Cozaar tablets contain the active ingredient losartan potassium, which is a type of medicine called an angiotensin II antagonist. It works by preventing the action of a hormone in the body called angiotensin II.

Angiotensin II normally acts on special receptors in the body, with two main results. Firstly, it causes the peripheral blood vessels to narrow, and secondly, it stimulates the production of another hormone called aldosterone. Aldosterone causes salt and water to be retained by the kidneys, which increases the volume of fluid in the blood vessels.

Losartan blocks the receptors that angiotensin II acts on, and so prevents its actions. The main result of this is that the peripheral blood vessels are allowed to widen, which means that there is more space and less resistance in these blood vessels. This is the main mechanism by which the pressure in the blood vessels is lowered.

Blocking the actions of angiotensin II also reduces the action of aldosterone on the kidneys. The result of this is an increase in the amount of fluid removed from the blood by the kidneys. This decreases the amount of fluid in the blood vessels, which also lessens the resistance and pressure in the blood vessels.

The combined overall effect of these changes is to lower the blood pressure, hence losartan is used to treat high blood pressure.

Losartan has been shown to reduce the risk of stroke in people who have high blood pressure together with an enlargement in the left side of their heart (left ventricular hypertrophy). People with both these conditions may therefore be prescribed losartan to reduce their chances of experiencing a stroke. However, this medicine is not effective for this particular use in black patients.

Losartan has also been shown to delay the progression of kidney disease in people with type 2 diabetes who have related kidney complications. If you have diabetic kidney disease you may be prescribed losartan for this reason, regardless of whether or not you also have high blood pressure.

Use with caution in

• Elderly people over 75 years of age
  
  
• Decreased fluid volume in the body, eg due to diuretic therapy, low salt diet, kidney dialysis, diarrhoea, vomiting, dehydration
  
  
• History of decreased liver function
  
  
• Moderate to severely decreased kidney function
  
  
• Narrowing of the artery which supplies blood to the kidneys (renal artery stenosis)
  
  
• People who have had a kidney transplant

• Heart disease characterised by thickening of the internal heart muscle and a blockage inside the heart (hypertrophic obstructive cardiomyopathy)

• Narrowing of the main artery of the body (aortic stenosis)
  
  
• History of swelling of the lips, face or tongue (angioedema) caused by an ACE inhibitor or other medicine.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

• This medicine should not be used during pregnancy as it may be harmful to the developing foetus. You should use adequate contraception to avoid getting pregnant while taking this medicine. Seek medical advice from your doctor. If you get pregnant during treatment you should stop taking this medicine immediately and consult your doctor.
  
  
• It is not known whether this medicine passes into breast milk. Breastfeeding mothers should either stop treatment during the time that they are breastfeeding, or not breastfeed and continue treatment. This will depend on how important the medicine is for the mother’s health. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

• Dizziness
  
  
• Weakness or loss of strength (asthenia)
  
  
• Fatigue
  
  
• Balance problems involving the inner ear (vertigo)
  
  
• Low blood pressure (hypotension)
  
  
• High blood potassium level (hyperkalaemia)
  
  
• Diarrhoea
  
  
• Low red blood cell count (anaemia) or platelet count (thrombocytopenia)
  
  
• Inflammation of the liver (hepatitis)
  
  
• Alteration in results of liver function tests
  
  
• Migraine
  
  
• Pain in the muscles and joints
  
  
• Rash or itching
  
  
• Cough
  
  
• Severe swelling of lips, face or tongue (angioedema)
  
  

The side effects listed above may not include all of the side effects reported by the drug’s manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

Cozaar

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Cardura (Doxazosin mesylate)

DRUG CLASS AND MECHANISM : Cardura is in a class of drugs called inhibitor of the alpha 1 adrenergic nervous system. This group also includes alfusosin (Uroxatral), terazosin (Hytrin), tamsulosin (Flomax), and prazosin (Minipress). Elevated blood pressure (hypertension) is lowered by the action of these nerves, which provoke narowwing of blood vessels. As the prostate gland is also under the influence of the alpha adrenergic portion nervous system Cardura also relax the muscles around it. This can makes urination easier for men suffered by enlarged prostate glands.
STORAGE : Keep in a dry place at 30 degrees C (86 F).

PRESCRIBED FOR : Cardura is applied for the control of elevated blood pressure (hypertension) and for non-malignant prostatic hyperplasia (noncancerous enlargement of the prostate gland).

DOSING : The doses of Cardura should be directed by your physician. This can be accepted with meals or without them. Cardura should be taken the same time each day to support constant blood levels. If you are taking antacid drugs do not take Cardura within two hours after it. If stopped you must taper the dose.

DRUG INTERACTIONS : Do not use too much. First doses of Cardura or any Alpha 1 inhibitor should be accepted carefully. The first doses may cause strong lowering of the blood pressure and lead to dizziness and fainting, that’s why it is necessary to fallow the dose strictly. Usually it is correct to extend the dose slowly.

PREGNANCY : During pregnancy this drug should be accepted strictly under indications.

SIDE EFFECTS : An uncommon but dangerous side effect is a reduction of blood cells which normally take part in fighting with infection. Liver damage is uncommon. Dizziness and fainting can occur in case of fast redusing of the blood pressure. The acception of Cardura may lead to swelling of the ankles and fatigue. It is necessary to make periodic blood studies during taking Cardura. This drug may cause nausea, headaches, anxiety, insomnia, drowsiness, nasal congestion and sexual dysfunction, but it happens seldom. You can find out all additional information about this drug at your doctor or pharmacist.

Cardura

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Generic name: Spironolactone

Why is Aldactone prescribed?

Aldactone flushes excess salt and water from the body and controls high blood pressure. It is used in the diagnosis and treatment of hyperaldosteronism, a condition in which the adrenal gland secretes too much aldosterone (a hormone that regulates the body’s salt and potassium levels). It is also used in treating other conditions that require the elimination of excess fluid from the body. These conditions include congestive heart failure, high blood pressure, cirrhosis of the liver, kidney disease, and unusually low potassium levels in the blood. When used for high blood pressure, Aldactone can be taken alone or with other high blood pressure medications.

Most important fact about Aldactone

If you have high blood pressure, you must take Aldactone regularly for it to be effective. Since blood pressure declines gradually, it may be several weeks before you get the full benefit of Aldactone; and you must continue taking it even if you are feeling well. Aldactone does not cure high blood pressure; it merely keeps it under control.

How should you take Aldactone?

Take Aldactone exactly as prescribed by your doctor. Stopping Aldactone suddenly could cause your condition to worsen.

• If you miss a dose…
  Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never take 2 doses at the same time.

• Storage instructions…
  Store at room temperature.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Aldactone.

• Side effects may include:
  Abdominal cramps, breast development in males, change in potassium levels (leading to such symptoms as dry mouth, excessive thirst, weak or irregular heartbeat, and muscle pain or cramps), deepening of voice, diarrhea, drowsiness, excessive hairiness, fever, headache, hives, irregular menstruation, kidney problems, lack of coordination, lethargy, liver problems, mental confusion, postmenopausal bleeding, severe allergic reaction, sexual dysfunction, skin eruptions, stomach bleeding, stomach inflammation, ulcers, vomiting

Why should Aldactone not be prescribed?

You should not take Aldactone if you have kidney disease, an inability to urinate, difficulty urinating, or high potassium levels in your blood.

Special warnings about Aldactone

Potassium supplements or other diuretics that leave your potassium levels high, such as triamterene, should not be used while taking Aldactone, unless specifically indicated by your doctor. Symptoms of excess potassium include tingling sensations, fatigue, muscle weakness or paralysis, and a slow heartbeat. If you develop these problems, call your doctor immediately.

ACE inhibitors, used for blood pressure and heart failure, should not be taken while using Aldactone.

If you are taking Aldactone, your kidney function should be given a complete assessment and should continue to be monitored.

If you have liver disease, your doctor will be cautious about using this medication.

Excessive sweating, severe diarrhea, or vomiting could cause you to lose too much water and cause your blood pressure to become too low. Signs of dehydration include thirst, dry mouth, weakness, drowsiness, muscle fatigue, muscle cramps, restlessness, reduced urination, and a rapid heartbeat. Be sure to drink plenty of fluids whenever dehydration threatens, and be careful when exercising in hot weather.

Notify your doctor or dentist that you are taking Aldactone if you have a medical emergency, and before you have surgery or dental treatment.

Possible food and drug interactions when taking Aldactone

If Aldactone is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Aldactone with the following:

Special information if you are pregnant or breastfeeding

The effects of Aldactone during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. Aldactone appears in breast milk and could affect a nursing infant. If this medication is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment with this medication is finished.

Recommended dosage for Aldactone

Initial dosages of this medication are used to determine the presence of primary hyperaldosteronism (too much secretion of the adrenal hormone aldosterone). People can be tested with this medication over either a long or a short period of time.

In the long test, you take 400 milligrams per day for 3 to 4 weeks. If your potassium levels and blood pressure are corrected with this dosage in this time period, your physician may assume you have this condition.

In the short test, you receive 400 milligrams per day for 4 days. A laboratory test compares potassium levels while you are on Aldactone and after the medication is stopped. Your doctor may then make a diagnosis.

After the diagnosis of primary hyperaldosteronism is made and confirmed by more tests, the usual dose is 100 to 400 milligrams per day, prior to surgery. In those who are not good candidates for surgery, this drug is given over the long term at the lowest effective dose.

Fluid Retention (Congestive Heart Failure, Cirrhosis of the Liver, or Kidney Disorders)

The usual starting dosage is 100 milligrams daily either in a single dose or divided into smaller doses. However, your doctor may have you take daily doses as low as 25 milligrams or as high as 200 milligrams.

Your doctor may choose to adjust your dosage after an initial 5-day trial period or add another diuretic medication to this one.

Essential Hypertension (High Blood Pressure)

The usual starting dosage is 50 to 100 milligrams daily in a single dose or divided into smaller doses. This medication may be given with another diuretic or with other high blood pressure medications.

It may be up to 2 weeks before the full effect of this medication is seen. Your doctor can then adjust the dosage according to your response.

Hypokalemia (Potassium Loss)

Your doctor may have you take daily dosages of 25 milligrams to 100 milligrams when potassium loss caused by the effects of a diuretic cannot be treated by a potassium supplement.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

• Symptoms of Aldactone overdose may include:
  Confusion, diarrhea, dizziness, drowsiness, nausea, patchy raised skin rash, vomiting

Aldactone

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