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Generic Name: Hydrochlorothiazide and losartan
Brand Name(s):
Information updated: April 1, 2000
Overview
Hyzaar combines a new kind of blood pressure medicine (prescribed alone as
Cozaar) with an old-fashioned diuretic, hydrochlorothiazide (HCTZ).
It
is prescribed for high blood pressure, especially if neither drug alone has
lowered blood pressure adequately.
Hyzaar may be less effective for
African-American patients.
Side Effects and Interactions
People on Hyzaar have experienced dizziness,
weakness, insomnia, muscle cramps or pains, nasal congestion and sinusitis.
Other side effects reported include faintness, low blood pressure,
diarrhea, vomiting, indigestion, chest pain and impotence.
Unusual but
serious reactions to hydrochlorothiazide include rashes which require medical
attention, allergic reactions (anaphylaxis) that involve difficulty breathing
and shock, changes in blood, increased blood sugar, and disturbances in the
balance of electrolytes.
Periodic blood tests are necessary to check on
levels of potassium, magnesium, and other electrolytes. Report any symptoms to
the physician promptly.
Dizziness or faintness may be worsened by
alcohol, barbiturates, narcotic pain medicine, or dehydration through excess
sweating, diarrhea or vomiting. Be especially careful when sitting or standing
up.
Hyzaar is not appropriate during the second or third trimesters of
pregnancy. If a woman taking Hyzaar becomes pregnant, she should consult her
doctor as soon as possible.
The dose of diabetes medicine may need to be
adjusted.
Questran and Colestid may reduce absorption of HCTZ and should
be taken at a different time of day.
Muscle relaxants and cortisone-like
drugs also have the potential to interact.
Arthritis drugs, including
OTC NSAIDs like Advil
or Aleve, may interfere with the effectiveness of HCTZ.
Lithium is not
considered compatible with this diuretic and may become more
toxic.
Hydrochlorothiazide alone can make the skin more sensitive to the
sun. Avoiding sun exposure or using sunscreen and protective clothing are
sensible precautions for those taking Hyzaar.
Tagamet
may increase the level of Hyzaar slightly, while phenobarbital reduces it.
Interactions with other drugs such as erythromycin,
Nizoral, or Sporanox have not been documented but are theoretically possible
because losartan is metabolized by CYP 450 enzymes in the liver.
Licorice
can greatly increase potassium loss due to medicines such as
hydrochlorothiazide.
Check with your doctor and pharmacist to make sure
Hyzaar is safe in combination with any other drugs or herbs you take.
Special Precautions
Hyzaar is not recommended for people with liver disease. Serious kidney problems may also interfere with the safe use of Hyzaar.
Hydrochlorothiazide can aggravate lupus (SLE). Make sure your physician is aware of your health history.
Taking the Medicine
Hyzaar may be taken when convenient, with or without food.
It is taken once or twice a
day, according to the prescription.
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Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. Their syndicated radio show can be heard on public radio.
© 2000