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Hyzaar (losartan, hydrochlorothiazide) is a combination medication used to treat high blood pressure when a single medication is not producing good results.

The two medications 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.

Together the two medications lower blood pressure, improve oxygen flow, and reduce the overall workload of the heart. Untreated, high blood pressure can lead to injury of blood vessels and the heart; ultimately it may lead to heart attack, stroke, kidney failure, and other unpleasant or potentially lethal conditions.

Hyzaar is usually prescribed in one of three scenarios:

• The patient is already taking HCTZ and losartan individually and wishes to combine them for convenience;
• The patient has already been taking either HCTZ or losartan and needs to add another medication to fully control blood pressure;
• The patient isn't taking anything for blood pressure but will likely need multiple medications to control it.

Regardless, Hyzaar will lower blood pressure, usually significantly so. Occasionally some individuals will need to add a third treatment.

Taking Hyzaar

Hyzaar comes in tablets, of which there are three dosage strengths to choose from:

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

The medication is taken just once per day, usually in the morning as it will increase urine output. Food is optional.

Treatment is typically as follows:

• Patients taking both losartan and HCTZ individually should start with the same doses of Hyzaar, or as close as possible.
• Patients taking one or the other medication individually should start with the same dose of the one being taken and the lowest dose of the new medication.
• Patients new to blood pressure treatment should be started on 50/12.5 mg losartan/HCTZ.

It takes about three weeks of treatment to see maximum benefit, and doctors will usually wait that long before adjusting dosage.

Individuals taking Hyzaar are usually encouraged to also make lifestyle changes; quitting smoking, regulating salt, exercise, and so forth. Some patients are able to successfully make and maintain these changes, eventually no longer needing to rely on medications like Hyzaar. Others are unable to make adequate changes, or lifestyle is not the problem; these individuals may need to rely on blood pressure medications for the remainder of life.

Warnings Before Use

Hyzaar is well-tolerated, but it will lower blood pressure. Patients may experience symptoms---particularly at the start of treatment or following dosage changes---of low blood pressure, including dizziness or lightheadedness when rising from a resting position. As long as these symptoms are mild they're not cause for concern, and should stop occurring in the first few weeks of Hyzaar use.

If also taking medications to lower cholesterol---particularly bile acid-binding resins such as cholestyramine or colestipol---Hyzaar 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 Hyzaar may produce little to no benefit.

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

Hyzaar 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.