Losartan and hydrochlorothiazide: Drug information

(For additional information see "Losartan and hydrochlorothiazide: Patient drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)

ALERT: US Boxed Warning

Fetal toxicity:

Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus. When pregnancy is detected, discontinue therapy as soon as possible.

Brand Names: US

Hyzaar

Brand Names: Canada

ACT Losartan/HCT;
Apo-Losartan/HCTZ;
Auro-Losartan HCT;
Hyzaar;
Hyzaar DS;
JAMP-Losartan HCTZ;
Losartan-HCT;
Losartan-HCTZ;
Mint-Losartan/HCTZ;
Mint-Losartan/HCTZ DS;
Mylan-Losartan/HCTZ;
PMS-Losartan/HCTZ;
Sandoz-Losartan HCT;
Sandoz-Losartan HCT DS;
Teva-Losartan/HCTZ

Pharmacologic Category

Angiotensin II Receptor Blocker;
Antihypertensive;
Diuretic, Thiazide

Dosing: Adult

Hypertension

Hypertension: Oral: Losartan 50 mg/hydrochlorothiazide 12.5 mg or losartan 100 mg/hydrochlorothiazide 12.5 mg or losartan 100 mg/hydrochlorothiazide 25 mg once daily; adjust dose as needed based on blood pressure response. Patients already taking losartan and/or hydrochlorothiazide may be switched to a combination product for individually titrated agents. Maximum dose: Losartan 100 mg/hydrochlorothiazide 25 mg per day.

Hypertension with left ventricular hypertrophy

Hypertension with left ventricular hypertrophy: Oral: Initial: Losartan 50 mg/hydrochlorothiazide 12.5 mg once daily; adjust dose as needed based on blood pressure response. Patients already taking losartan and/or hydrochlorothiazide may be switched to a combination product for individually titrated agents. Maximum dose: Losartan 100 mg/hydrochlorothiazide 25 mg once daily.

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

CrCl ≥30 mL/minute: No dosage adjustment necessary.

CrCl <30 mL/minute: Use is not recommended.

Dosing: Hepatic Impairment: Adult

Use is not recommended as initial therapy. Should be used with caution in patients with ascites due to cirrhosis (AASLD [Biggins 2021; AASLD [Runyon 2013]).

Dosing: Older Adult

Refer to adult dosing.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Also see individual agents.

1% to 10%:

Nervous system: Dizziness (6%)

Neuromuscular & skeletal: Back pain (2%)

Respiratory: Upper respiratory tract infection (6%)

Frequency not defined:

Cardiovascular: Chest pain, necrotizing angiitis, orthostatic syncope, palpitations, tachycardia, vasculitis

Dermatologic: Cutaneous lupus erythematosus, pruritus, skin photosensitivity, skin rash, toxic epidermal necrolysis, urticaria

Endocrine & metabolic: Electrolyte disorder (including hypokalemia, hyponatremia), hyperglycemia, hyperuricemia

Gastrointestinal: Abdominal pain, anorexia, dysgeusia, dyspepsia, gastric irritation, nausea, pancreatitis, sialadenitis, stomach cramps, vomiting

Genitourinary: Erectile dysfunction, glycosuria, impotence

Hematologic & oncologic: Agranulocytosis, anemia, aplastic anemia, hemolytic anemia, leukopenia, purpuric disease

Hepatic: Hepatic insufficiency, intrahepatic cholestatic jaundice, jaundice

Hypersensitivity: Hypersensitivity angiitis

Nervous system: Asthenia, headache, insomnia, malaise, migraine, paresthesia, restlessness

Neuromuscular & skeletal: Muscle cramps, muscle spasm

Ophthalmic: Blurred vision (transient), xanthopsia

Renal: Interstitial nephritis, renal failure syndrome, renal insufficiency

Respiratory: Nasal congestion

Postmarketing:

Dermatologic: Erythroderma

Hematologic & oncologic: Henoch-Schönlein purpura, thrombocytopenia

Hypersensitivity: Anaphylaxis, angioedema

Neuromuscular & skeletal: Rhabdomyolysis

Contraindications

Hypersensitivity to losartan, hydrochlorothiazide, sulfonamide-derived drugs, or any component of the formulation; concomitant use with aliskiren in patients with diabetes mellitus; anuria.

Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Note: Although the FDA-approved product labeling states this medication is contraindicated in patients with hypersensitivity to sulfonamide-containing drugs, the scientific basis of this cross-sensitivity has been challenged. See “Warnings/Precautions” for more detail.

Canadian labeling: Additional contraindications (not in U.S. labeling): Concomitant use with aliskiren in patients with moderate-to-severe renal impairment (GFR <60 mL/minute/1.73 m²)

Warnings/Precautions

Concerns related to adverse effects:

• Angioedema: Angioedema has been reported rarely with some angiotensin II receptor antagonists (ARBs) and may occur at any time during treatment (especially following first dose). It may involve the head and neck (potentially compromising airway) or the intestine (presenting with abdominal pain). Patients with idiopathic or hereditary angioedema or previous angioedema associated with ACE-inhibitor therapy may be at an increased risk. Prolonged frequent monitoring may be required, especially if tongue, glottis, or larynx are involved, as they are associated with airway obstruction. Patients with a history of airway surgery may have a higher risk of airway obstruction. Discontinue therapy immediately if angioedema occurs. Aggressive early management is critical. Intramuscular (IM) administration of epinephrine may be necessary. Do not readminister to patients who have had angioedema with ARBs.

• Electrolyte disturbances: Hyperkalemia may occur with losartan; risk factors include renal dysfunction, diabetes mellitus, and concomitant use of potassium-sparing diuretics, potassium supplements, and/or potassium-containing salts. Use cautiously, if at all, with these agents and monitor potassium closely. Thiazide diuretics may cause hypokalemia, hypochloremic alkalosis, hypomagnesemia, and hyponatremia.

• Hypersensitivity reactions: Hypersensitivity reactions may occur with hydrochlorothiazide. Risk is increased in patients with a history of allergy or bronchial asthma.

• Hypotension: Symptomatic hypotension may occur upon initiation in patients who are salt- or volume-depleted (eg, those treated with high-dose diuretics); correct volume depletion prior to administration. This transient hypotensive response is not a contraindication to further treatment with losartan/hydrochlorothiazide.

• Ocular effects: Hydrochlorothiazide may cause acute transient myopia and acute angle-closure glaucoma.

• Photosensitivity: Photosensitization may occur with use of hydrochlorothiazide.

• Renal function deterioration: May be associated with deterioration of renal function and/or increases in serum creatinine, particularly in patients with low renal blood flow (eg, renal artery stenosis, heart failure) whose glomerular filtration rate (GFR) is dependent on efferent arteriolar vasoconstriction by angiotensin II; deterioration may result in oliguria, acute renal failure, and progressive azotemia. Small increases in serum creatinine may occur following initiation; consider discontinuation only in patients with progressive and/or significant deterioration in renal function.

• Skin cancer, nonmelanoma: Prolonged use (≥3 years) may increase the risk for squamous cell carcinoma up to 4 times and increase the risk for basal cell carcinoma up to 1.25 times compared to patients not treated with hydrochlorothiazide (Pedersen 2018; Pottegård 2017).

• Sulfonamide (“sulfa”) allergy: The product labeling for many medications containing a sulfonamide chemical group includes a broad contraindication in patients with a prior allergic reaction to sulfonamides. There is a potential for cross-reactivity between members of a specific class (eg, two antibiotic sulfonamides). However, concerns for cross-reactivity have previously extended to all compounds containing the sulfonamide structure (SO₂NH₂). An expanded understanding of allergic mechanisms indicates cross-reactivity between antibiotic sulfonamides and nonantibiotic sulfonamides may not occur or at the very least this potential is extremely low (Brackett 2004; Johnson 2005; Slatore 2004; Tornero 2004). In particular, mechanisms of cross-reaction due to antibody production (anaphylaxis) are unlikely to occur with nonantibiotic sulfonamides. T-cell-mediated (type IV) reactions (eg, maculopapular rash) are less well understood and it is not possible to completely exclude this potential based on current insights. In cases where prior reactions were severe (Stevens-Johnson syndrome/TEN), some clinicians choose to avoid exposure to these classes.

Disease-related concerns:

• Aortic/mitral stenosis: Use losartan with caution in patients with significant aortic/mitral stenosis.

• Ascites: Generally, avoid use in patients with ascites due to cirrhosis or refractory ascites; if use cannot be avoided in patients with ascites due to cirrhosis, monitor BP and renal function carefully to avoid rapid development of renal failure (AASLD [Runyon 2013]).

• Bariatric surgery: Dehydration: Avoid diuretics in the immediate postoperative period after bariatric surgery; electrolyte disturbances and dehydration may occur. Diuretics may be resumed, if indicated, once oral fluid intake goals are met (Ziegler 2009).

• Diabetes: Use hydrochlorothiazide with caution in patients with prediabetes or diabetes mellitus; may see a change in glucose control.

• Gout: In certain patients with a history of gout, a familial predisposition to gout, or chronic renal failure, gout can be precipitated by hydrochlorothiazide. This risk may be increased with doses ≥25 mg (Gurwitz 1997).

• Hepatic impairment: Use is not recommended for initial therapy in patients with hepatic impairment. Use with caution in hepatic impairment or progressive hepatic disease; avoid electrolyte and acid/base imbalances that might lead to hepatic encephalopathy/coma.

• Hypercalcemia: Thiazide diuretics may decrease renal calcium excretion; consider avoiding use in patients with hypercalcemia.

• Hypercholesterolemia: Use with caution in patients with moderate or high cholesterol concentrations; increased cholesterol and triglyceride levels have been reported with thiazides.

• Parathyroid disease: Thiazide diuretics reduce calcium excretion; pathologic changes in the parathyroid glands with hypercalcemia and hypophosphatemia have been observed with prolonged use; should be discontinued prior to testing for parathyroid function.

• Renal artery stenosis: Use losartan with caution in patients with unstented unilateral/bilateral renal artery stenosis. When unstented bilateral renal artery stenosis is present, use is generally avoided due to the elevated risk of deterioration in renal function unless possible benefits outweigh risks.

• Renal impairment: Use losartan with caution with preexisting renal insufficiency. Avoid hydrochlorothiazide in severe renal disease (ineffective); may precipitate azotemia; discontinue or consider withholding if renal impairment occurs. Contraindicated in patients with anuria.

• Systemic lupus erythematosus (SLE): Hydrochlorothiazide can cause SLE exacerbation or activation.

Special populations:

• Black patients: In Black patients, the BP-lowering effects of ARBs (eg, losartan) may be less pronounced. The exact mechanism is not known; differences in the renin-angiotensin-aldosterone system, low renin levels, and salt sensitivity more commonly found in Black patients may contribute. Evidence suggests that an alternative agent (ie, atenolol) may be a more beneficial initial treatment option in Black patients (Brewster 2013; Helmer 2018; Julius 2004; manufacturer's labeling).

• Surgical patients: In patients on chronic angiotensin receptor blocker (ARB) therapy, intraoperative hypotension may occur with induction and maintenance of general anesthesia; however, discontinuation of therapy prior to surgery is controversial. If continued preoperatively, avoidance of hypotensive agents during surgery is prudent (Hillis, 2011).

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Tablet, Oral:

Hyzaar 50/12.5: Losartan potassium 50 mg and hydrochlorothiazide 12.5 mg [contains potassium 4.24 mg (0.108 mEq)]

Hyzaar 100/12.5: Losartan potassium 100 mg and hydrochlorothiazide 12.5 mg [contains potassium 8.48 mg (0.216 mEq)]

Hyzaar 100/25: Losartan potassium 100 mg and hydrochlorothiazide 25 mg [contains potassium 8.48 mg (0.216 mEq)]

Generic: 50/12.5: Losartan potassium 50 mg and hydrochlorothiazide 12.5 mg; 100/12.5: Losartan potassium 100 mg and hydrochlorothiazide 12.5 mg; 100/25: Losartan potassium 100 mg and hydrochlorothiazide 25 mg

Generic Equivalent Available: US

Yes

Pricing: US

Tablets (Hyzaar Oral)

50-12.5 mg (per each): $5.66

100-12.5 mg (per each): $7.73

100-25 mg (per each): $7.73

Tablets (Losartan Potassium-HCTZ Oral)

50-12.5 mg (per each): $2.50

100-12.5 mg (per each): $3.41

100-25 mg (per each): $3.41

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Administration: Adult

Administer without regard to meals; however, administer consistently with respect to food intake at about the same time every day.

Use: Labeled Indications

Hypertension: Management of hypertension.

Hypertension with left ventricular hypertrophy: To reduce the risk of stroke in patients with hypertension and left ventricular hypertrophy (LVH). Evidence suggests that an alternative agent (ie, atenolol) may be a more beneficial initial treatment option in Black patients (Dahlöf 2002; Julius 2004).

Medication Safety Issues

Sound-alike/look-alike issues:

Hyzaar may be confused with Cozaar

Older Adult: High-Risk Medication:

Beers Criteria: Diuretics (hydrochlorothiazide) are identified in the Beers Criteria as potentially inappropriate medications to be used with caution in patients 65 years and older because of the potential to cause or exacerbate syndrome of inappropriate antidiuretic hormone secretion (SIADH) or hyponatremia; monitor sodium concentration closely when initiating or adjusting the dose in older adults (Beers Criteria [AGS 2023]).

Metabolism/Transport Effects

Refer to individual components.

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

Ajmaline: Sulfonamides may enhance the adverse/toxic effect of Ajmaline. Specifically, the risk for cholestasis may be increased. Risk C: Monitor therapy

Alcohol (Ethyl): May enhance the orthostatic hypotensive effect of Thiazide and Thiazide-Like Diuretics. Risk C: Monitor therapy

Alfuzosin: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Aliskiren: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Aliskiren may enhance the hypotensive effect of Angiotensin II Receptor Blockers. Aliskiren may enhance the nephrotoxic effect of Angiotensin II Receptor Blockers. Management: Aliskiren use with ACEIs or ARBs in patients with diabetes is contraindicated. Combined use in other patients should be avoided, particularly when CrCl is less than 60 mL/min. If combined, monitor potassium, creatinine, and blood pressure closely. Risk D: Consider therapy modification

Allopurinol: Thiazide and Thiazide-Like Diuretics may enhance the potential for allergic or hypersensitivity reactions to Allopurinol. Risk C: Monitor therapy

Amifostine: Blood Pressure Lowering Agents may enhance the hypotensive effect of Amifostine. Management: When used at chemotherapy doses, hold blood pressure lowering medications for 24 hours before amifostine administration. If blood pressure lowering therapy cannot be held, do not administer amifostine. Use caution with radiotherapy doses of amifostine. Risk D: Consider therapy modification

Aminolevulinic Acid (Systemic): Photosensitizing Agents may enhance the photosensitizing effect of Aminolevulinic Acid (Systemic). Risk X: Avoid combination

Aminolevulinic Acid (Topical): Photosensitizing Agents may enhance the photosensitizing effect of Aminolevulinic Acid (Topical). Risk C: Monitor therapy

Amphetamines: May diminish the antihypertensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Angiotensin II: Receptor Blockers may diminish the therapeutic effect of Angiotensin II. Risk C: Monitor therapy

Angiotensin-Converting Enzyme Inhibitors: Angiotensin II Receptor Blockers may enhance the adverse/toxic effect of Angiotensin-Converting Enzyme Inhibitors. Angiotensin II Receptor Blockers may increase the serum concentration of Angiotensin-Converting Enzyme Inhibitors. Management: Use of telmisartan and ramipril is not recommended. It is not clear if any other combination of an ACE inhibitor and an ARB would be any safer. Consider alternatives when possible. Monitor blood pressure, renal function, and potassium if combined. Risk D: Consider therapy modification

Anticholinergic Agents: May increase the serum concentration of Thiazide and Thiazide-Like Diuretics. Risk C: Monitor therapy

Antidiabetic Agents: Thiazide and Thiazide-Like Diuretics may diminish the therapeutic effect of Antidiabetic Agents. Risk C: Monitor therapy

Antidiabetic Agents: Hyperglycemia-Associated Agents may diminish the therapeutic effect of Antidiabetic Agents. Risk C: Monitor therapy

Antihepaciviral Combination Products: May increase the serum concentration of Losartan. Management: Consider decreasing the losartan dose and monitoring for evidence of hypotension and worsening renal function if these agents are used in combination. Risk D: Consider therapy modification

Antipsychotic Agents (Second Generation [Atypical]): Blood Pressure Lowering Agents may enhance the hypotensive effect of Antipsychotic Agents (Second Generation [Atypical]). Risk C: Monitor therapy

Arginine: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Arsenic Trioxide: Thiazide and Thiazide-Like Diuretics may enhance the hypotensive effect of Arsenic Trioxide. Thiazide and Thiazide-Like Diuretics may enhance the QTc-prolonging effect of Arsenic Trioxide. Management: When possible, avoid concurrent use of arsenic trioxide with drugs that can cause electrolyte abnormalities, such as the thiazide and thiazide-like diuretics. Risk D: Consider therapy modification

Barbiturates: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Benperidol: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Berberine-Containing Products: May enhance the hypotensive effect of Losartan. Berberine-Containing Products may increase the serum concentration of Losartan. Risk C: Monitor therapy

Beta2-Agonists: May enhance the hypokalemic effect of Thiazide and Thiazide-Like Diuretics. Risk C: Monitor therapy

Bile Acid Sequestrants: May decrease the absorption of Thiazide and Thiazide-Like Diuretics. The diuretic response is likewise decreased. Management: Consider separating administraton of bile acid sequestrants and thiazide diuretics by at least 4 hours. Monitor for decreased therapeutic effects of thiazide diuretics if coadministered with a bile acid sequestrant. Risk D: Consider therapy modification

Brigatinib: May diminish the antihypertensive effect of Antihypertensive Agents. Brigatinib may enhance the bradycardic effect of Antihypertensive Agents. Risk C: Monitor therapy

Brimonidine (Topical): May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Bromperidol: May diminish the hypotensive effect of Blood Pressure Lowering Agents. Blood Pressure Lowering Agents may enhance the hypotensive effect of Bromperidol. Risk X: Avoid combination

Calcium Salts: Thiazide and Thiazide-Like Diuretics may increase the serum concentration of Calcium Salts. Risk C: Monitor therapy

Cardiac Glycosides: Thiazide and Thiazide-Like Diuretics may enhance the adverse/toxic effect of Cardiac Glycosides. Specifically, cardiac glycoside toxicity may be enhanced by the hypokalemic and hypomagnesemic effect of thiazide diuretics. Risk C: Monitor therapy

Corticosteroids (Systemic): May enhance the hypokalemic effect of Thiazide and Thiazide-Like Diuretics. Risk C: Monitor therapy

CycloPHOSphamide: Thiazide and Thiazide-Like Diuretics may enhance the adverse/toxic effect of CycloPHOSphamide. Specifically, granulocytopenia may be enhanced. Risk C: Monitor therapy

CYP2C9 Inhibitors (Moderate): May decrease serum concentrations of the active metabolite(s) of Losartan. CYP2C9 Inhibitors (Moderate) may increase the serum concentration of Losartan. Risk C: Monitor therapy

Dapoxetine: May enhance the orthostatic hypotensive effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Desmopressin: Hyponatremia-Associated Agents may enhance the hyponatremic effect of Desmopressin. Risk C: Monitor therapy

Dexketoprofen: May enhance the adverse/toxic effect of Sulfonamides. Risk C: Monitor therapy

Dexmethylphenidate: May diminish the therapeutic effect of Antihypertensive Agents. Risk C: Monitor therapy

Diacerein: May enhance the therapeutic effect of Diuretics. Specifically, the risk for dehydration or hypokalemia may be increased. Risk C: Monitor therapy

Diazoxide: Thiazide and Thiazide-Like Diuretics may enhance the adverse/toxic effect of Diazoxide. Risk C: Monitor therapy

Diazoxide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Dichlorphenamide: Thiazide and Thiazide-Like Diuretics may enhance the hypokalemic effect of Dichlorphenamide. Risk C: Monitor therapy

Dofetilide: HydroCHLOROthiazide may enhance the QTc-prolonging effect of Dofetilide. HydroCHLOROthiazide may increase the serum concentration of Dofetilide. Risk X: Avoid combination

Drospirenone-Containing Products: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

DULoxetine: Blood Pressure Lowering Agents may enhance the hypotensive effect of DULoxetine. Risk C: Monitor therapy

Eplerenone: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Finerenone: Angiotensin II Receptor Blockers may enhance the hyperkalemic effect of Finerenone. Risk C: Monitor therapy

Flunarizine: May enhance the therapeutic effect of Antihypertensive Agents. Risk C: Monitor therapy

Heparin: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Heparins (Low Molecular Weight): May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Herbal Products with Blood Pressure Increasing Effects: May diminish the antihypertensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Herbal Products with Blood Pressure Lowering Effects: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Hypotension-Associated Agents: Blood Pressure Lowering Agents may enhance the hypotensive effect of Hypotension-Associated Agents. Risk C: Monitor therapy

Indoramin: May enhance the hypotensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Ipragliflozin: May enhance the adverse/toxic effect of Thiazide and Thiazide-Like Diuretics. Specifically, the risk for intravascular volume depletion may be increased. Risk C: Monitor therapy

Ivabradine: Thiazide and Thiazide-Like Diuretics may enhance the arrhythmogenic effect of Ivabradine. Risk C: Monitor therapy

Levodopa-Foslevodopa: Blood Pressure Lowering Agents may enhance the hypotensive effect of Levodopa-Foslevodopa. Risk C: Monitor therapy

Levosulpiride: Thiazide and Thiazide-Like Diuretics may enhance the adverse/toxic effect of Levosulpiride. Risk X: Avoid combination

Licorice: May enhance the hypokalemic effect of Thiazide and Thiazide-Like Diuretics. Risk C: Monitor therapy

Lithium: Thiazide and Thiazide-Like Diuretics may decrease the excretion of Lithium. Management: Reduce the lithium dose if coadministered with thiazide or thiazide-like diuretics. Monitor serum lithium levels during coadministration with thiazide and thiazide-like diuretics. Risk D: Consider therapy modification

Lithium: Angiotensin II Receptor Blockers may increase the serum concentration of Lithium. Management: Initiate lithium at lower doses in patients receiving an angiotensin II receptor blocker (ARB). Consider lithium dose reductions in patients stable on lithium therapy who are initiating an ARB. Monitor lithium concentrations closely when combined. Risk D: Consider therapy modification

Loop Diuretics: May enhance the hypotensive effect of Angiotensin II Receptor Blockers. Loop Diuretics may enhance the nephrotoxic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Loop Diuretics: May enhance the hypotensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Lormetazepam: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Lumacaftor and Ivacaftor: May decrease the serum concentration of CYP2C9 Substrates (High Risk with Inhibitors or Inducers). Lumacaftor and Ivacaftor may increase the serum concentration of CYP2C9 Substrates (High Risk with Inhibitors or Inducers). Risk C: Monitor therapy

Mecamylamine: Thiazide and Thiazide-Like Diuretics may enhance the adverse/toxic effect of Mecamylamine. Management: Consider avoiding the use of mecamylamine and thiazide diuretics. If combined, mecamylamine prescribing information suggests reducing the mecamylamine dose by 50% in order to avoid excessive hypotension. Risk D: Consider therapy modification

Methenamine: Thiazide and Thiazide-Like Diuretics may diminish the therapeutic effect of Methenamine. Risk C: Monitor therapy

Methotrexate: HydroCHLOROthiazide may enhance the nephrotoxic effect of Methotrexate. Risk C: Monitor therapy

Methoxsalen (Systemic): Photosensitizing Agents may enhance the photosensitizing effect of Methoxsalen (Systemic). Risk C: Monitor therapy

Methylphenidate: May diminish the antihypertensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Molsidomine: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Multivitamins/Fluoride (with ADE): May enhance the hypercalcemic effect of Thiazide and Thiazide-Like Diuretics. Risk C: Monitor therapy

Multivitamins/Minerals (with ADEK, Folate, Iron): Thiazide and Thiazide-Like Diuretics may enhance the hypercalcemic effect of Multivitamins/Minerals (with ADEK, Folate, Iron). Risk C: Monitor therapy

Multivitamins/Minerals (with AE, No Iron): Thiazide and Thiazide-Like Diuretics may increase the serum concentration of Multivitamins/Minerals (with AE, No Iron). Specifically, thiazide diuretics may decrease the excretion of calcium, and continued concomitant use can also result in metabolic alkalosis. Risk C: Monitor therapy

Naftopidil: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Neuromuscular-Blocking Agents (Nondepolarizing): Thiazide and Thiazide-Like Diuretics may enhance the neuromuscular-blocking effect of Neuromuscular-Blocking Agents (Nondepolarizing). Risk C: Monitor therapy

Nicergoline: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Nicorandil: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Nicorandil: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Nitroprusside: Blood Pressure Lowering Agents may enhance the hypotensive effect of Nitroprusside. Risk C: Monitor therapy

Nonsteroidal Anti-Inflammatory Agents: Thiazide and Thiazide-Like Diuretics may enhance the nephrotoxic effect of Nonsteroidal Anti-Inflammatory Agents. Nonsteroidal Anti-Inflammatory Agents may diminish the therapeutic effect of Thiazide and Thiazide-Like Diuretics. Risk C: Monitor therapy

Nonsteroidal Anti-Inflammatory Agents: Angiotensin II Receptor Blockers may enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents. Specifically, the combination may result in a significant decrease in renal function. Nonsteroidal Anti-Inflammatory Agents may diminish the therapeutic effect of Angiotensin II Receptor Blockers. The combination of these two agents may also significantly decrease glomerular filtration and renal function. Risk C: Monitor therapy

Nonsteroidal Anti-Inflammatory Agents (Topical): May diminish the therapeutic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Nonsteroidal Anti-Inflammatory Agents (Topical): May diminish the therapeutic effect of Thiazide and Thiazide-Like Diuretics. Risk C: Monitor therapy

Obinutuzumab: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Management: Consider temporarily withholding blood pressure lowering medications beginning 12 hours prior to obinutuzumab infusion and continuing until 1 hour after the end of the infusion. Risk D: Consider therapy modification

Opioid Agonists: May enhance the adverse/toxic effect of Diuretics. Opioid Agonists may diminish the therapeutic effect of Diuretics. Risk C: Monitor therapy

Pentoxifylline: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Pholcodine: Blood Pressure Lowering Agents may enhance the hypotensive effect of Pholcodine. Risk C: Monitor therapy

Phosphodiesterase 5 Inhibitors: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Polyethylene Glycol-Electrolyte Solution: Angiotensin II Receptor Blockers may enhance the nephrotoxic effect of Polyethylene Glycol-Electrolyte Solution. Risk C: Monitor therapy

Polyethylene Glycol-Electrolyte Solution: Diuretics may enhance the nephrotoxic effect of Polyethylene Glycol-Electrolyte Solution. Risk C: Monitor therapy

Porfimer: Photosensitizing Agents may enhance the photosensitizing effect of Porfimer. Risk C: Monitor therapy

Potassium Salts: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Potassium-Sparing Diuretics: Angiotensin II Receptor Blockers may enhance the hyperkalemic effect of Potassium-Sparing Diuretics. Risk C: Monitor therapy

Prazosin: Antihypertensive Agents may enhance the hypotensive effect of Prazosin. Risk C: Monitor therapy

Promazine: Thiazide and Thiazide-Like Diuretics may enhance the QTc-prolonging effect of Promazine. Risk X: Avoid combination

Prostacyclin Analogues: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Quinagolide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Ranolazine: May enhance the adverse/toxic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Reboxetine: May enhance the hypokalemic effect of Thiazide and Thiazide-Like Diuretics. Risk C: Monitor therapy

Selective Serotonin Reuptake Inhibitors: May enhance the hyponatremic effect of Thiazide and Thiazide-Like Diuretics. Risk C: Monitor therapy

Silodosin: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Sodium Phosphates: Angiotensin II Receptor Blockers may enhance the nephrotoxic effect of Sodium Phosphates. Specifically, the risk of acute phosphate nephropathy may be enhanced. Risk C: Monitor therapy

Sodium Phosphates: Diuretics may enhance the nephrotoxic effect of Sodium Phosphates. Specifically, the risk of acute phosphate nephropathy may be enhanced. Risk C: Monitor therapy

Sparsentan: May enhance the adverse/toxic effect of Angiotensin II Receptor Blockers. Risk X: Avoid combination

Tacrolimus (Systemic): Angiotensin II Receptor Blockers may enhance the hyperkalemic effect of Tacrolimus (Systemic). Risk C: Monitor therapy

Terazosin: Antihypertensive Agents may enhance the hypotensive effect of Terazosin. Risk C: Monitor therapy

Tolvaptan: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Topiramate: Thiazide and Thiazide-Like Diuretics may enhance the hypokalemic effect of Topiramate. Thiazide and Thiazide-Like Diuretics may increase the serum concentration of Topiramate. Risk C: Monitor therapy

Toremifene: Thiazide and Thiazide-Like Diuretics may enhance the hypercalcemic effect of Toremifene. Risk C: Monitor therapy

Trimethoprim: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Urapidil: Antihypertensive Agents may enhance the hypotensive effect of Urapidil. Risk C: Monitor therapy

Verteporfin: Photosensitizing Agents may enhance the photosensitizing effect of Verteporfin. Risk C: Monitor therapy

Vitamin D Analogs: Thiazide and Thiazide-Like Diuretics may enhance the hypercalcemic effect of Vitamin D Analogs. Risk C: Monitor therapy

Pregnancy Considerations

[US Boxed Warning]: Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus. When pregnancy is detected, discontinue therapy as soon as possible.

Refer to individual monographs for additional information.

Breastfeeding Considerations

It is not known if losartan is excreted in breast milk; thiazide diuretics are excreted in breast milk.

Due to the potential for serious adverse reactions in the breastfed infant, the manufacturer recommends a decision be made whether to discontinue breastfeeding or to discontinue the drug, taking into account the importance of treatment to the mother.

Refer to individual monographs for additional information.

Dietary Considerations

Some products may contain potassium.

Monitoring Parameters

Baseline and periodic BP, serum electrolytes, renal function, visual acuity, ocular pain.

Mechanism of Action

Losartan: As a selective and competitive, nonpeptide angiotensin II receptor antagonist, losartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II; losartan interacts reversibly at the AT1 and AT2 receptors of many tissues and has slow dissociation kinetics; its affinity for the AT1 receptor is 1000 times greater than the AT2 receptor. Angiotensin II receptor antagonists may induce a more complete inhibition of the renin-angiotensin system than ACE inhibitors, they do not affect the response to bradykinin, and are less likely to be associated with nonrenin-angiotensin effects (eg, cough and angioedema). Losartan increases urinary flow rate and in addition to being natriuretic and kaliuretic, increases excretion of chloride, magnesium, uric acid, calcium, and phosphate.

Hydrochlorothiazide: Inhibits sodium reabsorption in the distal tubules causing increased excretion of sodium and water as well as potassium and hydrogen ions.

Pharmacokinetics (Adult Data Unless Noted)

See individual agents.

Brand Names: International

International Brand Names by Country

For country code abbreviations (show table)

(AE) United Arab Emirates: Fortzaar | Hyzaar | Losakal plus ds | Losakal plus ls | Sortiva H;
(AR) Argentina: Antipresol d | Biablan d | Cozaarex d | Enromic d | Fensartan d | Loctenk D | Loplac d | Losacor d | Niten d | Niten d 100 | Paxon d | Presimax d | Prisonil D | Tacardia D | Tacicul d | Temisartan diur | Tenopres d;
(AT) Austria: Cosaar plus | Losarcomp | Losartan mepha plus | Losartan-HCT 1A Pharma | Losartan-HCT G.L. | Losartan-HCT Hexal | Losartan-HCT Sandoz | Losartan/HCT Actavis | Losartan/HCT Arcana | Losartan/hct krka | Losartan/HCT MSD | Losartan/hct ranbaxy | Losartan/Hct Ratiopharm | Losartan/HCT STADA | Losartan/Hct Teva | Losartan/hydrochlorothiazid bluefish;
(BD) Bangladesh: Acusan plus | Angitan plus | Anin plus | Anreb plus | Cardisan plus | Cardoplus | Lk Plus | Lopo Plus | Losacard-hz | Losan plus | Losan-d | Losardil-h | Losardil-hs | Losarva plus | Lospil plus | Nusartan plus | Osartil plus | Ostan Plus | Precon plus | Preslo h | Renosart plus | Rosatan-h | Sb losak plus | Xelotan Plus;
(BE) Belgium: Co Losartan | Co Losartan Apotex | Co-Losaratio | Cozaar plus | Loortan plus | Losartan plus;
(BF) Burkina Faso: Asmolos ht | Co losar | Colosar denk | Diprezar | Diprezar fort | Raasar h | Zyltan-h;
(BG) Bulgaria: Co hypertonic | Lorista h | Lorista HD | Lorista HL | Losarcon co | Lozap h | Rasoltan Plus | Tores;
(BR) Brazil: Aradois h | Cardvita h | Corus h | Hipress | Hyzaar | Lorsar + hct | Lorsar hct | Losartana potassica + hidroclorotiazida | Losartana potassica+hidroclorotiazida | Neopress | Neopress h | Torlos h | Valtrian Hct | Zaarpress HCT | Zart H;
(CH) Switzerland: Co Losartan | Co losartan spirig | Cosaar plus | Losartan hct actavis | Losartan hct axapharm | Losartan hct helvepharm | Losartan hct mepha lactabs | Losartan hct zentiva | Losartan plus;
(CI) Côte d'Ivoire: Co losar | Co Medzar | Co medzar fort | Co zartan | Co zartan fort | Colosar denk | Diprezar | Diprezar fort | Hyzaar | Locard h | Lopo Plus | Losarmax 50 | Losartil plus | Raasar h | Zyltan-h;
(CL) Chile: Aratan d | Corodin d | Hyzaar | Losapres-d | Losartan potasico/hidroclortiazida | Sanipresin-D | Simperten d | Tensivel-D;
(CN) China: An nei xi | Hyzaar | Losartan potassium and hydrochlorothiazide | Nai di ya | Xi shan;
(CO) Colombia: Aralox h | Cotasar plus | Expopress h | Hidroclorotiazida + losartan | Hyzaar | Hyzaar forte | Lodestar zid | Losanorm-h | Losarbay H | Losartan + hctz denk | Losartan + hidroclorotiazida | Losartan + Hidroclorotiazida la Sante | Losartan + hidroclorotiazida mk | Losartan HCT | Losartan potasico + hidroclorotiazida | Losartan potasico/hidroclorotiazida | Losartan w/Hidroclorotiazida | Losartan+hidroclorotiazida | Losartan/HCT | Loscar Plus | Satoren h | Satoren h forte | Tensartan-HCT;
(CZ) Czech Republic: Apo Combilos | Arionex combi | Giovax Plus H | Lorista h | Losagen Combi | Losap plus | Losaratio Plus H | Losartan / hydrochlorothiazid stada | Losartan hct bluefish | Losartan/hct krka | Loscomb | Lozap h | Nopretens Plus H | Sangona Combi;
(DE) Germany: Cozaar comp | Cozaar plus | Fortzaar | Hyzaar plus | Lorzaar plus | Losar Teva comp | Losar-Q comp | Losargamma HCT | Losarhct denk | Losarplus | Losartan actavis comp | Losartan Biomo comp. | Losartan comp CT | Losartan comp Heumann | Losartan comp Heunet | Losartan comp. AbZ | Losartan Dura plus | Losartan hct aaa | Losartan HCT Acis | Losartan hct aristo | Losartan HCT Atid | Losartan HCT Axcount | Losartan hct bluefish | Losartan hct dexcel | Losartan HCT Sandoz | Losartan hct zentiva | Losartan Hennig Plus | Losartan Hexal comp | Losartan hormosan comp | Losartan kalium comp basics | Losartan plus 1A Pharma | Losartan Ratiopharm comp | Losartan Winthrop comp. | Losartan-Kalium HCTad | Losartan-Kalium/Hydrochlorothiazid Orifarm | Losartan/HCT STADA;
(DK) Denmark: Anartan comp | Ancozan Comp | Cozaar comp | Fortzaar | Losartankalium/hydrochlorthiazid "Krka" | Losartankalium/hydrochlorthiazid "Teva" | Xartan h | Xartan hd;
(DO) Dominican Republic: Accord h | Angibloc D | Ara II D | Avantar Plus | Cardilat Simple D | Doxalam D | Eurolosart d | Hyzaar | Klovat d | Klovat Max | Losacor d | Losarfran D | Losartan + hidroclorotiazida | Losartan + Hidroclorotiazida Lam | Losartan H Feltrex | Losartan HCT | Losartan potasico hidroclorotiazida CALOX | Losartan+hidroclortiazida | Losartas ht | Nefrotal H | Nefrotal Plus | Paxon d | Presotan H | Renotensyl H | Rodicard h | Satoren h | Simperten d | Tamisen h | Xilanic plus;
(EC) Ecuador: Angioretic | Arados Hct | Beralosart d | Cardiovasc | Cardiovasc forte | Cardiovasc h | Convertal d | Convertal d 100 | Corodin d | Hyzaar | Lodestar zid | Losartan + Hidroclorotiazida la Sante | Losartan/hct mk | Losartan/hidroclorotiazida | Riocetic | Simperten d | Soolan htc;
(EE) Estonia: Fortzaar | Hyzaar | Lorista h | Losartan HCT | Lozap h;
(EG) Egypt: Amosar forte | Fortzaar | Hysartan | Hyzaar | Kanzar h | Loraz | Losar Plus | Losarmepha plus | Losazide | Lostapressin plus | Lozapress H | Modazar | Remtozar d;
(ES) Spain: Cozaar plus | Fortzaar | Lavestra hct | Losartan/Hidroclorotiazida Actavis | Losartan/hidroclorotiazida almus | Losartan/Hidroclorotiazida Alter | Losartan/hidroclorotiazida amneal | Losartan/Hidroclorotiazida Apotex | Losartan/hidroclorotiazida aristo | Losartan/Hidroclorotiazida Asol | Losartan/hidroclorotiazida Aurovitas | Losartan/Hidroclorotiazida Bluefish | Losartan/Hidroclorotiazida Cinfa | Losartan/hidroclorotiazida combix | Losartan/Hidroclorotiazida Kern Pharma | Losartan/Hidroclorotiazida Mabo | Losartan/Hidroclorotiazida Mylan | Losartan/Hidroclorotiazida Normon | Losartan/Hidroclorotiazida Pensa | Losartan/Hidroclorotiazida Pharmagenus | Losartan/Hidroclorotiazida Qualigen | Losartan/Hidroclorotiazida Ranbaxy | Losartan/Hidroclorotiazida Ratiopharm | Losartan/Hidroclorotiazida Sandoz | Losartan/Hidroclorotiazida Stada | Losartan/Hidroclorotiazida Sumol | Losartan/Hidroclorotiazida Tarbis | Losartan/Hidroclorotiazida TecniGen | Losartan/Hidroclorotiazida Teva | Losartan/Hidroclorotiazida UR | Losartan/Hidroclorotiazida Vir | Losartan/Hidroclorotiazida Winthrop;
(ET) Ethiopia: Colosar denk | Losa h | Losartan potassium and hydrochlorothiazide;
(FI) Finland: Cozaar comp | Losamyl comp | Losarstad Comp | Losartan HCT Bluef | Losartan/Hydrochlorthiazid Actavis | Losartan/Hydrochlorthiazid Krka | Losartan/Hydrochlorthiazid Orion | Losartan/Hydrochlorthiazid Sandoz | Losartan/Hydrochlorthiazid Teva | Losartan/Hydroklortiazid Orifarm | Losartiazid | Losatrix Comp;
(FR) France: Fortzaar | Hyzaar | Losartan/hydrochlorothiazide | Losartan/Hydrochlorothiazide Almus | Losartan/hydrochlorothiazide Alter | Losartan/hydrochlorothiazide Arrow | Losartan/Hydrochlorothiazide Biogaran | Losartan/hydrochlorothiazide Bouchara Record. | Losartan/Hydrochlorothiazide Cristers | Losartan/Hydrochlorothiazide EG | Losartan/hydrochlorothiazide evolugen | Losartan/hydrochlorothiazide isomed | Losartan/hydrochlorothiazide krka | Losartan/Hydrochlorothiazide Mylan | Losartan/hydrochlorothiazide phr lab | Losartan/Hydrochlorothiazide Qualimed | Losartan/Hydrochlorothiazide Ranbaxy | Losartan/Hydrochlorothiazide Sandoz | Losartan/hydrochlorothiazide teva | Losartan/Hydrochlorothiazide Winthrop | Losartan/Hydrochlorothiazide Zydus;
(GB) United Kingdom: Cozaar comp | Losartan potassium and hydrochlorothiazide | Losartan Potassium/Hydrochlorothiazide | Losartan/hydrochlorothiazide;
(GR) Greece: Cardzaar | Co Rabolan | Faxiven | Hypozar forte | Hysadrac | Hyzaar | Hyzaar extra forte | Loben plus | Logika | Lopernal | Lorotens plus | Lortamed plus | Lortazil plus | Losalet plus | Losarb plus | Losazide | Lozanel plus | Maxartan | Multiclop | Press Down Plus | Sartafin Plus;
(HK) Hong Kong: Cotiasar | Hyzaar | Hyzaar forte | Hyzaar plus | Losacor hct | Lostad hct | Osartil 50 plus | Zaart h | Zyltan-h;
(HR) Croatia: Fortzaar | Hyzaar | Lorista h | Lorista HD | Losartan h genera | Losartic plus | Lotan H;
(HU) Hungary: Co-Arbartan | Hyzaar | Lavestra H | Losartan HCT | Losartan hct 1a pharma | Losartan hct bluefish | Losartan HCT Ratiopharm | Lost HCT | Lostanorm Plus | Portiron HCT | Prelow Plus | Stadazar hct | Tervalon HCT;
(ID) Indonesia: Hyzaar;
(IE) Ireland: Cosartal plus | Cozaar comp | Cozatan comp | Losartan Hydrochlorothiazide Teva | Losartan/Hydrochlorothiazide bluefish | Lotanos Comp | Lozitar Comp | Myzaar Comp;
(IL) Israel: Losardex Plus | Lotan plus | Ocsaar Plus;
(IN) India: Actilop h | Alotan h | Alsartan-h | Angireb H | Angizaar h | Asart HT | Biosartan H | Bp cure h | Cardikare h | Cosart h | Covance D | Czar-h | Giftan-hc | Hysartas | Icosar h | Lara H | Lo H | Loar H | Lopassium h | Lopt h | Lorsave-h | Losa h | Losacar h | Losain h | Losalife H | Losamax-H | Losanorm-h | Losar H | Losartas ht | Losasun ht | Losatec h | Losatrust-h | Losavas-h | Loscom H | Losfirst h | Lospot-h | Lostan h | Lostat-h | Lot-h | Lotace-h | Lotak H | Lotas HT | Lotemos ht | Loten H | Lotop h | Loza ht | Ltk-H | Miotin H | Nusar h | Omnitan-h | Relate h | Repace h | Resilo H | Resitan h | Revas-h | Rigard H | Sarpot h | Strok Rok | Tozaar-h | Vazortan h | Zaart h | Zargo h | Zeosartan h | Zilos H | Zyltan-h;
(IQ) Iraq: Losart H;
(IS) Iceland: Lopress comp | Presmin combo;
(IT) Italy: Forzaar | Hizaar | Lorcombi | Losartan e idroclorotiazide aurobindo | Losartan e idroclorotiazide doc generici | Losartan e Idroclorotiazide Ranbaxy | Losartan e idroclorotiazide s.f.group | Losartan e idroclorotiazide tecnigen | Losartan hct ate | Losartan hct Doc | Losartan Hct EG | Losartan hct grp | Losartan Hct Myl | Losartan hct Rat | Losartan Hct San | Losartan hct Tev | Losartan Hct Wpi | Losartan idroclorotiazide almus | Losartan idroclorotiazide mylan generics | Losartan idroclorotiazide sandoz | Losartan/idroclorotiazide teva | Losazid | Lozid | Neo Lotan P.100/25 | Neo lotan plus | Prectiazide;
(JO) Jordan: Hyzaar;
(JP) Japan: Losarhyd | Losarhyd ffp | Losarhyd ld;
(KE) Kenya: Alsartan-h | Angizaar h | Bepsar plus | Carditan h | Cardoplus | Colosar denk | Dawalor H | Dinlaar h | Kanzar h | Lora hc | Lortan h | Losacar h | Losakind h | Losangio ht | Losapress h | Losar H | Losartas ht | Losastal hl | Losatec h | Losi ht | Lotenz h | Lozart h | Normozide | Nusar h | Presartan h | Prosan hz | Repace h | Reten h | Tozaar h | Unizar h | Xartan 50 h | Zaart h | Zyltan-h;
(KR) Korea, Republic of: Aukostan plus | Aukostan plus f | Azertan Plus | Azertan plus-f | Bearotan plus | Bearotan plus f | Bearotan plus pro | Bicoza plus | Bicoza plus f | Br sartan plus | Br sartan plus f | Brsartan Plus | Ceroz Plus | Ceroz plus pro | Cezarplus | Cezarplus F | CezarplusPro | Chlotan plus | Colosa plus | Cortan da plus | Cortan da plus f | Cortan da plus pro | Cosal plus | Cosaltan Plus | Cosarotan plus | Cosartan plus | Cosartan Plus pro | Cosatin Plus | Cosatinplus | Cosca Plus | Cosca plus f | Cosca plus pro | Cozaar plus | Cozaar plus f | Cozaar plus pro | Cozahu plus | Cozaltanplus | Cozan plus | Cozanew plus | Cozarotan plus pro | Cozartan plus | Cozartan plus f | Cozartan plus pro | Cozasartan plus | Cozatan Plus | Daehwa losartan plus f | Elsartan plus | Husartan | Hyloza | Hyzaltan plus F | Hyzaltanplus | Il Yang Losartan Plus | Il yang losartan plus f | Il yang losartan plus pro | Inno.n losartan plus | Inno.n losartan plus f | Inno.n losartan plus pro | Jw lozaltan plus | Karozaar plus | Kosartan plus | Kukje losartan plus | Kukje losartan plus f | L sartan plus | Locartan plus f | Locatan plus | Locatan plus f | Locatan plus pro | Locotan plus | Loderplus | Lodplus f | Losachro d | Losaco plus | Losacom | Losacom f | Losacom pro | Losain plus | Losain plus f | Losal plus | Losal plus v | Losargen plus | Losarmax plus | Losarpin plus | Losartal plus | Losartam Plus | Losartam plus f | Losartam plus pro | Losartan plus | Losartan plus f | Losartin Plus | Losartin plus f | Losarwin plus | Losastar plus | Losat plus | Losata Plus | Losata Plus F | Losatam plus | Losatam plus f | Losatam plus pro | Losatan plus | Losatin plus f | Lositenplus | Lotan plus | Lotan plus f | Lotein plus f | Lozacal plus f | Lozarcom | Lozarkan Plus | Lozarkan plus pro | Lozarsin Plus | Lozasartan Plus | Lozasartan plus pro | Lozata plus | Lozata plus f | Lozatal plus | Lozetin plus | Lozetplus | Loziten Plus | Luzatan plus | Nurotan plus | Nurotanplus f | Osartan Plus | Rocatan plus | Rocatan Plus Pro | Ropin plus | Ropin plus F | Rosain plus | Rosain plus f | Rosaninplus | Rosaninplus f | Rosaplem | Rosaplus | Rosaplus F | Rosar plus | Rosas plus | Roza m | Rozalplus | Rozaplus | Rozaplus f | Rozasaltanplus | Rozatan plus | Rozataplus | Rozentan plus | Rozetinplus | Salotan plus | Salotan plus-f | Sarlotan plus | Sarlotan plus f | Sarlotan plus pro | Sezarplus | Simsatan plus | Ucodinplus | Wonsartan Plus | Wonsartan plus f | Wonsartan Plus Pro | Zaratan Plus | Zaratan Plus F | Zarotan plus | Zartan plus | Zerosartan plus;
(KW) Kuwait: Fortzaar | Hyzaar | Sortiva H;
(LB) Lebanon: Cardzaar | Fortzaar | Hyzaar | Losanet h forte | Losanet-H | Losartan/hydrochlorothiazide Arrow | Losartan/hydrochlorothiazide bgr;
(LT) Lithuania: Covance hct | Fortzaar | Hyzaar | Lorista h | Losartan Hydrochlorothiazide Actavis | Losartan potassium/ Hydrochlorothiazide Milpharm | Sartens Plus | Sartizid | Tarnasol Plus;
(LU) Luxembourg: Cozaar plus | Loortan plus | Losartan plus | Losartan Ratiopharm comp;
(LV) Latvia: Covance hct | Fortzaar | Hyzaar | Lorista h | Lozap h | Sartens Plus;
(MA) Morocco: Ancine plus | Bi hyplos | Co Anginib | Co Medzar | Co Rosar | Co tanzaar | Co vizartan | Diprezar | Hyzaar | Losartan/Hctz Gt | Vizartan d;
(MX) Mexico: Angitor ht | Co Tarsan | Hyzaar | Lodestar zid | LOSARTAN / HIDROCLOROTIAZIDA | Losartan and hidroclorotiazida liomont | Losartan and hidroclorotiazida teva | Saravanta d | Systocal duo | Takilpam urti | Viopexa h;
(MY) Malaysia: Acetan HCT | Fortzaar | Hyzaar | Lorista h | Lostad hct | Presartan h | Tozaar h | Tozaar plus | Zosaar hct | Zylovaa h;
(NG) Nigeria: Czartan h | Loryza h | Losapress h | Losartan potassium and hydrochlorothiazide | Losarzide | Lozatan h | Nusar h;
(NL) Netherlands: Cozaar plus | Entrizen/HCT | Fortzaar | Forzaar | Hyzaar | Kaliumlosartan/hydrochloorthiazide | Kaliumlosartan/Hydrochloorthiazide Actavis | Kaliumlosartan/Hydrochloorthiazide ratiopharm | Kaliumlosartan/Hydrochloorthiazide Sandoz | Losartan/hydrochloorthiazide | Losartankalium/HCT | Losartankalium/HCT CF | Losartankalium/HCT PCH | Losartankalium/hct xiromed | Losartankalium/Hydrochloorthiazide | Losartankalium/hydrochloorthiazide A | Losartankalium/Hydrochloorthiazide Apotex | Losartankalium/hydrochloorthiazide Bluefish | Losartankalium/Hydrochloorthiazide Mylan | Losazid;
(NO) Norway: Cozaar comp | Fortzaar | Hyzaar | Losartan Hydrochlorothiazide Teva | Losartan plus | Losartan/HCT Orifarm | Losartan/Hydrochlorothiazide bluefish | Losartan/Hydrochlorothiazide Sandoz;
(NZ) New Zealand: Arrow losartan potassium & hydrochlorothiazide | Hyzaar | Losartan/Hydrochlorothiazide Generic health;
(PE) Peru: Artanbix d | Corodin d | Covance D | Hyzaar | Losacor d | Losartan + hidroclorotiazida | Presartan h | Rifex d;
(PH) Philippines: 2zaris | A.R.A + H | Actizar h | Angiotrust | Angizaar h | Anin 50 plus | AnzaPlus | Arbloc Plus | Artal h | Artazide | Co normoten | Cohart | Combetzar | Combizar | Coxart | Duosar | Ecozar Plus | Ekosart plus | Getzar Plus | Gosart plus | Hextan plus | Hyzaar | Kenzar Plus | Lipewin H Forte | Loras plus | Lorzan | Losacar h | Losargard Plus | Losarite | Losart H | Losawin H | Lozarsin Plus | Medzart plus | Neosartan Plus | Nipartan H | Presartan h | Prestan plus | Prozart plus | Punsartan | Rossar plus | Sartan-h | Thiaxtan | Vazortan h | Vivasartan plus | Wilopres plus | Xartan Plus | Zarnat plus | Zartan plus | Zeftan plus;
(PK) Pakistan: Acozar h | Actilop h | Artazide | Bepsar plus | Blaze plus | Co A2A | Co Aceartin | Co-eziday | Corik-h | Diu-tansin | Dv losartan plus | Fortzaar | Giozar-D | Hysartan | Hyzaar | Larsen T | Lopec h | Lopgon | Loplus | Losaan-H | Losanta Diu | Losap h | Losar Plus | Losascot plus | Losaten h | Lotansin d | Lotense-h | Lousa plus | Medisartan plus | Nonsart | Normozide | Osran-tz | Sar-k plus | Sarcol H | Sartan-h | Sarutan Plus | Vezaar plus | Xavor-diu | Xetaplus | Zaarlo forte;
(PL) Poland: Hyzaar | Lakea hct | Loreblok HCT | Lorista h | Lorista HD | Losacor hct | Losagen Combi | Losargamma HCT | Losartan + hct genoptim | Losartan hct bluefish | Losartan hct pfizer | Losartan+hct arrow | Lozap hct | Presartan h | Rasoltan HCT | Sortabax hct | Stadazar hct | Xartan hct;
(PR) Puerto Rico: Hyzaar | Losartan k/hctz | Losartan pot hctz | Losartan potassium and hydrochlorothiazide | Losartan potassium/hctz;
(PT) Portugal: Cotiasar | Cozaar plus | Fortzaar | Hipara | Lorista h | Lortaan plus | Losarbio | Losartan + Hidroclorotiazida Actavis | Losartan + hidroclorotiazida almus | Losartan + hidroclorotiazida aurobindo | Losartan + hidroclorotiazida Azevedos | Losartan + hidroclorotiazida Basi | Losartan + hidroclorotiazida bluefish | Losartan + hidroclorotiazida Bluepharma | Losartan + hidroclorotiazida germed | Losartan + Hidroclorotiazida Medirex | Losartan + Hidroclorotiazida Mepha | Losartan + Hidroclorotiazida Oara | Losartan + hidroclorotiazida ratiopharm | Losartan + hidroclorotiazida rominguer | Losartan + Hidroclorotiazida Stada | Losartan + hidroclorotiazida teva | Losartan + hidroclorotiazida Wynn | Losartan+hidroclorotiazida | Losartan+Hidroclorotiazida Mylan;
(PY) Paraguay: Accord h | Convertal d | Coronovo d | Coronovo d forte | Gadotensil D | Hecordil d | Hipercor d | Lozax d | Lozax d forte | Rhytmus d | Simperten d | Tensofar d;
(QA) Qatar: Fortzaar | Hyzaar | Losanet-H | Sortiva H;
(RO) Romania: Hyzaar | Lorista h | Lorista HL;
(RU) Russian Federation: Bloctran ht | Cardomin plus sanovel | Gizortan | Hydrochlorothiazide + losartan | Hydrochlorothiazide losartan | Hyzaar | Hyzaar forte | Lakea H | Lorista h | LORISTA h100 | Lorista HD | Losarel plus | Losartan N | Losartan n canon | Losartan N richter | Losartan/hydrochlorothiazide teva | Lozap plus | Presartan h | Presartan n | Simartan n | Vasotens h | Vazotenz h;
(SA) Saudi Arabia: Azar d | Fortzaar | Hyzaar | Pms losartan hctz | Sortiva H;
(SE) Sweden: Fortzaar comp | Losarstad comp stada | Losartan/hydrochlorothiazide amneal | Losartan/Hydrochlorothiazide bluefish | Losartan/hydrochlorothiazide krka | Losartan/Hydrochlorothiazide Medical Valley | Losartan/Hydrochlorothiazide Sandoz | Losartan/hydrochlorothiazide teva | Losartan/hydroklortiazid actavis | Losartan/hydroklortiazid jubilant | Losartan/Hydroklortiazid Orifarm | Losatrix Comp | Losazid comp | Marozid | Tanlozid;
(SG) Singapore: Hyzaar | Losartan+hct;
(SI) Slovenia: Fortzaar | Hyzaar | Lorista h | Lorista HD | Losartic HC;
(SK) Slovakia: Asortek combi | Hyzaar | Lakea Comp | Losartan/HCT | Losartan/hydrochlorotiazid bluefish | Losartan/hydrochlorotiazid krka | Loscomb | Lozap h;
(TH) Thailand: Fortzaar | Hyzaar;
(TN) Tunisia: Co losar | Co Losartan | Co Medzar | Co zartan | Hyzaar;
(TR) Turkey: Co-Hilos | Eklips | Eklips plus | Felow Plus | Hyzaar | Losapres plus | Losartil plus | Loxibin Plus | Pensartan | Sarilen plus | Sarvastan;
(TW) Taiwan: Hisart | Hyzaar | Losa & hydro | Losartan sandoz | Losarzide | Synzar;
(UA) Ukraine: Angizaar plus | Cardomin plus | Co sentor | Hyzaar | Locard | Lorista h | Lorista HD | Losartan plus teva | Losartic plus | Lozap plus | Lozeks plus | Nostasartan h | Presartan h | Tozaar g;
(UG) Uganda: Angizaar h | Colosar denk | Losa h | Losacar h | Losartas ht | Presartan h | Tozaar h;
(UY) Uruguay: Cartan D | Convertal d | Diurosartan | Loxar D | Ras d | Tensilar D;
(VE) Venezuela, Bolivarian Republic of: Cormatic | Hyzaar | Hyzaar plus | Klovat d | Lodestar hct | Losapres plus | Losartan HCT | Losartan potasico hidroclorotiazida | Losartan potasico/hidroclorotiazida | Losartan/hidroclotiazida | Nefrotal H | Ofapres Plus | Redyscar H | Sortal HCT | Tenseretic;
(VN) Viet Nam: Agilosart h | Lousartan | Nerazzu hct | Opesartan plus | Pyzacar hct | Zadirex H;
(ZA) South Africa: Austell losartan co | Ciplazar Co | Co normoten | Cozaar comp | Fortzaar | Hytenza Co | Lohype plus | Losaar Plus | Losacar Co | Losartan co unicorn | Lozaan co | Netrasol Co | Sartoc | Zartan Co;
(ZM) Zambia: Colosar denk | Los arb comp | Losa h | Losakind h | Nusar h | Presartan h | Tozaar-h | Vazortan h;
(ZW) Zimbabwe: Presartan h | Tozaar-h

2023 American Geriatrics Society Beers Criteria Update Expert Panel. American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;71(7):2052-2081. doi:10.1111/jgs.18372 [PubMed 37139824]
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Hyzaar (losartan/hydrochlorothiazide) [prescribing information]. Jersey City, NJ: Organon LLC; June 2021.
Hyzaar (losartan/hydrochlorothiazide) [prescribing information]. Jersey City, NJ: Organon LLC; March 2023.
Hyzaar and Hyzaar DS (losartan/hydrochlorothiazide) [product monograph]. Kirkland, Quebec, Canada: Organon Canada Inc; November 2022.
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Losartan and hydrochlorothiazide: Drug information