Arbium Plus Tablet

Combination of an ARB and a thiazide diuretic for:

• High blood pressure not adequately controlled by losartan or hydrochlorothiazide alone
• Reducing stroke risk in hypertensive patients with left ventricular hypertrophy

Adults: 1 tablet (losartan 50 mg + hydrochlorothiazide 12.5 mg) once daily; may be increased to 100/12.5 mg or 100/25 mg once daily (maximum).

• Take at the same time each day, with or without food, preferably in the morning (diuretic effect).
• Full effect within 3 weeks.
• Not for children; not recommended in severe kidney impairment (eGFR below 30).

• Pregnancy
• Anuria, severe kidney impairment
• Severe liver impairment, cholestasis
• Low potassium or sodium, or high calcium that does not respond to treatment
• Symptomatic gout
• Allergy to losartan, thiazides or sulphonamides
• Use with aliskiren in diabetes or kidney impairment

Common: dizziness, tiredness, headache, low blood pressure on standing, cough (less than ACE inhibitors), raised uric acid.

Electrolyte/metabolic: low potassium or sodium, raised blood sugar and cholesterol, gout attacks.

Less common: sun sensitivity, impotence, muscle cramps.

Rare but serious: angioedema, kidney failure, acute myopia and angle-closure glaucoma (sudden eye pain/vision loss), pancreatitis, severe skin reactions, increased risk of non-melanoma skin cancer with long-term hydrochlorothiazide.

• Check potassium, sodium, kidney function, uric acid and sugar periodically.
• Avoid dehydration; use sun protection and check the skin regularly.
• Diabetes: sugar control may change.
• Lupus may be activated by thiazides.

Contraindicated in pregnancy. Not recommended while breastfeeding (thiazides can reduce milk production).

• Lithium (toxicity — avoid)
• NSAIDs (reduced effect, kidney injury)
• Potassium supplements/potassium-sparing diuretics (potassium changes)
• Digoxin, sotalol, other QT drugs (risk with low potassium)
• Diabetes medicines (dose may need adjusting)
• Alcohol, barbiturates, opioids (dizziness on standing)
• Cholestyramine (reduces absorption)

Low blood pressure, fast heartbeat, dehydration and electrolyte loss. Seek medical care.

Store below 30°C, protected from light and moisture.