Amlodipine + Losartan

Indications

Amlodipine + Losartan is used for: Hypertension

Adult Dose

Oral Mild to moderate hypertension Adult: Per tablet contains amlodipine 5 mg and losartan potassium 50 mg: Initial: 1 tablet once daily; may increase to 2 tablets daily if the BP control is inadequate after 1-2 wk.

Child Dose

Renal Dose

Administration

Contra Indications

Known hypersensitivity. Avoid concomitant K supplements. Pregnancy.

Precautions

Impaired hepatic or renal function, CHF, sick-sinus syndrome, severe ventricular dysfunction, hypertrophic cardiomyopathy. Elderly, children. Lactation. Volume-depleted patients; patients on diuretics and salt restriction; renal artery stenosis. Monitor serum K concentration.

Pregnancy-Lactation

Interactions

Amlodipine: Increased metabolism with rifampin. Reduced hypotensive effect with calcium. Potentiates effects of thiazide diuretics and ACE inhibitors. Avoid combination with β-blockers in patients with markedly impaired left ventricular function. Losartan: Concurrent use with NSAIDs may further worsen renal function. Cimetidine may increase the AUC of losartan by about 18%. Phenobarbital and other enzyme inducers may decrease levels of losartan and its active metabolite. Ketoconazole inhibits the conversion of losartan to its active metabolite. Concurrent use with potassium-sparing diuretics or potassium supplements or salt substitutes containing potassium may increase serum potassium levels. Reduces lithium excretion; monitor lithium levels if used together. Potentially Fatal: Increased cyclosporine levels. Risk of lithium toxicity with losartan. Hypotensive effect of losartan potentiated by diuretics and other antihypertensives. Risk of hyperkalaemia increases with concomitant ACE inhibitors, potassium-sparing diuretics and K supplements.

Adverse Effects

Side effects of Amlodipine + Losartan : Headache, dizziness, back pain, myalgia, resp tract disorders, asthenia/fatigue; first-dose hypotension; rash, cough, angioedema; neutropaenial GI disturbances; transient elevation of liver enzymes; taste disturbances and hyperkalaemia. Potentially Fatal: Hypotension, bradycardia, conductive system delay, CCF.

Mechanism of Action

Amlodipine inhibits the movement of Ca ions across the cell membrane into vascular smooth muscles and myocytes. Action is greater in the arterial resistant vessels causing peripheral vasodilatation and reduction in afterload. Losartan is an angiotensin II receptor (type AT1) antagonists 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 by selectively antagonising the binding of angiotensin II to AT1 receptors.