Prosan HZ Tablet 1 Strip

✔️ Uses of Prosan HZ

• Hypertension (high blood pressure)

✔️ Side Effects of Prosan HZ

Common side effects are generally mild, including dizziness and symptomatic hypotension, especially in those with volume depletion. Rarely, side effects such as hyperkalemia, angioedema, vertigo, gastrointestinal issues, and other conditions like hepatitis, atrial fibrillation, and syncope may occur. Serious reactions such as anaphylaxis, pancreatitis, and rhabdomyolysis are rare.

✔️ How does

Losartan is an angiotensin II receptor antagonist that works by blocking the effects of angiotensin II, a potent vasoconstrictor. This helps to reduce vasoconstriction and aldosterone secretion by preventing angiotensin II from binding to the AT1 receptor, which is found in tissues such as vascular smooth muscle and the adrenal gland. Losartan does not inhibit ACE (angiotensin-converting enzyme) nor does it interfere with other hormone receptors or ion channels important in cardiovascular regulation.

Hydrochlorothiazide is a thiazide diuretic that acts on renal tubular mechanisms, increasing sodium and chloride excretion. This diuretic action reduces plasma volume, which leads to increased renin activity, aldosterone secretion, urinary potassium loss, and reduced serum potassium. The addition of Losartan helps mitigate potassium loss associated with thiazide diuretics by blocking angiotensin II effects.

✔️ Dosage for Hypertension

• Start with 50/12.5 mg (one tablet) daily.
• If needed, increase the dose to 100/25 mg daily.
• If Losartan 100 mg alone is not effective, patients can be switched to 100/12.5 mg combination once daily.
• For patients with left ventricular hypertrophy, start with 50/12.5 mg. If more blood pressure reduction is needed, increase to 100/12.5 mg, and then 100/25 mg if required. The maximum dose is 100/25 mg once daily.

✔️ Severe Hypertension:

• Begin with 50/12.5 mg daily.
• If insufficient response occurs after 2-4 weeks, increase to 100/25 mg daily.
• The maximum dose is 100/25 mg once daily.

✔️ Renal Impairment:

• The standard dose of 50/12.5 mg is suitable for patients with creatinine clearance >30 ml/min. For those with more severe renal impairment, loop diuretics are preferred over thiazides.

✔️ Hepatic Impairment:

Not recommended for use in patients with liver impairment as the 25 mg starting dose cannot be administered.

✔️ Pediatric Use:

The safety and efficacy in children have not been established.

✔️ Overdose Effects

Losartan: Overdosage could lead to hypotension and tachycardia and in some cases bradycardia due to parasympathetic stimulation. Supportive treatment should be provided. Hemodialysis is not effective in removing Losartan or its metabolites.

Hydrochlorothiazide: Overdose may cause electrolyte depletion, such as hypokalemia and dehydration. If digitalis has also been taken, hypokalemia could worsen cardiac arrhythmias. Hemodialysis is not proven to effectively remove Hydrochlorothiazide.

✔️ Directions for Use:

This medication can be taken with or without food, alongside other antihypertensive drugs. Take Prosan HZ as advised by your physician. Swallow Prosan HZ with a glass of water. Do not crush or chew the medicine. Your doctor will decide the correct dose and duration for you depending on your age, body weight, and disease condition. 

✔️ Interactions

Losartan: There are no significant drug interactions found with Hydrochlorothiazide, Digoxin, Warfarin, Cimetidine, and Phenobarbital. However, combining with potassium-sparing diuretics, potassium supplements, or salt substitutes can increase serum potassium levels. Indomethacin may reduce the antihypertensive effect of Losartan.

Hydrochlorothiazide: Alcohol, barbiturates, and narcotics may enhance the orthostatic hypotension effect. Adjustments may be needed for antidiabetic drugs. When used with other antihypertensive drugs, the effects may be additive or enhanced. Cholestyramine and colestipol resins can impair the absorption of Hydrochlorothiazide.

✔️ Contraindications

The combination is contraindicated in patients who are hypersensitive to any of its components. It should not be used in patients with anuria or those who are allergic to sulfonamide-derived drugs due to the Hydrochlorothiazide component.

✔️ Pregnancy & Lactation

• Pregnancy: Angiotensin II receptor antagonists should generally be avoided during pregnancy unless necessary due to potential adverse effects on fetal blood pressure, renal function, and the development of skull defects and oligohydramnios.
• Lactation: Limited information exists on the use of angiotensin II receptor antagonists while breastfeeding. They are not recommended during lactation, and alternative treatments with better-established safety profiles should be considered.

✔️ Precautions & Warnings

• Hypersensitivity: Monitor for signs of angioedema.
• Periodic serum electrolyte tests are recommended to check for electrolyte imbalances.
• Hypokalemia may develop, especially during diuresis or in patients with cirrhosis or prolonged use.
• Use with caution in patients with impaired renal function and those experiencing symptomatic hypotension.

✔️ Storage Conditions:

Store below 30°C. Keep out of the reach of children.