Lozap Plus, tablets coated. captivity. about. 50 mg+12.5 mg, 30 pcs.

Regular increases in blood pressure invariably lead to serious diseases such as stroke, heart attack, heart and kidney failure.

This problem is faced not only by older people, but also by the younger generation.

It is almost impossible to get rid of this disease, but with careful monitoring of pressure changes and taking medications, you can significantly reduce the risk of various types of complications.

Among the variety of drugs intended to reduce, maintain and control blood pressure levels within normal limits, the drugs Lozap and Lozap plus (LP) stand out for their characteristics. These medications not only reduce blood pressure, but also pressure in the pulmonary circulation.

They also reduce stress on the heart and have a moderate diuretic effect. But the difference between Lozap and Lozap plus can be understood if you carefully study the composition of both medications.

Lozap plus and Lozap: what's the difference?

Both drugs have almost the same effect and are indicated for use in the same conditions. They differ in that Lozap contains only one active component, and LP - two. The main active component in them is the same, and the second substance in Lozap plus is additional, enhancing the effect of the first.

Lozap plus tablets

Medicines are available in a single dosage form - tablets for oral administration. The main active ingredient in their composition is losartan. The drug also contains hydrochlorothiazide.

Losartan lowers blood pressure and reduces the load on the heart, and hydrochlorothiazide has a diuretic effect, thereby enhancing the hypotensive effect of the first substance. This is the main difference between medications and each other.

To enhance the hypotensive effect of ACE inhibitor drugs, diuretics are often used. Manufacturers have combined these components in the drug Lozap Plus, which is very convenient for a person who only needs to take one tablet to reduce blood pressure.

Indications for use

The drugs have the following indications for use:

• hypertension in adults and children over 6 years of age;
• diabetic nephropathy;
• chronic heart failure.

The difference between the drugs is that the indications for the use of the drug include conditions that require additional treatment with diuretics.

The use of these medications increases exercise tolerance in people with symptoms of heart failure.

Lozap plus is more often indicated for use in elderly patients, as well as for those who are not suitable for other ACE inhibitors due to severe side effects.

Differences between medications in medicinal properties

Lozap has the following medicinal properties:

• reduces the concentration of aldosterone and adrenaline in the blood;
• reduces pressure in the pulmonary circulation.

Due to the presence of hydrochlorothiazide in the composition of the drug, it has additional properties:

• lowers the concentration of potassium in the blood;
• activates the production of rhinin, a hormone responsible for the speed of blood flow;
• helps increase the concentration of uric acid in the body.

Both drugs are well absorbed by the body and are quickly absorbed into the blood from the stomach.

Lozap® AM

Pharmacological properties

Drug Lozap® AM

The results of two bioequivalence studies involving healthy volunteers showed that Lozap® AM in doses of 5 mg + 50 mg and 5 mg + 100 mg is bioequivalent to the combined use of corresponding doses of amlodipine camsylate and losartan potassium in the form of separate tablets.

Amlodipine

The bioequivalence of amlodipine besylate and amlodipine camsylate was assessed in a randomized, blinded, crossover study in healthy volunteers. The results obtained in the study showed that amlodipine camsylate 5 mg tablets are bioequivalent to amlodipine besylate 5 mg tablets.

Mechanism of action

Drug Lozap® AM

The drug Lozap® AM contains two active substances with a complementary mechanism of action to improve blood pressure (BP) control in patients with arterial hypertension (AH): losartan potassium, an angiotensin II receptor antagonist (ARA II), and amlodipine, a blocker " slow" calcium channels (SCMC).

Losartan blocks the vasoconstrictor effect of angiotensin II and the latter's stimulation of aldosterone release by selectively inhibiting the binding of angiotensin II to AT1 receptors in many tissues.

Amlodipine is a peripheral arterial vasodilator that acts directly on vascular smooth muscle, resulting in a decrease in peripheral vascular resistance and a decrease in blood pressure.

Losartan

Angiotensin II is a powerful vasoconstrictor, the main active hormone of the renin-angiotensin-aldosterone system (RAAS), as well as a decisive pathophysiological link in the development of hypertension.

Angiotensin II binds to AT1 receptors found in many tissues (vascular smooth muscle, adrenal glands, kidneys and heart) and performs several important biological functions, including vasoconstriction and aldosterone release. In addition, angiotensin II stimulates the proliferation of smooth muscle cells.

AT2 receptors are the second type of receptor to which angiotensin II binds, but its role in the regulation of cardiovascular function is unknown.

Losartan is a selective antagonist of AT1 - angiotensin II receptors, highly effective when taken orally. Losartan and its pharmacologically active carboxylated metabolite (E-3174) both in vitro and in vivo block all physiological effects of angiotensin II, regardless of its source or route of synthesis.

Unlike some peptide angiotensin II antagonists, losartan does not have agonist properties.

Losartan selectively binds to AT1 receptors and does not bind to or block receptors of other hormones and ion channels that play an important role in regulating the function of the cardiovascular system. In addition, losartan does not inhibit angiotensin-converting enzyme (ACE, kininase II), which is responsible for the destruction of bradykinin. Therefore, effects not directly related to AT1 receptor blockade, such as increased bradykinin-mediated effects or the development of edema (losartan 1.7%, placebo 1.9%), are not related to the action of losartan.

Amlodipine

Amlodipine is a dihydropyridine calcium antagonist (calcium ion antagonist or slow channel blocker) that inhibits the transmembrane entry of calcium ions into vascular smooth muscle cells and cardiomyocytes.

Experimental data suggest that amlodipine binds to both dihydropyridine and non-dihydropyridine binding sites on slow calcium channel receptors. The process of contraction of the myocardium and vascular smooth muscle depends on the transmembrane entry into the cell of extracellular calcium ions through specific ion channels. Amlodipine selectively inhibits transmembrane calcium entry, affecting vascular smooth muscle cells more than cardiomyocytes.

In vitro

a negative inotropic effect can be detected, however, in studies on intact animals using amlodipine in therapeutic doses, this effect was not detected. Amlodipine does not affect serum calcium levels. Within the physiological pH range, amlodipine is an ionized compound (pKa = 8.6), and its kinetic interaction with the calcium channel receptor is characterized by gradual association and dissociation with the receptor binding site, which leads to a gradual development of the effect.

Amlodipine is a peripheral arterial vasodilator that acts directly on vascular smooth muscle, which leads to a decrease in peripheral vascular resistance and a decrease in blood pressure.

Pharmacodynamics

Drug Lozap® AM

The drug Lozap®AM has been shown to effectively reduce blood pressure. Both losartan and amlodipine reduce blood pressure by reducing peripheral resistance. Blocking the entry of calcium into the cell and reducing the vasoconstrictive effect caused by the action of angiotensin II are complementary mechanisms.

Losartan

Losartan suppresses the increase in systolic and diastolic blood pressure during angiotensin II infusion. At the moment of reaching the maximum concentration (Cmax) of losartan in the blood plasma after taking losartan at a dose of 100 mg, the above effect of angiotensin II is suppressed by approximately 85%, and 24 hours after single and multiple doses - by 26-39%.

During the period of taking losartan, elimination of the negative feedback, which consists in the suppression of renin secretion by angiotensin II, leads to an increase in plasma renin activity (PRA). An increase in ARP leads to an increase in the concentration of angiotensin II in the blood plasma. With long-term (6-week) treatment of patients with hypertension with losartan at a dose of 100 mg/day, a 2-3-fold increase in the concentration of angiotensin II in the blood plasma was observed at the time the losartan Cmax was reached.

In some patients, an even greater increase in angiotensin II concentrations was observed, especially with a short duration of treatment (2 weeks). Despite this, during treatment, an antihypertensive effect and a decrease in plasma aldosterone concentrations appeared after 2 and 6 weeks of therapy, indicating effective blockade of angiotensin II receptors. After discontinuation of losartan, ARP and angiotensin II concentrations decreased within 3 days to the values ​​observed before the start of losartan administration.

Since losartan is a specific antagonist of angiotensin II AT1 receptors, it does not inhibit ACE (kininase II), an enzyme that inactivates bradykinin. A study comparing the effects of losartan at doses of 20 mg and 100 mg with the effects of an ACE inhibitor on angiotensin I, angiotensin II and bradykinin showed that losartan blocked the effects of angiotensin I and angiotensin II without affecting the effects of bradykinin. This is due to the specific mechanism of action of losartan. The ACE inhibitor blocked responses to angiotensin I and increased the effects due to bradykinin without affecting the response to angiotensin II, demonstrating a pharmacodynamic difference between losartan and ACE inhibitors.

Plasma concentrations of losartan and its active metabolite, as well as the antihypertensive effect of losartan, increase with increasing dose of the drug. Since losartan and its active metabolite are angiotensin II receptor antagonists, they both contribute to the antihypertensive effect.

In a study with a single dose of 100 mg of losartan, which included healthy volunteers (men), oral administration of the drug under high- and low-salt diets did not affect the glomerular filtration rate (GFR), effective renal plasma flow and filtration fraction. Losartan had a natriuretic effect that was more pronounced with a low-salt diet and did not appear to be associated with suppression of early sodium reabsorption in the proximal renal tubules.

Losartan also caused a transient increase in renal excretion of uric acid.

In patients with hypertension, proteinuria (at least 2 g/24 hours), without diabetes mellitus and taking losartan for 8 weeks at a dose of 50 mg with a gradual increase to 100 mg, a significant decrease in proteinuria (by 42%), fractional excretion of albumin was observed and immunoglobulins (IgG). In these patients, losartan stabilized GFR and reduced the filtration fraction.

In postmenopausal women with hypertension who took losartan at a dose of 50 mg for 4 weeks, there was no effect of therapy on the renal and systemic levels of prostaglandins.

Losartan does not affect autonomic reflexes and does not have a long-term effect on the concentration of norepinephrine in the blood plasma.

In patients with hypertension, losartan in doses up to 150 mg/day did not cause clinically significant changes in the concentration of fasting triglycerides, total cholesterol and high-density lipoprotein cholesterol. At the same doses, losartan had no effect on fasting blood glucose concentrations.

In general, losartan caused a decrease in serum uric acid concentrations (usually less than 0.4 mg/dL) that persisted during long-term treatment. In controlled clinical studies involving patients with hypertension, no cases of drug withdrawal due to an increase in creatinine concentration or serum potassium levels were recorded.

A 12-week parallel study, which included patients with left ventricular failure (NYHA functional class II-IV), most of whom were taking diuretics and/or cardiac glycosides, compared the effects of losartan at doses of 2.5, 10, 25 and 50 mg/day with placebo. At doses of 25 and 50 mg/day, the drug exhibited positive hemodynamic and neurohormonal effects, which persisted throughout the study.

Hemodynamic effects included an increase in cardiac index and a decrease in pulmonary capillary wedge pressure, as well as a decrease in total peripheral vascular resistance, mean systemic blood pressure, and heart rate (HR). The incidence of arterial hypotension in these patients depended on the dose of the drug.

Neurohormonal effects included decreased concentrations of aldosterone and norepinephrine in the blood.

Amlodipine

Hemodynamics

In patients with hypertension, after taking therapeutic doses, amlodipine causes vasodilation, which leads to a decrease in blood pressure in the supine and standing positions. This decrease in blood pressure is not accompanied by significant changes in heart rate or plasma catecholamine concentrations with long-term use. Although in studies evaluating hemodynamic parameters in patients with stable angina pectoris, a decrease in blood pressure and an increase in heart rate was observed with a single intravenous administration of amlodipine, in clinical studies, repeated oral administration of amlodipine did not lead to clinically significant changes in heart rate or blood pressure in normotensive patients with angina pectoris.

With long-term oral administration once a day, the antihypertensive effect persists for at least 24 hours. The concentration of amlodipine in the blood plasma correlates with the antihypertensive effect in both young and elderly patients. The magnitude of the decrease in blood pressure when taking amlodipine also correlates with the severity of the increase in blood pressure before treatment. Thus, patients with moderate hypertension (diastolic pressure 105-114 mm Hg) had an approximately 50% greater antihypertensive effect than patients with mild hypertension (diastolic pressure 90-104 mm Hg. ).

In patients with normal blood pressure, no clinically significant changes in blood pressure were observed (+1/-2 mmHg).

In patients with hypertension and normal renal function, taking amlodipine in therapeutic doses led to a decrease in renal vascular resistance, an increase in GFR and effective renal plasma flow without changing the filtration fraction or proteinuria.

As with other CBCMs, hemodynamic parameters of cardiac function at rest and during exercise (or pacing) in patients with normal ventricular function treated with amlodipine generally showed a slight increase in cardiac index without a significant change in the rate of increase in left ventricular cavity pressure at the beginning of the period. ejection (dP/dt) or left ventricular end-diastolic pressure or volume. In studies assessing hemodynamic parameters, amlodipine did not have a negative inotropic effect when used at therapeutic doses in healthy volunteers, even when used simultaneously with beta-blockers. However, similar results were observed in healthy volunteers or in patients with heart failure in the compensation stage when using drugs that have a pronounced negative inotropic effect.

Electrophysiological effects

Amlodipine did not affect sinoatrial node function or atrioventricular conduction in healthy volunteers. In patients with chronic stable angina, intravenous administration of 10 mg amlodipine did not have a significant effect on A-H and HV conduction and sinus node recovery time after cardiac stimulation.

Similar results were obtained in patients taking amlodipine and beta-blockers concomitantly.

In clinical studies in which patients with hypertension or angina pectoris took amlodipine concomitantly with beta-blockers, no adverse effects on electrocardiographic parameters were observed.

In clinical studies in patients with angina only, amlodipine therapy did not affect electrocardiographic intervals or cause greater atrioventricular block.

How to take medications: dosage, release form

The tablets are taken once a day, preferably in the morning. They should not be crushed or crushed and should be swallowed whole with plenty of clean water.

The course of therapy is prescribed by the doctor, taking into account the effectiveness of the treatment and the patient’s condition.

For hypertension, take the medicine 50 mg per day. To achieve a more noticeable effect, the dose is sometimes increased to 100 mg. For heart failure, take the medicine 12.5 mg once a day.

Gradually, the dose of the drug is doubled. If a person simultaneously takes high doses of diuretics, the daily dose of drugs is reduced to 25 mg.

It should also be noted that there is a difference between Lozap and Lozap plus in the form of release. The first has a dosage of 50 or 12.5 milligrams, and the second is available in only one form: hydrochlorothiazide contains 12.5 mg, and losartan potassium in this drug contains 50 mg. The shape of Lozapa tablets is round, and LP is oblong, with a transverse notch.

general description

Is as follows:

Side effects

Typically, the use of these medications does not cause any particular discomfort.

With excessive consumption, that is, with an overdose, the following ailments may occur:

• nausea;
• insomnia;
• cough and nasal congestion;
• diarrhea;
• swelling of the limbs;
• abdominal pain;
• cramps of the calf muscles;
• asthenia and rapid heart rate.

Lozap plus has a number of contraindications:

• anuria;
• hypovolemia.

In case of drug overdose, tachycardia or bradycardia and hypotension may occur. In such cases, you must stop taking them!

For what diseases is it taken?

The described medications should be taken when:

• hypertension;
• diabetic nephropathy;
• chronic heart failure.

And also in order to reduce the likelihood of developing cardiovascular diseases and reduce mortality in people with hypertrophy and hypertension of the left ventricle of the heart.

In addition to the indications described, taking Lozapa Plus is recommended for conditions where additional diuretic therapy is required. The drug can be used by elderly people. In a situation where other ACE inhibitors are not suitable, Lozap Plus can also be prescribed.

Alcohol compatibility

Both drugs should not be taken with alcoholic beverages. This can lead to a sharp decrease in blood pressure, and also appear:

• nausea;
• vomit;
• dizziness;
• general malaise;
• impaired coordination of movements;
• coldness of the upper and lower extremities.

But simultaneous intake of alcohol and drugs will significantly reduce the therapeutic intake of the drug. This drug, unlike Lozap, contains a diuretic substance. Under the influence of alcohol, urination significantly increases, as a result of which the concentration of the main active substance in the body decreases markedly.

Reviews about the drugs

Among those who take both medications, many note that they reduce blood pressure well. But some have noticed that Lozap Plus helps them better.

Such patients say that it lasts a little longer and reduces blood pressure faster. The majority of patients approve of the fact that both drugs can be taken regardless of food intake, and also that they take the medicine only once a day.

Among the advantages of both drugs is that they do not cause allergic reactions. But patients like LP because it does not require additional diuretics. Negative reviews are mainly due to the fact that Lozap plus costs about twice as much as the regular drug. At the same time, they note that it is more profitable to buy large packages of medicines.

Compound

The described drugs are based on one active substance – losartan. Lozap Plus contains the addition of hydrochlorothiazide, which complements and enhances the effect of the first.

The main substance helps in reducing blood pressure to normal and protects the heart from stress. The additional component has a diuretic effect, increasing the effectiveness of the main ingredient. “Lozap plus” stands out because it has a stronger hypotensive effect.

Video on the topic

About the features of treating hypertension with Lozap in the video:

The doctor will help the patient decide which of the 2 varieties of Lozap is better in each individual case. The main difference between the medications is the more pronounced hypotensive effect of Lozap plus tablets. Many consider it more convenient to use, because if combination therapy is prescribed, you will not have to drink an additional diuretic.

It is already contained in the drug. The cost of the medicines also differs: Lozap costs 2 times less than Lozap plus. Despite the fact that both drugs belong to the same drug group and have approximately the same effect, you should not replace one drug with another on your own.

The information on the MyMedNews.ru website is for reference and general information, collected from publicly available sources and cannot serve as a basis for making a decision on the use of medications in the course of treatment.

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List of contraindications

It is difficult for an ordinary person to say how “Lozap” differs from “Lozap plus”. The medications in question are not intended for children. As a rule, they are prescribed to those who are over 18 years old. Women carrying a child and those who are breastfeeding are contraindicated in taking the drug. In case of individual intolerance to the main substances of the drugs, their use is contraindicated.

Taking Lozapa Plus is prohibited for bilateral renal artery stenosis. Anuria and hypovolemia are also conditions in which taking medications is undesirable.