Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For losartan and hydrochlorothiazide, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to losartan, sulfonamides (sulfa drugs), bumetanide, furosemide, acetazolamide, dichlorphenamide, or methazolamide or to hydrochlorothiazide or any of the other thiazide diuretics (water pills). Also tell your health care professional if you are allergic to any other substances, such as foods, sulfites or other preservatives, or dyes.

Pregnancy—Use of losartan during pregnancy, especially after the first 3 months, can cause low blood pressure, kidney failure, too much potassium, or death in newborns. Additionally, when hydrochlorothiazide is used during pregnancy, it may cause jaundice, blood problems, and other side effects in the newborn baby. Therefore, it is important that you check with your doctor immediately if you think that you may be pregnant .

Breast-feeding—It is not known whether losartan passes into breast milk. However, it does pass into the milk of lactating rats. Hydrochlorothiazide does pass into breast milk. Be sure that you discuss this with your doctor if you decide to breast-feed while taking these medicines.

Children—Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of losartan and hydrochlorothiazide combination in children with use in other age groups.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way as they do in younger adults. Although there is no specific information comparing the use of losartan and hydrochlorothiazide combination in the elderly with use in other age groups, this medicine is not expected to cause different side effects or problems in older people than it does in younger adults.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine. When you are taking losartan and hydrochlorothiazide, it is especially important that your health care professional know if you are taking the following:

• Lithium (e.g., Lithane, Lithobid)—Hydrochlorothiazide may increase blood levels of lithium, which may increase the risk of adverse reactions

Other medical problems—The presence of other medical problems may affect the use of losartan and hydrochlorothiazide. Make sure you tell your doctor if you have any other medical problems, especially:

• Allergy or
• Asthma, bronchial—May have an increased risk of allergic reaction to hydrochlorothiazide

• Fluid or electrolyte (e.g., potassium, chloride, sodium) imbalance (due to excessive perspiration, vomiting, diarrhea, etc.)—The side effects of losartan and hydrochlorothiazide may be increased

• Heart failure, severe—Lowering of blood pressure by these medicines may make this condition worse

• Kidney disease or
• Liver disease—These conditions may be aggravated by losartan and hydrochlorothiazide

• Sympathectomy—Blood pressure-lowering effects may be increased

• Systemic lupus erythematosus (SLE)—Symptoms of this condition may be made worse with use of hydrochlorothiazide