losartan and hydrochlorothiazide, Hyzaar (cont.)

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Medical and Pharmacy Editor:

Blood sugar levels can be elevated by HCTZ, necessitating adjustment in the doses of medications that are used for treating diabetes.

Combining HCTZ with corticosteroids may increase the risk for low levels of blood potassium and other electrolytes. Low blood potassium (hypokalemia) can increase the toxicity of digoxin (Lanoxin). Cholestyramine (Questran, Questran Light) and colestipol (Colestid) bind to hydrochlorothiazide and reduce its absorption from the gastrointestinal tract by 43%-85%.

PREGNANCY: When used in the second or third trimester of pregnancy ACE inhibitors and ARBs can cause injury and even death to the fetus. Hyzaar should not be used during pregnancy.

NURSING MOTHERS: It is not known whether losartan is excreted in breast milk , but losartan and its active metabolite are excreted in rat milk. Due to the possibility of harm to the nursing infant, if possible, losartan should be discontinued by women who are breastfeeding. HCTZ is excreted in breast milk.

SIDE EFFECTS: Common side effects include nausea, vomiting, back pain, stomach upset, dizziness, and upper respiratory infection. Hyzaar may also cause a persistent cough, severe hypotension, changes in electrolyte concentrations, impotence, and angioedema. Hyzaar may reduce kidney function in some patients and should not be used by patients who have bilateral renal artery stenosis (narrowing of both arteries going to the kidneys). Rare cases of rhabdomyolysis (muscle breakdown), hepatitis, ,reduced number of platelets, and pancreatitis have been reported.

Reference: FDA Prescribing Information

Last Editorial Review: 4/25/2012

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