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Indication & Dosage
 
 
Oral
MILD TO MODERATE HYPERTENSION
Adult: one tab daily (losartan K 50mg + ramipril 1.25mg). Treatment should be initiated with a lower dose and the dosage may be gradually increased till the max response is observed.
The initial recommended dose for patients with CrCl < 40ml/min/1.73m3 is losartan K 50mg plus ramipril 1.25mg once daily. The dosage adjustment is recommended in cirrhotic patients, impaired liver function.
   
Precautions Patients on diuretic, renal impairment, heart failure and hereditary edema, serum K conc should be monitored in elderly and patients with renal stenosis and lactation.
   
Adverse Drug Reactions

First-dose hypotension, angioedema, hyperkalaemia, dyspepsia, muscle cramp, myalgia, dizziness, insomnia, nasal congestion, cough, upper resp infection, sinusitis, asthenia, oedema, abdominal pain, chest pain, nausea, headache, pharyngitis, superficial peeling of palms and haemolysis, renal impairment, pancytopaenia, haemolytic anaemia, thrombocytopaenia, increase in BUN and serum creatinine, angioneurotic oedema, cough, arthralgia, fever, impotence, increased sweating, malaise, wt gain, rash.

   
Interactions Concomitant use of potassium-sparing diuretics (eg, spironolactone, triamterene, amiloride), K supplements, or salt substitutes containing K may lead to increase in serum potassium. Cimetidine may increase AUC of losartan, phenobarbital may reduce the AUC of losartan and that of its active metabolite. Co-administration with diuretics can cause hypotension. Serum lithium level is increased when lithium is co-administered with ramipril.
   
   
 

 

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