Angilock Plus 100 mg+25 mg

Description

Indications
Angilock Plus is prescribed for managing hypertension. Additionally, it helps reduce the risk of stroke in patients with high blood pressure and left ventricular hypertrophy.
Take this medication as directed by a registered physician.

Pharmacology
Angiotensin II, a powerful vasoconstrictor, is formed from angiotensin I through the action of angiotensin-converting enzyme (ACE). It plays a crucial role in the renin-angiotensin system, contributing to hypertension and stimulating aldosterone secretion from the adrenal cortex. Losartan and its active metabolite work by selectively blocking the AT1 receptor, thereby inhibiting the vasoconstrictive and aldosterone-secreting effects of angiotensin II. Unlike ACE inhibitors, Losartan does not affect the breakdown of bradykinin or interfere with other hormone receptors or ion channels related to cardiovascular function.

Hydrochlorothiazide is a thiazide diuretic that enhances the excretion of sodium and chloride by altering renal tubular reabsorption. Its diuretic effect reduces plasma volume, which in turn increases plasma renin activity, aldosterone secretion, and potassium excretion, potentially leading to decreased serum potassium levels. The combination of Hydrochlorothiazide with an angiotensin II receptor antagonist helps mitigate potassium loss associated with diuretic use.

Dosage

Hypertension:

• The standard initial dose is one tablet (50/12.5 mg) taken once daily.
• If blood pressure remains uncontrolled, the dosage may be increased to 100/25 mg once daily.
• Patients not responding to Losartan 100 mg alone may switch to the 100/12.5 mg combination.
• For hypertensive patients with left ventricular hypertrophy, the initial dose is 50/12.5 mg. If further blood pressure reduction is required, the dose may be increased to 100/12.5 mg and subsequently to 100/25 mg.
• Maximum recommended dose: 100/25 mg once daily.
• Full antihypertensive effects are typically achieved within three weeks of starting treatment.
• Elderly patients do not require an initial dosage adjustment, but the maximum dose (100/25 mg) should not be used as the starting dose.

Severe Hypertension:

• Initial treatment starts with one tablet (50/12.5 mg) once daily.
• If necessary, after 2 to 4 weeks, the dose may be increased to 100/25 mg once daily.
• Maximum dose: 100/25 mg once daily.

Take this medication as directed by a registered physician.

Administration
Angilock Plus can be taken with or without food and may be used in combination with other antihypertensive medications.

Take this medication as directed by a registered physician.

Drug Interactions

Losartan Potassium:

• No significant pharmacokinetic interactions have been observed with Hydrochlorothiazide, Digoxin, Warfarin, Cimetidine, or Phenobarbital.
• Using potassium-sparing diuretics (e.g., Spironolactone, Triamterene, Amiloride), potassium supplements, or salt substitutes containing potassium may increase serum potassium levels.
• The antihypertensive effect of Losartan may be reduced when taken with non-steroidal anti-inflammatory drugs (NSAIDs) like Indomethacin.

Hydrochlorothiazide:

• Alcohol, barbiturates, and narcotics may enhance orthostatic hypotension.
• Antidiabetic medications (oral agents or insulin) may require dosage adjustments.
• Other antihypertensive drugs may have an additive effect.
• Cholestyramine and colestipol may reduce the absorption of Hydrochlorothiazide.

Contraindications
This medication should not be used in individuals with hypersensitivity to any of its components. Due to the presence of Hydrochlorothiazide, it is contraindicated in patients with anuria or known hypersensitivity to sulfonamide-derived drugs.

Side Effects
Most side effects are mild. Possible reactions include:

• Dizziness or symptomatic hypotension, especially in patients with volume depletion.
• Occasional hyperkalemia.
• Rare cases of angioedema with angiotensin II receptor blockers.
• Less common side effects: gastrointestinal disturbances, vertigo, palpitations, edema, dyspnea, headache, sleep disturbances, rash, and malaise.
• Rare but serious effects: hepatitis, cerebrovascular events, atrial fibrillation, pancreatitis, anaphylaxis, depression, erectile dysfunction, anemia, thrombocytopenia, hyponatremia, joint or muscle pain, renal impairment, rhabdomyolysis, photosensitivity, tinnitus, and vasculitis (including Henoch-Schonlein purpura).

Pregnancy & Lactation

• Angiotensin II receptor blockers should be avoided during pregnancy unless absolutely necessary, as they may affect fetal and neonatal blood pressure regulation and kidney function, with reported cases of skull defects and oligohydramnios.
• Due to limited data on their use during breastfeeding, alternative antihypertensive treatments with established safety profiles are recommended.

Precautions & Warnings

• Patients should be monitored for signs of angioedema.
• Regular assessment of serum electrolytes is necessary to detect imbalances.
• Hypokalemia may develop in cases of rapid diuresis, severe liver disease, or prolonged use.
• Patients with impaired kidney function or symptomatic hypotension require close monitoring.

Use in Special Populations

Renal Impairment:

• The usual dosage regimen (50/12.5 mg) is appropriate for patients with creatinine clearance >30 ml/min.
• For those with severe renal impairment, loop diuretics are preferred, and Hydrochlorothiazide is not recommended.

Hepatic Impairment:

• The Losartan-Hydrochlorothiazide combination is not recommended for patients requiring a 25 mg starting dose of Losartan due to hepatic impairment.

Pediatric Use:

• The safety and effectiveness of this medication in pediatric patients have not been established.

Overdose Effects

Losartan Potassium:

• Limited human data exist regarding overdose effects. Symptoms may include hypotension and tachycardia, with bradycardia possible due to vagal stimulation. Supportive care should be provided if symptomatic hypotension occurs.
• Hemodialysis is not effective in removing Losartan or its active metabolite.

Hydrochlorothiazide:

• Overdose may cause electrolyte imbalances, including hypokalemia, hypochloremia, and dehydration from excessive diuresis.
• In patients taking digitalis, hypokalemia may increase the risk of arrhythmias.
• The extent to which Hydrochlorothiazide is removed by hemodialysis remains uncertain.

Therapeutic Class
Combination antihypertensive medications.

Storage Conditions

• Store at a temperature not exceeding 30°C.
• Keep out of reach of children.