Cozaar-comp

How does it work?

Cozaar-comp tablets contain two active ingredients, hydrochlorothiazide and losartan potassium.

Hydrochlorothiazide is a type of medicine known as a thiazide diuretic. Thiazide diuretics act in the kidney, where they increase the production of urine. They work by causing the kidneys to increase the amount of salts, such as potassium and sodium, that are filtered out of the blood and into the urine. When these salts are filtered out of the blood by the kidneys, water is also drawn alongside. As hydrochlorothiazide increases the removal of salts from the blood, it also causes more water to be drawn out of the blood and into the urine. Removing water from the blood decreases the volume of fluid circulating through the blood vessels, which lowers the pressure within the blood vessels, ie lowers blood pressure. It also decreases the effort required by the heart to pump the blood around the body.

Losartan is a type of medicine called an angiotensin II receptor 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. It causes the peripheral blood vessels to narrow, and it also 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 helps lower blood pressure.

These two medicines are used together to have a combined effect in treating high blood pressure.

It has also 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 this medicine to reduce their chances of experiencing a stroke. However, this medicine is not effective for this particular use in black patients.

What is it used for?

High blood pressure

Reducing risk of stroke in people with high blood pressure and an enlarged heart (left ventricular hypertrophy)

Warning!

As diuretics cause your kidneys to produce more urine, you may prefer to take this medicine in the morning rather than before going to bed, as this will reduce the likelihood of you needing to get up in the night to visit the toilet. Seek further advice from your doctor or pharmacist.

This medicine can occasionally cause your blood pressure to drop when you move from a lying down or sitting position to sitting or standing. This may make you feel dizzy or unsteady. To avoid this try getting up slowly. If you do feel dizzy, sit or lie down until the symptoms pass.

Dizziness and weariness may occasionally occur during treatment with blood pressure lowering medicines. This may be made worse by drinking alcohol. If you are affected, caution is required when driving or operating machinery.

It is recommended that people taking this medicine have their blood pressure, kidney function and fluid and salt (electrolyte) balance monitored regularly.

If you experience any of the following symptoms while taking this medicine you should inform your doctor promptly, so that the amount of fluids and salts in your body can be checked: thirst, lethargy, confusion, weakness, drowsiness, muscle cramps, scanty production of urine, abnormal heart rhythm, seizures, nausea and vomiting.

If you need a test to assess the functioning of your parathyroid gland your doctor may ask you to stop taking this medicine beforehand, as it may interfere with the test results.

This medicine is not recommended for children.

Use with caution in

Elderly people over 75 years of age

Decreased volume of fluid in the body, eg due to high doses of diuretics, severe vomiting or diarrhoea

Decreased kidney function

Narrowing of the artery which supplies blood to the kidneys (renal artery stenosis)

People who have had a kidney transplant

Severe heart failure

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

Narrowing of one of the valves in the heart (mitral valve stenosis)

Narrowing of the main artery of the body (aortic stenosis)

Diabetes

Gout

High levels of calcium in the blood (hypercalcaemia)

High levels of fats (lipids) such as cholesterol and triglycerides in the blood

Long-term inflammation of skin and some internal organs (systemic lupus erythematosus)

Not to be used in

Allergy to medicines from the sulphonamide group, eg the antibiotic sulfamethoxazole

Decreased liver function

Moderate to severely decreased kidney function

Failure of the kidneys to produce urine (anuria)

Pregnancy

Breastfeeding

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

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 is likely to be harmful to the unborn baby. You should use adequate contraception to avoid getting pregnant while taking this medicine. If you do get pregnant, stop taking this medicine and inform your doctor immediately. Seek further medical advice from your doctor.

It is not known whether losartan passes into breast milk, however thiazides do pass into breast milk. As this may have unwanted effects on the nursing infant, 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

Fatigue

Balance problems involving the inner ear (vertigo)

Inflammation of the liver (hepatitis)

Cough

Skin reactions such as rash or itch

Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain

Loss of appetite

Cramps

Disturbances in the levels of blood cells in the blood

Disturbances in the levels of salts (electrolytes, eg sodium and potassium) in the blood

Raised blood sugar level

Disturbance in kidney or liver function

Headache

Pain in the muscles (myalgia)

Severe swelling of lips, face, throat or tongue (allergic reaction called 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.

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