Acusan Plus 50 - Tablet Hydrochlorothiazide + Losartan Potassium - 12.5mg+50mg 10 Tablet(s) / Strip Concord Pharmaceuticals Ltd. Introduction: Acusan Plus 50 is a combination of two medicines. It helps to control high blood pressure in different ways. If high blood pressure is not treated it can lead to heart attacks, strokes and kidney failure. You can take Acusan Plus 50 with or without food. The dose will depend on your condition and how your respond to the medicine. Try to take it at the same time each day. It is important to keep taking this medicine until your doctor tells you not to. It contains a diuretic (water pill) and will make you urinate more so, it is... Uses of Acusan Plus 50: Hypertension (high blood pressure) Side effects of Acusan Plus 50: NauseaTaste changeUpset stomachDiarrheaHeadacheDizzinessWeaknessDecreased blood pressureIncreased blood uric acidIncreased blood lipid levelGlucose intoleranceElectrolyte imbalance How to use Acusan Plus 50: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Acusan Plus 50 may be taken with or without food, but it is better to take it at a fixed time. How Acusan Plus 50 works: Acusan Plus 50 is a combination of two medicines: Losartan and Hydrochlorothiazide, which lowers the blood pressure effectively. Losartan is an angiotensin receptor blocker (ARB). It works by blocking the hormone angiotensin thereby relaxing blood vessels. This allows the blood to flow more smoothly and the heart to pump more efficiently. Hydrochlorothiazide is a diuretic that removes extra water and certain electrolytes from the body. Over time it also relaxes blood vessels and improves blood flow. Indication: Hypertension, Stroke, risk reduction of hypertensive or LVH patients Adult Dose: Hypertension Initial: 50 mg/12.5 mg PO qDay If dose titrated upward, do not to exceed final titration of 100 mg/25 mg PO qDay or 50 mg/12.5 mg PO q12hr Decrease losartan to 25 mg PO qDay initially if volume depleted Child Dose: Safety and efficacy not established Renal Dose: Renal impairment CrCl 30 mL/min: No dosage adjustment required Contraindication: Pregnancy, lactation; intravascular volume depletion. Mode of Action: Hydrochlorothiazide increases renal excretion of sodium and chloride and reduces cardiac load. Losartan is an angiotensin II receptor (type AT1) antagonist antihypertensive which acts by blocking the actions of angiotensin II of renin-angiotensin-aldosterone system. The drug and its active metabolite selectively block the vasoconstrictor and aldosterone secreting effects of angiotensin II. The two drugs exert additive effects in hypertension. Precaution: Existing electrolyte disturbances; hepatic cirrhosis; severe hepatic failure; oedema; elderly (>75 yr); renal impairment; hepatic impairment; diabetes, gout, hyperlipidaemia; hyperuricaemia; ECG: LVH and/or ventricular ectopics extrasystoles); volume depleted patients; patients on diuretics and salt restriction; renal artery stenosis; aortic and mitral stenosis. Monitor potassium concentration. Discontinue before performing tests for parathyroid function. Lactation: Discontinue drug or do not nurse Side Effect: >10% Losartan Fatigue (14%),Hypoglycemia (14%),Chest pain (12%),Cough, incidence higher in previous cough related to ACE therapy (3-11%) 1-10% Losartan Diarrhea (2-10%),URI (8%),Hypotension (7%),Dizziness (4%),Nausea (2%) Hydrochlorothiazide Hypotension,Anorexia,Epigastric distress,Hypokalemia,Phototoxicity,Thrombocytopenia Potentially Fatal: Hypersensitivity reactions; hemolytic anaemia; toxic epidermal necrolysis. Interaction: Reduced excretion of lithium; effect of diuretic, natriuretic & other antihypertensive w/ NSAIDs including selective COX-2 inhibitors. Do not co-administer w/ aliskiren in patients w/ diabetes & renal impairment. Losartan: Rifampin & fluconazole. Increased serum potassium w/ K-sparing diuretics (eg spironolactone, triamterene, amiloride), K supplements or salt substitutes containing K. Hydrochlorothiazide: Potentiate orthostatic hypotension w/ alcohol, barbiturates or narcotics. Antidiabetic drugs (oral agents, insulin), other antihypertensive drugs. Impaired absorption w/ cholestyramine & colestipol resins. Intensified electrolyte depletion w/ corticosteroids, ACTH, glycyrrhizin (liquorice). Possible decreased response to pressor amines (eg adrenaline); increased response to nondepolarizing skeletal muscle relaxants (eg tubocurarine). May...