Cozaar Compound (losartan, hctz) is a combination medication used to help patients with hypertension reduce blood pressure, reducing risk of heart attack, stroke, kidney damage, and other potentially severe complications of hypertension.

The two ingredients in this product are:

• Losartan is an angiotensin receptor blocker (ARB) that relaxes and widens blood vessels, improving blood flow and oxygen delivery to the heart.
• Hydrochlorothiazide, more commonly called HCTZ, is a thiazide diuretic that removes salts and excess fluid through urine. This lowers overall blood volume, which lowers blood pressure.

Both products can be purchased individually, and treatment often begins with one of them or a similar medication. Combination medications are typically reserved for those who do not experience sufficient benefit from a single medication, though some patients may be started on a combination medication if a doctor is confident that a single medication will not suffice.

While losartan and hctz can be used as single treatments in young children, Cozaar Compound is not recommended for use in patients under age 18.

Product Overview

Cozaar Compound comes in tablets, of which there are three strengths:

• 50/12.5 mg losartan/hctz
• 100/12.5 mg losartan/hctz
• 100/25 mg losartan/hctz

The standard starting dose is 50/12.5 mg losartan/hctz once per day, which may be increased, if needed, to 100/12.5 or 100/25 mg losartan/hctz. The maximum daily dose is 100/25 losartan/hctz, which should not be exceeded. Two 50/12.5 mg tablets provide the same benefit as a single 100/25 mg tablet, so there's no need to discard lower-dose tablets if dosage is increased.

In other words:

• Most patients start with 50/12.5 mg losartan/hctz once per day.
• If needed, dosage may be increased to 100/50 mg losartan/hctz once per day.
• Do not exceed 100/50 mg losartan/hctz per day.

Treatment should be daily over the long term; some patients will take Cozaar Compound or a similar medication for the remainder of life.

The occasional missed dose is not cause for concern; it should be skipped entirely and treatment resumed as usual with the next dose. However, frequent missing of doses can become problematic, and may even cause complications if the maximum dose per day is taken.

If treatment ends, speak to a doctor about a discontinuation plan. Like most antihypertensive treatments, Cozaar Compound should not be ended abruptly; dosage should be gradually lowered over time.

Lifestyle Changes

Many patients prescribed Cozaar Compounds will also be advised to make lifestyle changes. In fact, for many patients, making and maintaining lifestyle changes is the only way to stop dependency on Cozaar Compound to keep blood pressure at safe levels.

Recommended changes usually include:

• Reaching and maintaining a healthy weight
• Quitting smoking
• Managing blood sugar
• Managing blood cholesterol
• Avoiding unnecessary stress

Lifestyle changes will be individualized from patient to patient, and may vary to some degree according to location. Patients are advised to at least try to make recommended changes, as the benefits can be tremendous.

Some patients are unable or unwilling to make recommended changes, or do make changes but see little difference in hypertension. These patients will most likely need Cozaar Compound or a similar medication for the remainder of life.

Adverse Effects

Patients taking Cozaar Compound may experience symptoms of low blood pressure, particularly at the start of treatment or following dosage adjustments. Symptoms include:

• Dizziness
• Lightheadedness
• Tingling in extremities
• Clammy skin
• Mild fatigue

As long as these symptoms are mild they're not cause for concern, and should stop occurring within the first few weeks of Cozaar Compound use.

Rarely serious side effects will develop. Seek medical attention if experiencing:

• Fainting
• Eye pain
• Vision changes
• Muscle weakness
• Muscle cramps
• Rapid, slow, or irregular heartbeat
• Severe confusion
• Difficulty urinating

If also taking medications to lower cholesterol---particularly bile acid-binding resins such as cholestyramine or colestipol---Cozaar Compound should be taken at least 4 hours before or 4 to 6 hours after.

Black patients who have hypertension and left ventricular hypertrophy should be aware that Cozaar Compound may produce little to no benefit.

Cozaar Compound may cause harm to unborn babies; this medication is not preferred in pregnant women and only used in life-threatening scenarios when other medications are unavailable or cannot be used. It is unknown how it effects nursing infants.