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Losartan | Angiotensin II receptor antagonist |
Hydrochlorothiazide | Thiazide diuretic |
Clinical data | |
Trade names | Hyzaar, others |
AHFS/Drugs.com | Professional Drug Facts |
License data | |
Routes of administration | By mouth |
ATC code | |
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CompTox Dashboard (EPA) |
Losartan/hydrochlorothiazide, sold under the brand name Hyzaar among others, is a fixed-dose combination medication used to treat high blood pressure when losartan is not sufficient. [1] [2] It consists of losartan, an angiotensin II receptor blocker; and hydrochlorothiazide, a thiazide diuretic. [1] [2] It is taken by mouth. [1] [2]
Common side effects include dizziness, back pain, and upper respiratory tract infections. [1] Serious side effects may include low blood pressure, kidney problems, allergic reactions, and electrolyte problems. [1] Use in pregnancy and breastfeeding is not recommended. [3] Losartan works by blocking the effects of angiotensin II while hydrochlorothiazide works by decreasing the ability of the kidneys to absorb electrolytes. [1]
The combination was approved for medical use in the United States in 1995. [1] It is available as a generic medication. [2] In 2022, it was the 75th most commonly prescribed medication in the United States, with more than 8 million prescriptions. [4] [5]
The combination is indicated for the treatment of hypertension, to lower blood pressure; [1] and for the reduction of the risk of stroke in people with hypertension and left ventricular hypertrophy. [1]
Common side effects include dizziness, headache, back pain, rash, fever, diarrhea, cough, and upper respiratory tract infections. [1] Serious side effects may include low blood pressure, kidney problems, allergic reactions, and electrolyte problems. [1]
Drug interactions include lithium, agents increasing serum levels of potassium, nonsteroidal anti-inflammatory drugs (NSAIDs), antidiabetic drugs, cholestyramine, and colestipol. [1]
Losartan works by blocking the effects of angiotensin II by preventing it from binding to the angiotensin I receptor while hydrochlorothiazide works by decreasing the ability of the kidneys to absorb electrolytes. The effects of hydrochlorothiazide indirectly lower the levels of serum potassium. However, with coadministration of losartan which is an angiotensin II receptor antagonist, the low levels of potassium are reversed. [1]
The losartan/hydrochlorothiazide combination preparation is marketed by Merck under the brand name Hyzaar and by Xeno Pharmaceuticals under the name Anzaplus. [6] Merck, Sharp & Dohme market it as Ocsaar Plus in Israel. It is marketed as Cozaar comp in Sweden and South Africa.
Hydrochlorothiazide, sold under the brand name Hydrodiuril among others, is a diuretic medication used to treat hypertension and swelling due to fluid build-up. Other uses include treating diabetes insipidus and renal tubular acidosis and to decrease the risk of kidney stones in those with a high calcium level in the urine. Hydrochlorothiazide is taken by mouth and may be combined with other blood pressure medications as a single pill to increase effectiveness. Hydrochlorothiazide is a thiazide medication which inhibits reabsorption of sodium and chloride ions from the distal convoluted tubules of the kidneys, causing a natriuresis. This initially increases urine volume and lowers blood volume. It is believed to reduce peripheral vascular resistance.
Antihypertensives are a class of drugs that are used to treat hypertension. Antihypertensive therapy seeks to prevent the complications of high blood pressure, such as stroke, heart failure, kidney failure and myocardial infarction. Evidence suggests that reduction of the blood pressure by 5 mmHg can decrease the risk of stroke by 34% and of ischaemic heart disease by 21%, and can reduce the likelihood of dementia, heart failure, and mortality from cardiovascular disease. There are many classes of antihypertensives, which lower blood pressure by different means. Among the most important and most widely used medications are thiazide diuretics, calcium channel blockers, ACE inhibitors, angiotensin II receptor antagonists (ARBs), and beta blockers.
Enalapril, sold under the brand name Vasotec among others, is an ACE inhibitor medication used to treat high blood pressure, diabetic kidney disease, and heart failure. For heart failure, it is generally used with a diuretic, such as furosemide. It is given by mouth or by injection into a vein. Onset of effects are typically within an hour when taken by mouth and last for up to a day.
Irbesartan, sold under the brand name Aprovel among others, is a medication used to treat high blood pressure, heart failure, and diabetic kidney disease. It is a reasonable initial treatment for high blood pressure. It is taken by mouth. Versions are available as the combination irbesartan/hydrochlorothiazide.
Amiloride, sold under the trade name Midamor among others, is a medication typically used with other medications to treat high blood pressure or swelling due to heart failure or cirrhosis of the liver. Amiloride is classified as a potassium-sparing diuretic. Amiloride is often used together with another diuretic, such as a thiazide or loop diuretic. It is taken by mouth. Onset of action is about two hours and it lasts for about a day.
Chlortalidone, also known as chlorthalidone, is a thiazide-like diuretic drug used to treat high blood pressure, swelling, diabetes insipidus, and renal tubular acidosis. Because chlortalidone is effective in most patients with high blood pressure, it is considered a preferred initial treatment. It is also used to prevent calcium-based kidney stones. It is taken by mouth. Effects generally begin within three hours and last for up to three days. Long-term treatment with chlortalidone is more effective than hydrochlorothiazide for prevention of heart attack or stroke.
Lisinopril is a medication belonging to the drug class of angiotensin-converting enzyme (ACE) inhibitors and is used to treat hypertension, heart failure, and heart attacks. For high blood pressure it is usually a first-line treatment. It is also used to prevent kidney problems in people with diabetes mellitus. Lisinopril is taken orally. Full effect may take up to four weeks to occur.
Ramipril, sold under the brand name Altace among others, is an ACE inhibitor type medication used to treat high blood pressure, heart failure, and diabetic kidney disease. It can also be used as a preventative medication in patients over 55 years old to reduce the risk of having a heart attack, stroke or cardiovascular death in patients shown to be at high risk, such as some diabetics and patients with vascular disease. It is a reasonable initial treatment for high blood pressure. It is taken by mouth.
Quinapril, sold under the brand name Accupril by the Pfizer corporation. It a medication used to treat high blood pressure (hypertension), heart failure, and diabetic kidney disease. It is a first line treatment for high blood pressure. It is taken by mouth.
Telmisartan, sold under the brand name Micardis among others, is a medication used to treat high blood pressure, heart failure, and diabetic kidney disease. It is a reasonable initial treatment for high blood pressure. It is taken by mouth. Versions are available as the combination telmisartan/hydrochlorothiazide, telmisartan/cilnidipine and telmisartan/amlodipine.
Benazepril, sold under the brand name Lotensin among others, is a medication used to treat high blood pressure, heart failure, and diabetic kidney disease. It is a reasonable initial treatment for high blood pressure. It is taken by mouth. Versions are available as the combinations benazepril/hydrochlorothiazide and benazepril/amlodipine.
Losartan, sold under the brand name Cozaar among others, is a medication used to treat high blood pressure (hypertension). It is in the angiotensin receptor blocker (ARB) family of medication, and is considered protective of the kidneys. Besides hypertension, it is also used in diabetic kidney disease, heart failure, and left ventricular enlargement. It comes as a tablet that is taken by mouth. It may be used alone or in addition to other blood pressure medication. Up to six weeks may be required for the full effects to occur.
Valsartan, sold under the brand name Diovan among others, is a medication used to treat high blood pressure, heart failure, and diabetic kidney disease. It belongs to a class of medications referred to as angiotensin II receptor blockers (ARBs). It is a reasonable initial treatment for high blood pressure. It is taken by mouth.
Olmesartan, sold under the brand name Benicar among others, is a medication used to treat high blood pressure (hypertension). It is taken orally. Versions are available as the combination olmesartan/hydrochlorothiazide and olmesartan/amlodipine. It is available as a prodrug, olmesartan medoxomil.
Lisinopril/hydrochlorothiazide, sold under the brand name Zestoretic among others, is a fixed-dose combination medication used for the treatment of high blood pressure (hypertension). It contains lisinopril, an ACE inhibitor, and hydrochlorothiazide, a diuretic. Typically, it becomes an option once a person is doing well on the individual components. It is taken by mouth.
Amlodipine/benazepril, sold under the brand name Lotrel among others, is a fixed-dose combination medication used to treat high blood pressure. It is a combination of amlodipine, as the besilate, a calcium channel blocker, and benazepril, an angiotensin converting enzyme inhibitor. It may be used if a single agent is not sufficient. It is taken by mouth.
Telmisartan/hydrochlorothiazide, sold under the brand name Micardis HCT among others, is a fixed-dose combination medication used to treat high blood pressure. It is a combination of telmisartan an angiotensin II receptor antagonist with hydrochlorothiazide a diuretic. It may be used if telmisartan by itself is not sufficient. It is taken by mouth.
Valsartan/hydrochlorothiazide, sold under the brand name Diovan HCT among others, is a medication used to treat high blood pressure when valsartan is not sufficient. It is a combination of valsartan, an angiotensin receptor blocker with hydrochlorothiazide, a diuretic. It is taken by mouth.
Hydrochlorothiazide/triamterene, also known as co-triamterzide, is a fixed-dose combination medication of hydrochlorothiazide and triamterene. It is used to treat high blood pressure and edema (swelling). Specifically it is used in those who develop low blood potassium (hypokalemia) when on only hydrochlorothiazide. It is taken by mouth.
Olmesartan/hydrochlorothiazide, sold under the brand name Benicar HCT among others, is a fixed-dose combination medication used to treat high blood pressure. It is a combination of olmesartan medoxomil, an angiotensin II receptor blocker and hydrochlorothiazide, a diuretic. It may be used if olmesartan is not sufficient to manage blood pressure. It is taken by mouth.