Hyzaar 100 25

Apo-Losartan/HCTZ

How does this medication work? What will it do for me?

This is a combination product that contains 2 medications used to lower high blood pressure (hypertension), losartan and hydrochlorothiazide.

Losartan belongs to the class of medications called angiotensin II receptor blockers. They help to lower blood pressure by relaxing blood vessels. Hydrochlorothiazide belongs to the class of medications called diuretics or “water pills.” It helps control blood pressure by getting rid of excess salt and water.

This combination medication is prescribed when your doctor feels it is appropriate for you to be taking both medications. It is usually prescribed after a person’s blood pressure is stabilized on losartan and hydrochlorothiazide taken individually.

It usually takes 3 to 6 weeks to see the full effects of this medication.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

50 mg/12.5 mg
Each light yellow to yellow-coloured, film-coated, oval-shaped, biconvex tablet, engraved “APO” on one side and “50 12.5” on the other side, contains 50 mg of losartan potassium and 12.5 mg of hydrochlorothiazide. Nonmedicinal ingredients: carnauba wax, hydroxypropyl cellulose, hydroxypropyl methylcellulose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, pregelatinized starch, quinoline yellow Aluminum Lake, and titanium dioxide.

100 mg/12.5 mg
Each white to off-white-coloured, oval-shaped, biconvex, film-coated tablet, with “APO” engraved on one side and “100 12.5” on the other side, contains 100 mg of losartan potassium and 12.5 mg of hydrochlorothiazide. Nonmedicinal ingredients: hydroxypropyl cellulose, hydroxypropyl methylcellulose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, pregelatinized starch, and titanium dioxide.

100 mg/25 mg
Each light yellow to yellow-coloured, film-coated, oval-shaped, biconvex tablet, engraved “APO” on one side and “100 25” on the other side, contains 100 mg of losartan potassium and 25 mg of hydrochlorothiazide. Nonmedicinal ingredients: carnauba wax, hydroxypropyl cellulose, hydroxypropyl methylcellulose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, pregelatinized starch, quinoline yellow Aluminum Lake, and titanium dioxide.

How should I use this medication?

Once the dose of each medication (losartan and hydrochlorothiazide) has been determined, the combination tablets can be started. The recommended dose is one tablet once daily. The maximum dose is one tablet per day.

The medication can be taken with or without food, but should be taken consistently. This means that if you usually take it with food, continue to take it with food, and if you usually take it without food, continue to take it without food.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important that this medication be taken exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take losartan – hydrochlorothiazide if you:

  • are allergic to losartan, hydrochlorothiazide, or any ingredient of the medication
  • are allergic to sulfa (sulfonamide) medications (e.g., sulfamethoxazole)
  • are pregnant or breast-feeding
  • have anuria (are able to pass little or no urine)
  • have diabetes or kidney disease and are taking aliskiren
  • have been diagnosed with hereditary angioedema
  • have galactose intolerance (a rare hereditary condition)

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • abdominal pain
  • back or leg pain
  • constipation
  • cough
  • decreased appetite
  • diarrhea
  • dizziness when rising from a sitting or lying position
  • headache
  • muscle cramps
  • nausea
  • pins and needles sensation
  • sensitivity to the sun
  • sexual difficulties
  • taste alterations
  • tiredness
  • trouble sleeping
  • vomiting

Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • pounding, rapid heartbeat
  • signs of anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
  • signs of bleeding (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don’t stop bleeding)
  • signs of electrolyte changes (e.g., irregular heartbeat, muscle weakness, general feeling of being unwell, lack of energy, confusion, muscle pain or cramps, drowsiness)
  • signs of gout (e.g., joint pain, swelling and warmth of joints)
  • signs of infections (symptoms may include fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness)
  • signs of kidney problems (e.g., decreased urination, nausea, vomiting, swelling of the feet and ankles)
  • signs of liver damage (yellowing of skin or whites of eyes, abdominal pain, loss of appetite, brown urine, light-coloured stools, tiredness, or weakness)
  • signs of low blood pressure such as dizziness, lightheadedness, or fainting
  • signs of muscle damage (e.g., unexplained muscle pain, tenderness or weakness, or brown or discoloured urine)
  • skin rash (especially if you also have joint pain)
  • swelling legs, ankles, or hands
  • symptoms of high blood sugar (e.g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odour)
  • symptoms of increased pressure in the eyes (e.g., decreased or blurred vision, eye pain, red eye, swelling of the eye)
  • vision changes (blurred vision, increased eye pressure, eye pain)

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • chest pain
  • signs of a serious allergic reaction (swelling of face or throat, hives, difficulty breathing)
  • severe skin rash, including skin blistering and peeling (possibly with headache, fever, coughing, or aching before the rash begins)
  • signs of pancreatitis (e.g., abdominal pain on the upper left side, back pain, nausea, fever, chills, rapid heartbeat, swollen abdomen)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take this medication.

HEALTH CANADA ADVISORY

January 31, 2019

Health Canada has issued new restrictions concerning the use of hydrochlorothiazide. To read the full Health Canada Advisory, visit Health Canada’s web site at www.hc-sc.gc.ca.

Allergic reaction: Some people who are allergic to sulfonamide medications also experience allergic reactions to hydrochlorothiazide. Before you take this medication, inform your doctor about any previous adverse reactions you have had to medications, especially to sulfonamide antibiotics or diabetes medications. Contact your doctor at once if you experience signs of an allergic reaction, such as skin rash, itching, difficulty breathing or swelling of the face and throat.

Cholesterol: Cholesterol and triglyceride levels may increase when taking hydrochlorothiazide. Talk to your doctor about whether you will need to have your cholesterol levels tested while you are taking this medication. If you have increased cholesterol or triglyceride levels, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Diabetes: Hydrochlorothiazide may make it more difficult for people with diabetes to control their blood sugar levels. High blood sugar may occur, glucose tolerance may change, and diabetes may worsen. A dose adjustment of diabetes medications, including insulin, may be required. If you have diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Electrolytes: The use of hydrochlorothiazide can reduce the levels of electrolytes such as potassium, sodium, magnesium, and chloride, and increase the levels of calcium. Your doctor will periodically check to see if these levels are in balance and a potassium supplement may be recommended. Warning signs or symptoms of fluid and electrolyte imbalance include:

  • confusion
  • drowsiness
  • dryness of mouth
  • lethargy
  • low blood pressure
  • muscle pains or cramps
  • muscular fatigue
  • nausea and vomiting
  • racing heartbeat
  • restlessness
  • seizures
  • thirst
  • weakness

Gout: An acute gout attack may occur in some patients taking losartan – hydrochlorothiazide as a result of high levels of uric acid in the blood. Symptoms of an acute gout attack include sudden pain, swelling, and stiffness in the affected joint, often the big toe. You may also experience a fever. If this is your first attack, seek medical attention as soon as possible. If you have had gout attacks before, follow your doctor’s instructions for dealing with the attack.

Heart Problems:. Losartan – hydrochlorothiazide can cause fluid to build up in the body, increasing the work the heart must do to keep the blood circulating. If you have had a recent heart attack, or you have congestive heart failure, taking losartan – hydrochlorothiazide can make symptoms of these heart conditions worse. If you have a history of heart problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Kidney function: Losartan – hydrochlorothiazide can cause changes to kidney function that may result in decreased kidney function, kidney failure, or possibly death. This is particularly likely for those who already have kidney problems. Certain people have experienced changes in kidney function (e.g., people with narrowed blood vessels in their kidneys, or those with severe congestive heart failure). The use of diuretics (water pills), nonsteroidal anti-inflammatory drugs (NSAIDs), or aliskiren may further increase risk of kidney problems for people already at risk for this problem. If you have reduced kidney function, renal artery stenosis (narrowing of blood vessels in the kidneys), or congestive heart failure, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. People with reduced liver function may need a lower-than-normal dose of losartan; therefore, it may be necessary to use the components of the combination product separately. If you have reduced liver function or liver disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. This medication is not recommended for people with severe liver impairment.

This medication may also cause a decrease in liver function. If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Low blood pressure: Occasionally, a greater-than-expected drop in blood pressure occurs after taking this medication. It is more likely to occur if you are taking additional diuretics (water pills), have reduced salt intake, are on dialysis, or are experiencing diarrhea or vomiting. Blood pressure should be monitored more often in these situations. To reduce the risk of dizziness, those with low blood pressure or those just starting to take this medication should stand or sit up slowly when getting up from a lying down or sitting position.

If low blood pressure causes you to faint or feel lightheaded, contact your doctor.

Excessive sweating and lack of fluid intake may lead to an excessive fall in blood pressure because of reduced fluid in your blood vessels. Vomiting or diarrhea may also lead to a fall in blood pressure. Consult your doctor if you feel your blood pressure is too low.

Lupus: There have been reports of a worsening or activation of lupus in people taking hydrochlorothiazide. If you have lupus, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Potassium levels: Increases in blood levels of potassium occur for approximately 2% of people who take this medication. This rarely causes problems, but your doctor will likely want to monitor your potassium levels through blood tests. Avoid using salt substitutes that contain potassium while you are taking losartan – hydrochlorothiazide.

Vision changes: Hydrochlorothiazide occasionally causes vision changes including increased eye pressure and myopia (nearsightedness). If you experience any eye symptoms, such as pain or change in vision, contact your doctor as soon as possible.

Pregnancy: Losartan may cause severe harm to an unborn fetus if it is taken by the mother during pregnancy. Pregnant women should not take this medication. If you become pregnant while taking this medication, stop taking it immediately and call your doctor.

Breast-feeding: It is not known if losartan passes into breast milk. Hydrochlorothiazide does pass into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children. This medication is not recommended for children.

Seniors: Seniors may be more sensitive to the effects of this medication and may experience more side effects.

What other drugs could interact with this medication?

There may be interaction between losartan – hydrochlorothiazide and any of the following:

  • aclidinium
  • alcohol
  • aldesleukin
  • aliskiren
  • allopurinol
  • amifostine
  • amiodarone
  • alpha-adrenergic blocking agents (e.g., clonidine, doxazosin, prazosin, terazosin)
  • amphetamines (e.g., dextroamphetamine, lisdexamphetamine)
  • angiotensin converting enzyme inhibitors (ACEIs; captopril, enalapril, ramipril)
  • other angiotensin receptor blockers (ARBs; e.g., candasartan, irbesartan, valsartan)
  • antihistamines (e.g,. cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine)
  • antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
  • aprepitant
  • atropine
  • azelastine
  • “azole” antifungals (e.g., itraconazole, ketoconazole, voriconazole)
  • barbiturates (e.g., butalbital, pentobarbital phenobarbital)
  • belladonna
  • benztropine
  • beta-blockers (e.g., atenolol, carvedilol, propranolol)
  • beta 2 agonists (e.g., salbutamol, formoterol, terbutaline)
  • bosentan
  • brimonidine
  • calcitriol
  • calcium carbonate, calcium citrate
  • calcium channel blockers (e.g., amlodipine, diltiazem, nifedipine, verapamil)
  • capecitabine
  • carbamazepine
  • ceritinib
  • cholestyramine
  • ciprofloxacin
  • colestipol
  • inhaled corticosteroids (e.g., budesonide, ciclesonide, fluticasone)
  • oral corticosteroids (e.g., dexamethasone, hydrocortisone, prednisone)
  • cyclobenzaprine
  • cyclophosphamide
  • cyclosporine
  • dabrafenib
  • dapsone
  • darifenacin
  • deferasirox
  • dexamethasone
  • diabetes medications (e.g., chlorpropamide, glipizide, glyburide, insulin, metformin, , rosiglitazone)
  • digoxin
  • disopyramide
  • diuretics (water pills; e.g., furosemide, hydrochlorothiazide, triamterene)
  • dofetilide
  • drospirenone
  • enzalutamide
  • eplerenone
  • eslicarbazepine
  • fenofibrate
  • flavoxate
  • fluorouracil
  • fluvastatin
  • gemfibrozil
  • glycopyrrolate
  • guanfacine
  • heparin
  • hepatitis C antiviral combinations (e.g., ombitasvir/paritaprevir/ritonavir/dasabuvir, ombitasvir/paritaprevir/ritonavir)
  • HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delavirdine, efavirenz, etravirine, nevirapine)
  • hydralazine
  • ipratropium
  • leflunomide
  • levodopa
  • lithium
  • low molecular weight heparins (e.g., dalteparin, enoxaparin, tinzaparin)
  • medications that increase blood levels of potassium (e.g., potassium chloride, salt substitutes containing potassium)
  • methylphenidate
  • mifepristone
  • milk thistle
  • minoxidil
  • mitotane
  • modafinil
  • montelukast
  • monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, phenelzine, rasagiline, selegiline, tranylcypromine)
  • multivitamins/minerals with ADE
  • narcotic pain relievers (e.g., codeine, fentanyl, morphine)
  • nilotinib
  • nitrates (e.g., nitroglycerin, isosorbide dinitrate, isosorbide mononitrate)
  • nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen, naproxen)
  • obinutuzumab
  • omeprazole
  • orphenadrine
  • oxcarbazepine
  • oxybutynin
  • paclitaxel
  • peginterferon alfa-2b
  • pentoxifylline
  • phenytoin
  • phosphodiesterase 5 inhibitors (e.g., sildenafil, tadalafil, vardenafil)
  • porfimer
  • primidone
  • quinine
  • rifabutin
  • repaglinide
  • rifampin
  • St. John’s wort
  • salmeterol
  • scopolamine
  • selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, duloxetine, fluoxetine, paroxetine, sertraline)
  • siltuximab
  • sodium phosphates
  • sorafenib
  • sulfonamide antibiotics (e.g., sulfadiazine, sulfamethoxazole, sulfisoxazole)
  • tamoxifen
  • tegafur
  • ticagrelor
  • tiotropium
  • tizanidine
  • tocilizumab
  • tolcapone
  • tolterodine
  • tolvaptan
  • topiramate
  • tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine, trimipramine)
  • trimethoprim
  • umeclidinium
  • vitamin D
  • warfarin
  • yohimbine
  • zafirlukast
  • zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. 1996 – 2020. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Apo-LosartanHCTZ

50 mg/12.5 mg
Each yellow, oval-shaped, film-coated tablet, marked with code “717” on one side and plain on the other, contains 50 mg of losartan potassium and 12.5 mg of hydrochlorothiazide. Nonmedicinal ingredients: hydroxypropyl cellulose, hypromellose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, pregelatinized starch, quinoline yellow aluminum lake or D&C Yellow No. 10 Aluminum Lake, and titanium dioxide. May contain carnauba wax.

100 mg/12.5 mg
Each white to off-white, oval-shaped, film-coated tablet, with code “745” on one side and plain on the other, contains 100 mg of losartan potassium and 12.5 mg of hydrochlorothiazide. Nonmedicinal ingredients: hydroxypropyl cellulose, hypromellose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, pregelatinized starch, and titanium dioxide. May contain carnauba wax.

hydrochlorothiazide and losartan (Hyzaar)

Brand Names: Hyzaar

Generic Name: hydrochlorothiazide and losartan

  • What is hydrochlorothiazide and losartan (Hyzaar)?
  • What are the possible side effects of hydrochlorothiazide and losartan (Hyzaar)?
  • What is the most important information I should know about hydrochlorothiazide and losartan (Hyzaar)?
  • What should I discuss with my healthcare provider before taking hydrochlorothiazide and losartan (Hyzaar)?
  • How should I take hydrochlorothiazide and losartan (Hyzaar)?
  • What happens if I miss a dose (Hyzaar)?
  • What happens if I overdose (Hyzaar)?
  • What should I avoid while taking hydrochlorothiazide and losartan (Hyzaar)?
  • What other drugs will affect hydrochlorothiazide and losartan (Hyzaar)?
  • Where can I get more information (Hyzaar)?

What is hydrochlorothiazide and losartan (Hyzaar)?

Hydrochlorothiazide is a diuretic (water pill). Losartan is an angiotensin II receptor antagonist (sometimes called an ARB blocker).

Hydrochlorothiazide and losartan is a combination medicine used to treat high blood pressure (hypertension). It is also used to lower the risk of stroke in certain people with heart disease.

Hydrochlorothiazide and losartan may also be used for purposes not listed in this medication guide.

000060745_PB

oval, white, imprinted with 745

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oval, yellow, imprinted with 747

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oval, yellow, imprinted with 93, 7367

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oval, yellow, imprinted with 93, 7368

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oval, white, imprinted with 93, 7369

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round, white, imprinted with SZ 309

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round, white, imprinted with SZ 349

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round, white, imprinted with SZ 390

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oval, yellow, imprinted with 717

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oval, white, imprinted with 745

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oval, yellow, imprinted with 747

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oval, yellow, imprinted with 116

136680118_PB

oval, yellow, imprinted with 1118

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oval, white, imprinted with F, 74

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oval, yellow, imprinted with E, 49

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oval, yellow, imprinted with E, 48

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oval, white, imprinted with LU, M42

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oblong, white, imprinted with ZD18

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oblong, white, imprinted with ZD19

Hyzaar 12.5 mg-50 mg

oval, yellow, imprinted with 717

Hyzaar 12.5-100 mg

oval, white, imprinted with 745

Hyzaar 25 mg-100 mg

oval, yellow, imprinted with 747

Losartan-HCTZ 100-12.5 mg-ROX

round, white, imprinted with 54, 931

Losartan-HCTZ 100-25 mg-ROX

round, yellow, imprinted with 54 557

Losartan-HCTZ 50-12.5 mg-ROX

round, yellow, imprinted with 54 717

What are the possible side effects of hydrochlorothiazide and losartan (Hyzaar)?

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • a light-headed feeling, like you might pass out;
  • irregular heartbeats;
  • eye pain, vision problems;
  • kidney problems–little or no urination, rapid weight gain, swelling in your hands, feet, or ankles;
  • new or worsening symptoms of lupus–joint pain, and a skin rash on your cheeks or arms that worsens in sunlight; or
  • signs of an electrolyte imbalance–increased thirst or urination, confusion, vomiting, constipation, muscle pain, leg cramps, irregular heartbeats, numbness or tingling, severe weakness, loss of movement, feeling jittery or unsteady.

Common side effects may include:

  • dizziness;
  • back pain; or
  • cold symptoms such as stuffy nose, sneezing, sore throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What is the most important information I should know about hydrochlorothiazide and losartan (Hyzaar)?

You should not use this medicine if you are unable to urinate.

Do not use if you are pregnant, and tell your doctor right away if you become pregnant. This medicine can cause injury or death to the unborn baby during your second or third trimester.

If you have diabetes, do not use hydrochlorothiazide and losartan together with any medication that contains aliskiren (a blood pressure medicine).

Generic Name: hydrochlorothiazide and losartan (HYE droe KLOR oh THYE a zide and loe SAR tan)
Brand Names: Hyzaar

Medically reviewed by Philip Thornton, DipPharm Last updated on Jan 6, 2020.

  • Overview
  • Side Effects
  • Dosage
  • Professional
  • Interactions
  • More

What is Hyzaar?

Hyzaar contains a combination of hydrochlorothiazide and losartan. Hydrochlorothiazide is a thiazide diuretic (water pill) that helps prevent your body from absorbing too much salt, which can cause fluid retention.

Losartan is an angiotensin II receptor antagonist (sometimes called an ARB blocker). Losartan keeps blood vessels from narrowing, which lowers blood pressure and improves blood flow.

Hyzaar is used to treat high blood pressure (hypertension).

Hyzaar is also used to lower the risk of stroke in certain people with heart disease.

Important Information

Do not use Hyzaar if you are pregnant. Stop using the medicine and tell your doctor right away if you become pregnant.

You should not use this medicine if you are unable to urinate.

If you have diabetes, do not use Hyzaar together with any medication that contains aliskiren (a blood pressure medicine).

You may also need to avoid taking Hyzaar with aliskiren if you have kidney disease.

In rare cases, Hyzaar can cause a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, and dark colored urine.

Before taking this medicine

You should not use Hyzaar if you are allergic to hydrochlorothiazide or losartan, if you are unable to urinate.

To make sure Hyzaar is safe for you, tell your doctor if you have ever had:

  • lupus;

  • liver or kidney disease;

  • asthma or allergies;

  • diabetes;

  • gout;

  • congestive heart failure;

  • glaucoma;

  • low or high levels of potassium in your blood;

  • high cholesterol or triglyceride levels; or

  • an allergy to penicillin or sulfa drugs.

Do not use if Hyzaar you are pregnant. Stop using the medicine and tell your doctor right away if you become pregnant. Hydrochlorothiazide and losartan can cause injury or death to the unborn baby if you take the medicine during your second or third trimester.

You should not breast-feed while using this medicine.

How should I take Hyzaar?

Take Hyzaar exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Your blood pressure will need to be checked often.

Call your doctor if you are sick with vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking this medicine. This can lead to very low blood pressure, a serious electrolyte imbalance, or kidney failure.

If you need surgery or medical tests, tell the surgeon ahead of time that you are using Hyzaar.

If you have high blood pressure, keep using Hyzaar even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life.

Store at room temperature away from moisture, heat, and light.

Hyzaar dosing information

Usual Adult Dose for Hypertension:

HYPERTENSION:
Hydrochlorothiazide 12.5 to 25 mg-Losartan 50 to 100 mg orally once a day
Maximum dose: Hydrochlorothiazide 25 mg-Losartan 100 mg orally once a day

-A patient whose blood pressure is not adequately controlled with hydrochlorothiazide or losartan monotherapy may be switched to hydrochlorothiazide 12.5 mg-losartan 50 mg orally once a day.
-May increase dose if blood pressure remains uncontrolled after about 3 weeks.
Use: Treatment of hypertension. This drug is not indicated for initial therapy except when hypertension is severe enough that the benefit of achieving prompt blood pressure control exceeds the risk of initiating combination therapy.
SEVERE HYPERTENSION:
Initial treatment: Hydrochlorothiazide 12.5 mg-Losartan 50 mg orally once a day; if blood pressure remains uncontrolled after 2 to 4 weeks, may initiate maximum dose.
Maximum dose: Hydrochlorothiazide 25 mg-Losartan 100 mg orally once a day
HYPERTENSION WITH LEFT VENTRICULAR HYPERTROPHY:
Initial therapy: Losartan monotherapy; if blood pressure remains uncontrolled, may initiate this drug.
Add-on therapy: Hydrochlorothiazide 12.5 mg-Losartan 50 mg orally once a day; if blood pressure remains uncontrolled, initiate hydrochlorothiazide 12.5 mg-losartan 100 mg orally once a day, followed by hydrochlorothiazide 25 mg-losartan 100 mg orally once a day, if needed.
Use: To reduce the risk of stroke in patients with hypertension and left ventricular hypertrophy, but there is evidence that this benefit does not apply to Black patients.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Hyzaar?

Do not use potassium supplements or salt substitutes, unless your doctor has told you to.

Drinking alcohol can further lower your blood pressure and may cause side effects.

Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids.

Hyzaar side effects

Get emergency medical help if you have signs of an allergic reaction to Hyzaar: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • a light-headed feeling, like you might pass out;

  • irregular heartbeats;

  • eye pain, vision problems;

  • kidney problems – little or no urination, rapid weight gain, swelling in your hands, feet, or ankles;

  • new or worsening symptoms of lupus – joint pain, and a skin rash on your cheeks or arms that worsens in sunlight; or

  • signs of an electrolyte imbalance – increased thirst or urination, confusion, vomiting, constipation, muscle pain, leg cramps, irregular heartbeats, numbness or tingling, severe weakness, loss of movement, feeling jittery or unsteady.

Common Hyzaar side effects may include:

  • dizziness;

  • back pain; or

  • cold symptoms such as stuffy nose, sneezing, sore throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Hyzaar?

If you also take cholestyramine or colestipol, take your Hyzaar dose 4 hours before or 4 to 6 hours after you take the other medicine.

Tell your doctor about all your other medicines, especially:

This list is not complete. Other drugs may interact with hydrochlorothiazide and losartan, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Hyzaar only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2020 Cerner Multum, Inc. Version: 15.01.

Medical Disclaimer

More about Hyzaar (hydrochlorothiazide / losartan)

  • Side Effects
  • During Pregnancy
  • Dosage Information
  • Drug Images
  • Drug Interactions
  • Pricing & Coupons
  • En Español
  • 21 Reviews
  • Generic Availability
  • Drug class: angiotensin II inhibitors with thiazides
  • FDA Alerts (9)

Consumer resources

  • Hyzaar
  • Hyzaar (Advanced Reading)

Professional resources

  • Hyzaar (FDA)

Related treatment guides

  • High Blood Pressure

losartan/hydrochlorothiazide (Rx)

Pregnancy

Therapy can cause fetal harm when administered to a pregnant woman; use of drugs that act on renin-angiotensin system during second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death

Most epidemiologic studies examining fetal abnormalities after exposure to antihypertensive use in first trimester have not distinguished drugs affecting renin-angiotensin system from other antihypertensive agents; when pregnancy is detected, discontinue therapy as soon as possible

Hypertension in pregnancy increases maternal risk for pre-eclampsia, gestational diabetes, premature delivery, and delivery complications (eg, need for cesarean section, post-partum hemorrhage)

Hypertension increases fetal risk for intrauterine growth restriction and intrauterine death; pregnant women with hypertension should be carefully monitored and managed accordingly

Fetal/neonatal adverse reactions

  • Losartan
    • Use of drugs that act on the renin-angiotensin system in second and third trimesters of pregnancy can result in oligohydramnios, reduced fetal renal function leading to anuria and renal failure, fetal lung hypoplasia, skeletal deformations, including skull hypoplasia, hypotension, and death
    • In the unusual case that there is no appropriate alternative to therapy with drugs affecting the renin- angiotensin system for a particular patient, apprise the mother of the potential risk to the fetus
    • Perform serial ultrasound examinations to assess the intra-amniotic environment; if oligohydramnios is observed, discontinue therapy, unless it is considered lifesaving for the mother
    • Fetal testing may be appropriate, based on week of gestation
    • Patients and physicians should be aware, however, that oligohydramnios may not appear until after fetus has sustained irreversible injury; closely observe neonates with histories of in utero exposure to drug combination for hypotension, oliguria, and hyperkalemia
    • In neonates with a history of in utero exposure to drug combination, if oliguria or hypotension occurs, support blood pressure and renal perfusion
    • Exchange transfusions or dialysis may be required as a means of reversing hypotension and replacing renal function
    • Thiazides can cross placenta, and concentrations reached in umbilical vein approach those in maternal plasma
    • Like other diuretics, the drug can cause placental hypoperfusion; it accumulates in amniotic fluid, with reported concentrations up to 19 times higher than in umbilical vein plasma
    • Use of thiazides during pregnancy is associated with a risk of fetal or neonatal jaundice or thrombocytopenia
    • Since they do not alter the course of preeclampsia, these drugs should not be used to treat hypertension in pregnant women
    • The use of hydrochlorothiazide for other indications in pregnancy should be avoided

Lactation

Not known whether losartan is excreted in human milk, but significant levels of losartan and its active metabolite were shown to be present in rat milk; thiazides appear in human milk; because of potential for adverse effects on nursing infant, a decision should be made whether to discontinue nursing or discontinue drug, taking into account importance of drug to mother

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.

Hyzaar Dosage

Hypertension

The usual starting dose of HYZAAR is 50/12.5 (losartan 50 mg/hydrochlorothiazide 12.5 mg) once daily. The dosage can be increased after 3 weeks of therapy to a maximum of 100/25 (losartan 100 mg/hydrochlorothiazide 25 mg) once daily as needed to control blood pressure .

Initiate a patient whose blood pressure is not adequately controlled with losartan 50 mg monotherapy with HYZAAR 50/12.5 once daily. If blood pressure remains uncontrolled after about 3 weeks of therapy, the dosage may be increased to two tablets of HYZAAR 50/12.5 once daily or one tablet of HYZAAR 100/25 once daily.

Initiate a patient whose blood pressure is not adequately controlled with losartan 100 mg monotherapy with HYZAAR 100/12.5 (losartan 100 mg/hydrochlorothiazide 12.5 mg) once daily. If blood pressure remains uncontrolled after about 3 weeks of therapy, increase the dose to two tablets of HYZAAR 50/12.5 once daily or one tablet of HYZAAR 100/25 once daily.

Initiate a patient whose blood pressure is inadequately controlled with hydrochlorothiazide 25 mg once daily, or is controlled but who experiences hypokalemia with this regimen, on HYZAAR 50/12.5 once daily, reducing the dose of hydrochlorothiazide without reducing the overall expected antihypertensive response. Evaluate the clinical response to HYZAAR 50/12.5 and, if blood pressure remains uncontrolled after about 3 weeks of therapy, increase the dose to two tablets of HYZAAR 50/12.5 once daily or one tablet of HYZAAR 100/25 once daily.

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