Sarcol H (losartan potassium + hydrochlorothiazide): Uses, Dosage & Side Effects

What it's for (Indications)

This medicine is used in the treatment of hypertension (including essential hypertension) and diabetic nephropathy (kidney disease caused by diabetes) in type II diabetes mellitus.

Dosage Information

Type	Guideline
Standard	Dosing must be individualized based on patient response and tolerability. Combination therapy is generally initiated after a patient has not achieved the desired blood pressure control with monotherapy, to minimize dose-independent side effects. The usual starting dose of losartan is 50 mg once daily. For patients with intravascular volume depletion (e.g., those treated with diuretics) or a history of hepatic impairment, a lower starting dose of losartan 25 mg is recommended. Total daily doses of losartan can range from 25 mg to 100 mg, administered once or twice daily. Hydrochlorothiazide is effective in doses of 12.5 mg to 50 mg once daily, with combination tablets typically containing 12.5 mg to 25 mg of hydrochlorothiazide. If the antihypertensive effect measured at trough with once-daily dosing is inadequate, a twice-daily regimen at the same total daily dose or an increase in dose may be considered. If a dose is missed, take it as soon as remembered. Do not take two doses at the same time to compensate for a missed dose.

Type

Guideline

Standard

Dosing must be individualized based on patient response and tolerability. Combination therapy is generally initiated after a patient has not achieved the desired blood pressure control with monotherapy, to minimize dose-independent side effects. The usual starting dose of losartan is 50 mg once daily. For patients with intravascular volume depletion (e.g., those treated with diuretics) or a history of hepatic impairment, a lower starting dose of losartan 25 mg is recommended. Total daily doses of losartan can range from 25 mg to 100 mg, administered once or twice daily. Hydrochlorothiazide is effective in doses of 12.5 mg to 50 mg once daily, with combination tablets typically containing 12.5 mg to 25 mg of hydrochlorothiazide. If the antihypertensive effect measured at trough with once-daily dosing is inadequate, a twice-daily regimen at the same total daily dose or an increase in dose may be considered. If a dose is missed, take it as soon as remembered. Do not take two doses at the same time to compensate for a missed dose.

Safety & Warnings

Common Side Effects

Common side effects include dizziness, diarrhea, fatigue, headache, insomnia, cough, back pain, chest pain, and irregular heartbeat.
Other reported side effects include liver function abnormalities, myalgia (muscle pain), migraine, urticaria (red itchy bumps on skin), and pruritus rash (pus-filled rash).
Rarely observed or severe side effects include anaphylactic reaction (life-threatening allergic reaction), angioedema (swelling under skin surface, including severe swelling), hepatitis (inflammation of the liver), anemia (lack of red blood cells), hypotension (low blood pressure), renal (kidney) impairment, and increased blood urea, creatinine, and potassium levels.

Serious Warnings

Black Box Warning: WARNING: FETAL TOXICITY. When pregnancy is detected, discontinue losartan potassium and hydrochlorothiazide tablets as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus.
Pregnancy: This medicine is absolutely contraindicated in pregnant females due to the risk of fetal toxicity, which can cause injury and death to the developing fetus.
Discontinue as soon as pregnancy is detected.
Lactation: This medicine is contraindicated in lactating females.
Renal Impairment: Patients with renal impairment (including those with renal artery stenosis, kidney transplantation, and severe heart failure) should be treated with caution.
Monitor serum potassium levels, especially in the elderly and those with renal impairment.
Hepatic Impairment: Patients with hepatic impairment require caution; a lower starting dose may be necessary.
Intravascular Volume Depletion: Patients who are intravascularly volume-depleted (e.
g.
, those treated with diuretics) should be treated with caution, and a lower starting dose is recommended to avoid symptomatic hypotension.
Angioedema: Patients with a history of angioedema (severe swelling under skin surface) should be closely monitored.
Cardiovascular Conditions: Caution is required in patients with primary aldosteronism, severe heart failure, aortic stenosis (narrowing), arrhythmias (abnormal heart rate and rhythm), or cardiomyopathy (heart muscle weakness).
Pediatric Use: This medicine should not be given to children.
Driving and Alcohol: Exercise caution when driving or operating machinery due to potential dizziness.
Avoid alcohol consumption as it may potentiate adverse effects.
General: Do not start this medication without consulting a healthcare professional.

How it Works (Mechanism of Action)

Losartan, an Angiotensin II Receptor Blocker (ARB), and its principal active metabolite selectively block the binding of Angiotensin II to the AT1 receptor, thereby preventing vasoconstriction and aldosterone secretion. Hydrochlorothiazide is a thiazide diuretic that contributes to the antihypertensive effect.