Minor
Established
説明
Losartan + hydrochlorothiazide is a guideline-recommended combination for hypertension; the primary interactions are additive hypotension and variable electrolyte effects.
機序
HCTZ promotes sodium and potassium loss and activates RAAS; losartan's AT1 blockade opposes angiotensin II–mediated vasoconstriction and partially retains potassium. Together they have additive blood pressure–lowering effects.
臨床的意義
Electrolyte monitoring is important: HCTZ promotes hypokalemia, hyponatremia, and hyperuricemia; losartan partially offsets the hypokalemia but hyperuricemia concern is reduced by losartan's uricosuric effect.
対処法
Monitor electrolytes and renal function at 4–6 weeks; fixed-dose combination products are widely available and well-studied.