Amlodipine -

increased metabolism with rifampicin

Reduced hypotensive effect of thiazide diuretics & ACE inhibitors

Avoid combination with beta blockers in patients with markedly impaired left ventricular function.

Losartan-

concurrent use with NSAIDs worsen renal function.

Cimetidine may increase the AUC of losartan by about 18% .

Phenobarbital and other enzyme inducers may decrease levels of losartan and its actived metabolite

Ketoconazole inhibits the conversion of losartan to its active metabolite

Concurrent use with pot sparing diuretics or k suplements or salt substitutes containing K may increase serum levels.

Reduce lithium excretion. Monitor lithium levels if used together.

Increased cyclosporine levels. Risk of lithium toxicity with losartan.

Hypotensive effects of losartan potentiated by diuretics and other antihypertensives .

Risk of hyperkalemia increases with concomittant ACE inhibitors, pot sparing diuretics or K supplements

Mild to moderate hypertension

Headache, dizziness, back pain, myalgia, respiratory tract disorders

Asthenia/fatigue First dose hypotension

Rash, angioedema, neutropaenial

GI disturbances

Transcient elevation of liver enzymes,

Taste disturbances and hyperkalemia.

Hypotension, bradycardia, conductive system delay CCF

Known hypersenstivity Avoid concimittant K supplements

Special precautions-

Impaired hepatic orv renal function.

CHF, sick sinus syndrome, severe ventricular dysfunction Hypertrophic cardiomyopathy Elderly

Children

Lactation

Volume depletion patients on diuretics and salt restriction

Renal artery stenosis.

Monitor serum and K concentration

Indication

Mild to moderate hyperetension

Dosage

Adult - each tab contains amlodipine 5mg + losartan K 50mg Initial - 1 tab once daily.

May increase to 2 tab daily if the BP control is inadequate after 1-2 week

Take with or without food

Take with or without food