Lotan H

Description

It appears you’re asking about Lotan H, which is a combination medication containing Losartan Potassium and Hydrochlorothiazide. This is the same combination found in “Losita H” that we discussed previously. The difference in name (“Lotan H” vs “Losita H”) usually indicates different pharmaceutical manufacturers or brand names for the same generic combination.

In Nepal, Lotan H Tablet is manufactured by Deurali Janta Pharmaceuticals Pvt. Ltd.

Since the active ingredients and their mechanisms are the same, the information provided for “Losita H” regarding its product overview, side effects, precautions, and prescriptions largely applies to “Lotan H” as well.

Product Overview: Lotan H (Losartan Potassium + Hydrochlorothiazide)

What it is: Lotan H is a fixed-dose combination medication used to manage high blood pressure. It contains:

• Losartan Potassium (an Angiotensin II Receptor Blocker – ARB): Works by blocking a hormone (angiotensin II) that constricts blood vessels, thus relaxing them and lowering blood pressure. It also has benefits for kidney protection, particularly in diabetic patients.
• Hydrochlorothiazide (a Thiazide Diuretic or “water pill”): Works by increasing the excretion of excess salt and water from the body through the kidneys, reducing fluid volume and thereby lowering blood pressure.

The combination of these two drugs offers a synergistic effect, providing more effective blood pressure control than either ingredient alone.

Therapeutic Class: Antihypertensive (Angiotensin II Receptor Blocker + Thiazide Diuretic Combination).

Indications (Uses):

• Essential Hypertension (High Blood Pressure): Lotan H is prescribed when blood pressure is not adequately controlled by either Losartan or Hydrochlorothiazide alone. It aims to lower blood pressure to reduce the risk of cardiovascular events like heart attack, stroke, and kidney damage.
• Stroke Risk Reduction: Specifically in hypertensive patients with Left Ventricular Hypertrophy (LVH), Losartan has been shown to reduce the risk of stroke.
• Diabetic Nephropathy: In type 2 diabetic patients with high blood pressure, it can help slow the progression of kidney disease.
• Heart Failure: While not a primary standalone indication for the combination, Losartan (the main component) is used in heart failure management to reduce workload on the heart.

Dosage and Administration:

• Common Strengths: Lotan H is available in strengths such as Losartan 50 mg + Hydrochlorothiazide 12.5 mg.
• Adult Dose for Hypertension: Typically starts with 50 mg/12.5 mg once daily. The dose may be increased up to 100 mg Losartan/25 mg Hydrochlorothiazide per day, either as a single dose or in two divided doses if needed, based on blood pressure response.
• Administration: It can be taken with or without food. It’s generally recommended to take it at the same time each day, usually in the morning to prevent nighttime urination due to the diuretic component.
• Important: Always adhere strictly to your doctor’s prescribed dosage and duration. Do not stop taking the medication abruptly without consulting your doctor.

Side Effects:

Side effects for Lotan H are largely similar to those for any Losartan/Hydrochlorothiazide combination.

Common Side Effects (generally mild and may resolve over time):

• Dizziness or Lightheadedness (especially when standing up quickly)
• Headache
• Fatigue/Weakness
• Nausea, Upset Stomach, Diarrhea
• Upper Respiratory Tract Infections (e.g., stuffy nose, cough)
• Back pain, muscle pain
• Electrolyte Imbalances: While Losartan can counteract potassium loss from Hydrochlorothiazide, monitoring is still important for:
  • Hyperkalemia (high potassium) or Hypokalemia (low potassium)
  • Hyponatremia (low sodium)
  • Hypomagnesemia (low magnesium)
• Increased Uric Acid (can worsen gout)
• Increased Blood Sugar Levels (especially in diabetics)
• Increased Blood Lipid Levels
• Taste changes
• Photosensitivity (increased sensitivity to sunlight; use sunscreen and protective clothing)

Serious or Less Common Side Effects (seek immediate medical attention if any of these occur):

• Angioedema: Rapid swelling of the face, lips, tongue, or throat, leading to difficulty breathing or swallowing. This is a medical emergency.
• Severe Hypotension: Extreme drop in blood pressure (fainting, profound dizziness).
• Kidney Problems: Signs include decreased urine output, swelling in hands/feet.
• Acute Angle-Closure Glaucoma: Sudden eye pain, blurred vision, or decreased vision.
• Severe Skin Reactions: Such as Stevens-Johnson syndrome (painful rash, blistering, peeling skin).
• Liver Problems: Jaundice (yellowing of skin/eyes), dark urine, persistent nausea/vomiting.
• Blood Disorders: Unexplained fever, sore throat, unusual bruising/bleeding.
• Severe Electrolyte Disturbances (leading to irregular heartbeat, seizures, severe weakness).

Precautions:

Before taking Lotan H, inform your doctor about your complete medical history and all medications.

• Allergies: Do not take if you are allergic to Losartan, Hydrochlorothiazide, other ARBs, or sulfa drugs.
• Pregnancy & Breastfeeding: Contraindicated during pregnancy (especially 2nd/3rd trimesters due to fetal harm). Generally not recommended during breastfeeding.
• Kidney Disease: Use with extreme caution. Contraindicated in severe kidney impairment or anuria. Close monitoring of kidney function is essential.
• Liver Disease: Use with caution, especially in severe cases.
• Diabetes: Close blood glucose monitoring is required. Contraindicated with aliskiren in diabetic patients with renal impairment.
• Electrolyte Monitoring: Regular blood tests are crucial to monitor potassium, sodium, and other electrolyte levels.
• Dehydration: Correct volume depletion before starting treatment.
• Gout: May increase uric acid levels.
• Driving/Operating Machinery: May cause dizziness; exercise caution.
• Alcohol: Avoid or limit alcohol, as it can worsen dizziness and lower blood pressure excessively.
• Dietary Potassium: Avoid potassium supplements, potassium-containing salt substitutes, or potassium-rich foods unless advised by your doctor.
• Other Medications: Inform your doctor about all medications, including NSAIDs, lithium, other antihypertensives, and certain cholesterol-lowering drugs (cholestyramine, colestipol).
• Surgery: Inform your healthcare team you are taking Lotan H before any surgical procedures.

Prescriptions:

Lotan H is a prescription-only medication in Nepal and elsewhere. It must be prescribed by a licensed doctor.

Your doctor will:

• Evaluate your medical history and current health status.
• Determine the appropriate starting dose and adjust it based on your blood pressure response.
• Provide clear instructions on how to take the medication.
• Schedule regular follow-up appointments to monitor your blood pressure, kidney function, and electrolyte levels.
• Discuss potential side effects and how to manage them.

Key points for patients:

• Take Lotan H exactly as prescribed.
• Do not stop the medication without consulting your doctor.
• Maintain a healthy lifestyle (diet, exercise) as advised by your doctor.
• Report any new or concerning symptoms to your doctor immediately.