, the maximum allowable number of tablets with a dosage of 50 / 12.5 mg is 2 pieces.
If adequate therapeutic effect from takingthe drug "Lorista N" is missing, then prescribe the drug "Lorista ND" tablets. Instructions for this tool include information on the maximum amount of a higher dosage (100/25 mg) per day, which is no more than 1 tablet.
By reducing the amount of blood circulating throughvessels, during treatment with high doses of diuretics, the initial daily dose of losartan is used 25 mg at a time. Therefore, therapy with such antihypertensive drugs is possible only after the exclusion of diuretics and the normalization of blood volume.
On the drug "Lorista" (pills) instruction is notcontains information on the need to adjust the dose for elderly patients and for people undergoing hemodialysis, or for those with renal insufficiency with creatinine clearance from 30 to 50 ml per minute.
To reduce the likelihood of diseasecardiovascular system and the number of deaths in patients with arterial hypertension and pathological changes in the left ventricle, a standard initial dose of losartan per day is prescribed at 50 mg per dose. If blood pressure reduction results were not achieved at the initial dosage, it is necessary to increase up to 100 mg of losartan, which is possible when using 2 tablets of Lorista N or 1 tablet of Lorista ND per day at a time.
Some Patients are possible manifestations of unwantedeffects of treatment with this antihypertensive drug. When using the drug "Lorista" (tablets), instructions for use include a list of side effects associated with various systems of the body.
The effect on the central nervous system is manifested by headache, systemic and non-systemic vertigo, insomnia, fatigue, migraine.
When affecting the cardiovascular system, the drug causes orthostatic dose-dependent hypotension, palpitations, tachycardia, vascular inflammation.
The effect on the respiratory system is manifested by coughing, an infection in the upper respiratory tract, pharyngitis, and swelling of the nasopharyngeal mucosa.
The digestive system fails in the form of diarrhea, dyspepsia, nausea, vomiting, abdominal pain, hepatitis, and abnormal liver function when liver enzymes and bilirubin are altered.
On the musculoskeletal system, the effect is manifested by myalgia, back pain, arthralgia.
The influence on the blood-forming organs is manifested by anemia and purpura.
Laboratory parameters are also characterized, which are characterized by hyperkalemia, an increase in the level of hemoglobin, creatinine, hematocrit, and urea in blood plasma.
The action may be accompanied by allergicreactions, manifested by urticaria, skin itch, anaphylactic shock, angioedema of the face, neck, upper torso and peripheral organs.
Not everyone can be treated with Lorista. Instructions for use does not recommend the use of this tool for anuria, a marked violation of the kidneys, when creatinine clearance is less than 30 ml per minute.
Hyperkalemia is contraindicated,refractory hypokalemia, water imbalance in the body during therapy with high doses of diuretics, severe liver function, increased pressure, deficiency of the enzyme lactase, glucose intolerance and galactose, pregnancy, breastfeeding, children and adolescents under 18 years of age.
Treatment with Lorista (tablets)the instruction prohibits in case of hypersensitivity to compounds of the sulfonamide series, to the substance losartan, hydrochlorothiazide, or auxiliary components of the drug.
Care is required when usingpatients with impaired water and electrolyte balance in the blood, when there are signs of hypochloraemic alkalosis, low content of sodium, potassium, magnesium ions and high concentrations of calcium ions in the human body.
Bilateral narrowing of the kidney arteries or narrowinglumen of an artery to a single kidney, diabetes mellitus, elevated levels of uric acid in blood plasma, deposition of urates in the joints, the presence in the past of allergic reactions to drugs that inhibit angiotensin-converting enzymes, bronchial asthma, systemic blood diseases serve as a reason for the careful use of antihypertensive medication.
During treatment with Lorista (tablets)instructions for use allows you to additionally take other antihypertensive drugs. For older people do not require special selection of the initial dosage.
The drug's actions can lead to an increase in serum creatinine and urea concentrations in patients who have bilateral renal artery stenosis or single kidney artery stenosis.
Under the influence of hydrochlorothiazide increasesarterial hypotension, electrolyte balance is disturbed, which is characterized by a decrease in circulating blood volume, hyponatremia, hypochloremic alkalosis, hypomagnemia, hypokalemia. The effect of the diuretic is aimed at increasing the concentration of cholesterol and triglycerides, changing the body's tolerance to glucose molecules, reducing the excretion of calcium ions in the urine, which leads to their increase in blood serum. Hydrochlorothiazide can cause hyperuricemia and gout.
The composition of the combined drug containsmilk sugar, which is contraindicated in patients suffering from a lack of the enzyme lactase, having galactosemia or glucose intolerance and galactose syndrome.
In the initial stages of treatment of hypotensivemeans may reduce pressure and dizziness, which violates the psychophysical activity of the body. Therefore, patients whose work is associated with increased attention in the management of road transport or complex mechanisms should determine their condition before taking up their duties.
AO "KRKA, ddNovo mesto is a manufacturer of the antihypertensive drug Lorista (tablets). The analogs of this product contain the active ingredient losartan potassium. For combination forms, similar medicines contain two active ingredients: losartan potassium and hydrochlorothiazide.
For the drug "Lorista" analogue will havethe same antihypertensive effect and similar side effects. One of such remedies is the drug “Cozaar”, tablets of 50 or 100 mg of losertanum potassium. The producer is the campaign “Merck Sharp and Dome B.V.”, the Netherlands.
For combined forms, the analog isGizaar and Gizaar Forte. The manufacturer is Merck Sharp and Dome B.V., the Netherlands. Smaller dosage tablets are coated with a yellow shell, oval in shape, marked “717” on one of the surfaces and risky to divide on the other side, and higher dosage oval tablets are coated with a white film cover labeled “745” on one side.
The composition of the drug "Gizaar Forte" includespotassium losartan in the amount of 100 mg and hydrochlorothiazide, which contains 12.5 mg. The composition of the drug "Gizaar" includes losartan potassium in the amount of 50 mg and hydrochlorothiazide, which contains 12.5 mg.
In contrast to the drug "Lorista ND", the drug"Gizaar Forte" contains half the amount of hydrochlorothiazide, and the content of potassium losertan is the same. Both drugs have antihypertensive effects with a small diuretic effect.
Another combined analog isdrug "Lozap plus" production "Zentiva AS", Czech Republic. Available in the form of oblong tablets with a risk on both surfaces, covered with a light yellow film. The medication contains losartan potassium in the amount of 50 mg and hydrochlorothiazide, which contains 12.5 mg.
A similar drug for "Lorista H" ismedicine "Vazotenz N", produced by Actavis Group as, Iceland. Available in two dosages. The lower dose tablets contain 50 mg of losartan potassium and 12.5 mg of hydrochlorothiazide, while the higher dosage tablets contain 100 mg of losartan potassium and 25 mg of hydrochlorothiazide.
The drug "Lorista" gets a variety of reviews. Some patients report improvement in the initial stages of treatment, when a decrease in blood pressure was observed. Others note an increase in blood pressure in the evening or a surge of emotionality. In this case, you have to cancel treatment with Lorista (pills). Instructions patient reviews are combined in the “Side Effects” section, which lists all possible adverse events that were recorded when using this antihypertensive drug.
The drug "Lorista" take every dayusing the minimum dosage, which over time increases due to habituation of the body to the active substance. The effect of treatment does not appear immediately, but as the drug accumulates in the body.