Pharmacological properties

Pharmacodynamics. lozartan — the synthetic antagonist of receptors of ii angiotensin (at1 type) for oral administration. ii angiotensin — a powerful vasoconstrictor — is active hormone renin-angiotenzinovoy of a system and one of the most important factors of a pathophysiology ag. ii angiotensin contacts a receptor of at1 which contains in many fabrics (for example in unstriated muscles of vessels, adrenal glands, kidneys and heart), defining a number of important biological effects, including vasoconstriction and release of Aldosteronum. ii angiotensin also stimulates proliferation of smooth muscle cells.

Lozartan selectively contacts a receptor of AT ₁ . In the conditions of in vitro and in vivo lozartan and it pharmacological an active metabolite — carboxyl acid (E-3174) — all physiologically significant influences of angiotensin II, irrespective of a source or a way of synthesis block.

Lozartan does not communicate and does not block other receptors of hormones or ion channels important for cardiovascular regulation. Lozartan does not suppress APF (kinase of II) — enzyme which promotes bradykinin disintegration. Thereof there is no strengthening of the side effects mediated by bradykinin.

elimination of negative back reaction of angiotensin II on secretion of renin leads

At use of a lozartan to increase in activity of renin in blood plasma (ARP). Such increase in ARP leads to growth of concentration of angiotensin II in blood plasma. Though there is such growth, antihypertensive activity and suppression of concentration of Aldosteronum in blood plasma remain that demonstrates effective blockade of receptors of angiotensin II. After treatment cancellation lozartany ARP and indicators of levels of angiotensin II within 3 days return to reference values.

As lozartan, and its main metabolite have higher affinity to AT ₁ - to receptors, than to AT ₂ - to receptors. The active metabolite is 10-40 times more active, than lozartan.

Pharmacokinetics. Absortion. After oral administration lozartan well is soaked up and exposed to metabolism of the first passing with forming of an active metabolite of carboxyl acid and inactive metabolites. The system bioavailability of tablets of a lozartan is about 33%. Average C _max a lozartan and its active metabolite are reached respectively in 1 and 3–4 h

Distribution. More than 99% of a lozartan and its active metabolite contact proteins of blood plasma, first of all albumine. The volume of distribution of a lozartan is 34 l.

Biotransformation. About 14% of a lozartan at in in introduction or oral administration turn into an active metabolite. Later in/in and oral administration of a lozartan of potassium, marked ¹⁴ With, radioactivity in the circulating blood plasma, as a rule, is characterized lozartany and its metabolite. The minimum conversion of a lozartan to its active metabolite was observed approximately in 1% of cases. Except an active metabolite also inactive metabolites are formed.

Removal. The plasma clearance of a lozartan and its active metabolite is 600 and 50 ml/min. respectively. The renal clearance of a lozartan and its active metabolite is about 74 and 26 ml/min. respectively. When lozartan apply orally, about 4% of a dose are allocated in not changed view with urine and about 6% of a dose — with urine in the form of an active metabolite. Pharmacokinetic properties of a lozartan and its active metabolite are linear at oral doses of a lozartan of potassium to 200 mg.

After oral administration of concentration in blood plasma of a lozartan and its active metabolite T _½ about 2 and 6–9 h respectively decrease poliexponentsialno with final. At the dose of 100 mg applied 1 time a day lozartan and its active metabolite do not collect in blood plasma in a significant amount.

Lozartan and his metabolites are removed by

both with bile, and with urine. After oral administration ¹⁴ S-mechennogo a lozartana about 35/43% are radioactive marked medicament also 58/50% are revealed in urine — in Calais.

Separate groups of patients. Concentration of a lozartan and its active metabolite in blood plasma of patients of advanced age with AG significantly do not differ from these indicators at young patients with AG.

were twice higher than

Concentration of a lozartan in blood plasma at women with AG in comparison with men while concentration of an active metabolite in blood plasma at men and women significantly did not differ.

At intake by patients with slight and moderate alcoholic cirrhosis of concentration of a lozartan and its active metabolite in blood plasma came to light respectively in 5 and 1.7 times is higher, than at young male volunteers.

did not differ in

Concentration of a lozartan in blood plasma at patients with clearance of creatinine of 10 ml/min. from those at persons with not changed function of kidneys. When comparing AUC at patients with normal function of kidneys of AUC of a lozartan at the patients who are on a hemodialysis was approximately twice more.

Plasma concentration of an active metabolite do not change at patients with a renal failure or the patients who are on a hemodialysis.

Lozartan and his active metabolite cannot be removed by

by means of a hemodialysis.

Pharmacokinetics at children. The pharmacokinetics of a lozartan was studied with participation of 50 children with AG aged from 1 month up to 16 years after oral administration of 1 times a day in doses from 0.54 to 0.77 mg/kg (average doses).

Results showed that the active metabolite of a lozartan is formed at patients of all age groups. Results indicate approximately similar indicators of pharmacokinetics of a lozartan after oral administration at newborns and children of preschool and school age. Pharmacokinetic indicators of a metabolite differed depending on an age group more. When comparing children of preschool age and teenagers such distinctions were significant. Newborns and children up to 2 years had rather high exposure.

Indication

Treatment of essential hypertensia at adults and also at children is aged more senior than 6 years.

• Treatment of a disease of kidneys at adult patients with AG and diabetes of the II type with a proteinuria of ≥0.5 g/days — as a part of antihypertensive therapy.
• Treatment of chronic heart failure (patients have 60 years and is more senior) when use of APF inhibitors is considered impossible because of incompatibility, especially in cough that is contraindicated. Patients with heart failure whose condition was stabilized at APF inhibitor use should not be treated lozartany. At the patient the fraction of emission of a left ventricle has to make ≤40%, a fortune has to be clinically stable, also the patient should adhere to the set mode of treatment of chronic heart failure.
• Reduction of risk of development of a stroke in adult patients with AG and a hypertrophy of a left ventricle that is documented by means of the ECG.

Use

should wash down

Tablet of a lozartan with a glass of water. use of medicament does not depend on meal.

AG. Usually initial and maintenance dose for most of patients makes 50 mg of 1 times a day (1 tablet of Lorista of 50 mg). The maximum antihypertensive effect is reached for the 3-6th week after an initiation of treatment. For some patients there can be favorable an increase in a dose of medicament to 100 mg of 1 times a day (morning).

to Lorist can be applied in combination with other antihypertensive drugs, especially diuretics (for example a hydrochlorothiazide).

Patients with AG and diabetes of the II type with a proteinuria of ≥0.5 g/days. Usually initial dose makes 50 mg (1 tablet of Lorista) of 1 times a day. The dose can be raised to 100 mg of 1 times a day depending on what indicators of the ABP in 1 month after an initiation of treatment. Lorista can be applied with other antihypertensive medicaments (for example diuretics, blockers of calcium channels, blockers α- or β-receptors and medicaments of the central action) and also insulin and other hypoglycemic widely used medicaments (for example sulphonylurea, glitazona and inhibitors of glucosidase).

Heart failure. Usually initial dose of Lorista at patients with chronic heart failure makes 12.5 mg of 1 times a day. As a rule, the dose is titrated with a week interval (namely: 12.5; 25; 50 mg/days) to a usual maintenance dose of 50 mg (1 tablet of Lorista) of 1 times a day depending on individual shipping.

Reduction of risk of development of a stroke in patients with AG and a hypertrophy of a left ventricle that is documented by means of the ECG. Usually initial dose makes 50 mg of a lozartan (1 tablet of Lorista of 50 mg) of 1 times a day. Depending on changes of the ABP level it is necessary to add a hydrochlorothiazide in a low dose to treatment and/or to raise Lorista's dose to 100 mg of 1 times a day.

Separate groups of patients

Use for patients with the lowered OCK. Patients with reduced OCK (for example owing to treatment by high doses of diuretics) should begin therapy with a dose of 25 mg of 1 times a day.

Use for patients with a renal failure and patients to whom hold hemodialysis sessions. At Lorista's appointment the patients with a renal failure and to patients to whom hold hemodialysis sessions do not need to carry out initial dose adjustment.

Use for patients with an abnormal liver function. For patients with an abnormal liver function in the anamnesis it is necessary to consider a question of prescribing of medicament in a smaller dose. There is no experience of treatment of patients with heavy abnormal liver functions therefore lozartan it is contraindicated to this group of patients.

Use for children. Data on efficiency and safety of use of a lozartan for children of 6-18 years for treatment of AG are limited. Also children have few data on pharmacokinetics with AG aged from 1 month

For children who can swallow of tablets and at whom the body weight of 20 kg and 50 kg, the recommended dose makes 25 mg of 1 times a day. In exceptional cases the dose can be increased to maximum — 50 mg of 1 times a day. The dose should be korrigirovat depending on influence on the ABP level.

At patients with the body weight of 50 kg usually single dose makes 50 mg of 1 times a day. In exceptional cases the dose can be raised to maximum — 100 mg of 1 times a day. Use of the doses exceeding 1.4 mg/kg (or 100 mg) in day, at children was not studied. Lozartan is not recommended for use for children up to 6 years as data on use of medicament for this group of patients are not enough.

Drug is not recommended to appoint to children with glomerular filtration rate 30 ml/min. / 1.73 m ² as there are no relevant data on use. Lozartan is also not recommended for use for children with an abnormal liver function.

Use for patients of advanced age. As a rule, there is no need for correction of an initial dose for patients of advanced age though patients should consider a possibility of prescribing of medicament in an initial dose of 25 mg 75 years are more senior.

Contraindication

Hypersensitivity to a lozartan or any other component of drug.

Pregnant women or women who are going to become pregnant (see Use during pregnancy and feeding by a breast). Heavy abnormal liver functions. Simultaneous use with aliskireny for patients with diabetes or a renal failure (the glomerular filtration rate (GFR) of 60 ml/min. / 1.73 m ² ) (see. Special INSTRUCTIONS).

Side reaction about which it was often reported in clinical trials dizziness was p>

.

Frequency of the side reactions provided below: very often (≥1/10); often (≥1/100, 1/10); infrequently (≥1/1000, 1/100); seldom (≥1/10,000, 1/1000); very seldom (1/10,000); it is unknown (it is impossible to determine by the available data).

AG

from nervous system: often — dizziness, vertigo; infrequently — drowsiness, a headache, insomnia, muscular spasms.

from heart: infrequently — palpitation, stenocardia, tachycardia.

from the vascular system: infrequently — symptomatic arterial hypotension (especially at patients with intravascular dehydration, for example with heavy heart failure or at treatment by diuretics in high doses), dose-dependent orthostatic effect.

from a digestive tract: infrequently — an abdominal pain, dyspepsia, obstipation.

from a respiratory system: infrequently — cough, cold, sinusitis, pharyngitis, an upper respiratory tract infection.

General state and disturbances connected with a medicament route of administration: infrequently — an asthenia, weakness, hypostases, rash.

Laboratory indicators

In controlled clinical trials clinically significant changes of standard laboratory indicators were seldom connected by

with use of tablets of a lozartan. The AlAT level increased seldom and was usually normalized after medicament withdrawal. The hyperpotassemia (potassium level in blood serum of 5.5 mmol/l) was observed at 1.5% of patients with AG.

Patients with a hypertrophy of a left ventricle of heart

from nervous system: often — dizziness.

from an organ of hearing and balance: often — vertigo.

General state and disturbances connected with a medicament route of administration: often — asthenia/weakness.

Chronic heart failure

from nervous system: infrequently — dizziness, a headache; seldom — paresthesias.

from heart: seldom — a syncope, fibrillation of auricles, a stroke.

from the vascular system: infrequently — arterial hypotension, including orthostatic hypotension.

Respiratory, thoracic and mediastinal disturbances: infrequently — dispnoe.

from a digestive tract: infrequently — diarrhea, nausea, vomiting.

from skin and hypodermic fabrics: infrequently — urticaria, an itching, rash.

General state and disturbances connected with a medicament route of administration: infrequently — asthenia/weakness.

Laboratory indicators: infrequently — increase in level of urea, creatinine in blood serum and potassium in blood serum.

AG and diabetes of the II type, followed by a disease of kidneys

from nervous system: often — dizziness.

from the vascular system: often — arterial hypotension.

General state and disturbances connected with a medicament route of administration: often — asthenia/weakness.

Laboratory indicators: often — a hypoglycemia, a hyperpotassemia.

Following side reactions arose more often at the patients accepting lozartan than patients have groups of placebo:

from blood and lymphatic system: it is unknown — anemia.

from heart: it is unknown — a syncope, palpitation.

from the vascular system: it is unknown — orthostatic arterial hypotension.

from a digestive tract: it is unknown — diarrhea.

from a skeletal and muscular system and connective tissue: it is unknown — a dorsodynia.

from kidneys and urinary tract: it is unknown — infections of urinary tract.

General state and disturbances connected with a medicament route of administration: it is unknown — grippopodobny symptoms.

Laboratory indicators: the patients with diabetes of the II type and a nephropathy receiving tablets of a lozartan had a hyperpotassemia 5.5 mekv/l in comparison with patients of group of placebo.

Post-marketing observation

was reported to

throughout post-marketing observation by

about the following by-effects:

from blood and lymphatic system: it is unknown — anemia, thrombocytopenia.

from an organ of hearing and a labyrinth: it is unknown — a ring in ears.

from the immune system: seldom — reactions of hypersensitivity (anaphylactic reactions, a Quincke's disease, including edema of laryngeal and glottis that leads to obstruction of airways and/or edema of face, lips, drinks and/or language; some patients in the anamnesis had a Quincke's disease that is connected with use of other medicines, including APF inhibitors; a vasculitis, including Shenlyayn's purpura — Genokh.

from nervous system: it is unknown — migraine, a dysgeusia.

Respiratory, thoracic and mediastinal disturbances: it is unknown — cough.

from a digestive tract: it is unknown — diarrhea, pancreatitis, vomiting.

from a gepatobiliarny system: seldom — hepatitis; it is unknown — an abnormal liver function.

from skin and hypodermic cellulose: it is unknown — urticaria, an itching, rash, a photosensitization, an erythrosis.

from a skeletal and muscular system and connective tissue: it is unknown — myalgia, an arthralgia, a rhabdomyolysis.

from a reproductive system and mammary glands: it is unknown — erectile dysfunction / impotence.

from kidneys and urinary tract: as about a consequence of inhibition renin-angiotensin-aldosteronovoy of a system it was reported about changes of function of kidneys, including a renal failure at patients of risk group; such changes can be reversible at the treatment termination.

Mental disturbances: it is unknown — a depression.

Laboratory indicators: it is unknown — a hyponatremia.

Children. The profile of side reactions at children is similar to a profile at adult patients. Data on side reactions at children are limited.

Special instructions

Quincke's disease. developing of a Quincke's disease is possible. it is necessary to control often a condition of patients with a Quincke's disease (edema of face, lips, throats and/or language) in the anamnesis.

Arterial hypotension and water and electrolytic imbalance. Symptomatic arterial hypotension, especially after use of the first dose of medicament or after increase in a dose, can arise at patients with the reduced OCK or deficiency of sodium caused by use of strong diuretics, dietary restriction of consumption of salt, diarrhea or vomiting. Such states demand correction before an initiation of treatment by Lorista or decrease in an initial dose of drug. The same recommendations concern children of 6 years.

Electrolytic imbalance. The electrolytic imbalance is often noted at patients with a renal failure (with diabetes or without it) that it is necessary to take into account. In clinical trial with participation of patients with diabetes of the II type and with a nephropathy the frequency of emergence of a hyperpotassemia was higher at treatment placebo, lozartany in comparison with group. Therefore it is regularly necessary to control potassium concentration in blood plasma and indicators of clearance of creatinine, especially at patients with heart failure and clearance of creatinine of 30-50 ml/min.

simultaneous use of a lozartan and kaliysberegayushchy diuretics, the additives containing potassium, the substitutes of salt containing potassium is not recommended to

.

Abnormal liver function. Based on the pharmacokinetic data indicating significant increase in concentration of a lozartan in blood plasma of patients with cirrhosis it is necessary to consider a question of a dose decline for patients with existence in the anamnesis of abnormal liver functions. There is no experience of therapeutic use of a lozartan for patients with heavy abnormal liver functions therefore lozartan such patients cannot accept.

Lozartan is not recommended to

for use for children with abnormal liver functions.

Renal failure. It was reported about emergence of changes of function of kidneys, including a renal failure which connected system renin-angiotenzinovoy with suppression (especially patients with dependence have functions of kidneys from a system renin-angiotensin-Aldosteronum, that is patients with heavy heart failure or with already existing renal failures).

Drugs influencing renin-angiotensin-aldosteronovuyu a system can cause increase in level of urea and creatinine of blood serum in patients with a bilateral stenosis of renal arteries or a stenosis of an artery of the only kidney. These changes in function of kidneys can be reversible after the therapy termination. Lozartan it is necessary to apply with care at patients with a bilateral stenosis of renal arteries or a stenosis of an artery of the only kidney.

Use for children with renal failures. Lozartan is not recommended for use for children with the glomerular filtration rate of 30 ml/min. / 1.73 to m ² as there are no relevant data on use.

During the period of use of a lozartan should control regularly function of kidneys as its deterioration is possible. Especially it concerns situations when lozartan apply in the presence of other morbid conditions (fever, dehydration) which can influence function of kidneys.

Simultaneous use of a lozartan and APF inhibitors worsens function of kidneys therefore such combination is not recommended.

Transplantation of a kidney. There is no experience concerning safety of use of medicament for patients which carried recently out transplantation of a kidney.

Primary hyper aldosteronism. At patients with primary hyper aldosteronism the effect, as a rule, is not observed at use of the antihypertensive medicaments operating by oppression system renin-angiotenzinovoy. Therefore Lorista is not recommended for this group of patients.

Coronary artery disease and cerebrovascular diseases. As well as at use of other antihypertensive drugs, excessive decrease in the ABP at patients with ischemic coronary artery diseases and cerebrovascular diseases can lead to development of a myocardial infarction or stroke.

Heart failure. As well as at use of other medicaments influencing renin-angiotensin-aldosteronovuyu a system the patients with heart failure with a renal failure or without it have a risk of developing heavy arterial hypotension and (often acute) renal failure. There is no sufficient therapeutic experience of use of a lozartan for patients with heart failure and the accompanying heavy renal failure, heavy heart failure (class IV on classification of NYHA) and also heart failure and symptomatic, life-threatening, arrhythmia. Therefore lozartan it is necessary to apply with care at such group of patients. It is necessary to apply at the same time with care a combination of a lozartan with blockers of β-adrenoceptors.

Stenosis of aortal and mitral valves, subaortic hypertrophic stenosis. As well as at use of other vazodilatator, with extra care appoint medicament to patients with a stenosis of the aortal or mitral valve or a subaortic hypertrophic stenosis.

Pregnancy. Use of antagonists of receptors of angiotensin II (MACAW of II) should not be begun during pregnancy. Except for cases when continuation of therapy of MACAW of II is considered necessary, the patients planning pregnancy should appoint alternative antihypertensive therapy with the established safety profile on use during pregnancy. If pregnancy is diagnosed, treatment of MACAW of II should be stopped immediately and if it is necessary, it is necessary to begin alternative treatment.

Other preventions and cautions. As it is established concerning APF inhibitors, lozartan and other antagonists of angiotensin are less effective in decrease in the ABP at patients of negroid race, than at other patients, perhaps, because of low activity of renin in this group of patients with AG.

Special information on some excipients. Lorista contains lactose. Patients with rare hereditary forms of intolerance of a galactose, deficiency of Lappa lactase or disturbance of absorption of glucose galactose should not use this drug.

Double blockade system renin-angiotensin-aldosteronovoy (SRAA). At simultaneous use of an aliskiren and antagonists of receptors of angiotensin II or APF inhibitors the risk of arterial hypotension, a hyperpotassemia and change of function of kidneys, including OPN increases. Due to the double blockade of RAAS the simultaneous use of an aliskiren and antagonists of receptors of angiotensin II or APF inhibitors is not recommended (see INTERACTIONS). In urgent cases double blockade RAAS should control carefully function of kidneys, level of electrolytes in blood and the ABP. It is not necessary to apply at the same time antagonists of receptors of angiotensin II and APF inhibitors at patients with diabetes.

Use during pregnancy or feeding by a breast

Pregnancy. It is contraindicated to use medicament at the pregnant women or women planning pregnancy. If during treatment the pregnancy is confirmed, its use needs to be stopped and replaced immediately with other medicine allowed for use for pregnant women. Epidemiological data on risk of teratogenic influence owing to use of APF inhibitors during the I trimester of pregnancy are not convincing, however small growth of risk is not excluded. As there are no controlled epidemiological data on risk of use of MACAW II, similar risks can exist also for this class of drugs. Except for cases when continuation of therapy of MACAW of II is considered necessary, the patients who plan pregnancy should appoint alternative antihypertensive therapy with the established safety profile on use during pregnancy. If pregnancy is diagnosed, treatment of MACAW of II should be stopped immediately and if it is necessary, it is necessary to begin alternative treatment.

Knows that use of MACAW II during II and III trimester pregnancies causes emergence of the fetotoksichesky phenomena (depression of function of kidneys, oligogidramnion, a delay of ossification of bones of a skull) and manifestations of neonatal toxicity (renal failure, arterial hypotension, a hyperpotassemia).

by

If during the II trimester of pregnancy applied MACAWS of II, it is recommended to carry out ultrasonography for check of function of kidneys and a condition of bones of a skull.

Condition of newborns whose mothers applied the MACAW of II should be checked often concerning development of arterial hypotension.

feeding Period breast. As there is no information concerning use of a lozartan during feeding by a breast, it is not recommended to appoint medicament during this period. Alternative treatment by medicaments with better the studied safety profile concerning use during feeding by a breast, especially newborn or premature children is desirable.

Children. Lozartan is not recommended for use for children up to 6 years as in this group of patients the data are limited.

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Ability to influence speed of response at control of vehicles or other mechanisms

did not conduct researches about influence of medicament on ability to run vehicles and other mechanisms. However it is necessary to remember a possibility of development of such side reactions as dizziness and drowsiness, especially in an initiation of treatment and at increase in a dose of drug.

Interaction

Other antihypertensive medicaments can enhance hypotensive effect of a lozartan. tricyclic antidepressants, antipsychotic means, Baclofenum, amifostin belong to other medicaments which can cause hypotension. increase in risk of developing of arterial hypotension can be the main or side effect of simultaneous use of these medicaments with antihypertensives.

Lozartan is metabolized by

mainly with participation of a system of P450 (CYP) 2C9 cytochrome with formation of an active metabolite of carboxyl acid. In clinical trials it was established what flukonazol (CYP inhibitor 2C9) reduces exposure of an active metabolite approximately by 50%. It is established that simultaneous use of a lozartan and rifampicin (inductor of enzymes of metabolism) leads to decrease by 40% of concentration of an active metabolite in blood plasma.

to

does not know Clinical value of this effect. There are no differences in exposure at simultaneous use of a lozartan and fluvastatin (weak CYP inhibitor 2C9).

As well as at use of other medicaments which block angiotensin II or its effects, simultaneous use of the medicaments detaining potassium in an organism (for example kaliysberegayushchy diuretics: Spironolactonum, Triamterenum, amiloride) or increasing potassium level (for example heparin), or the additives containing potassium or salt substitutes with potassium, can lead to increase in level of potassium in blood serum. Simultaneous use of such means is not recommended.

to

About reversible increase in concentration of lithium in blood serum and emergence of toxic manifestations it was reported at simultaneous use of lithium with APF inhibitors. It was also very seldom reported about such manifestations at use of MACAW of II. Simultaneous treatment by medicaments of lithium and lozartany should be carried out with care. If use of such combination is considered necessary, recommended to check lithium level in blood serum during the combined treatment.

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At simultaneous use of MACAW of II and NPVP (for example selection TsOG-2 inhibitors, acetylsalicylic acid in the doses having anti-inflammatory effect, non-selective NPVP) the antihypertensive effect can be weakened. Simultaneous use of antagonists of angiotensin II or diuretics with NPVP can lead to increase in risk of renal failures, including possible development of OPN and also to increase in level of potassium in blood serum, especially at patients with the existing renal failure. It is necessary to appoint such combination with care, especially to patients of advanced age. Patients should carry out the corresponding dehydration, it is also necessary to consider questions of monitoring of function of kidneys after the beginning of simultaneous use of medicaments and periodically in the course of treatment.

Research was shown that as a result of double blockade of RAAS at simultaneous use of APF inhibitors, antagonists of receptors of angiotensin II or an aliskiren the risk of side reactions, such as arterial hypotension, hyperpotassemia and changes of function of kidneys, including OPN in comparison with use of one agent of RAAS increases (see CONTRAINDICATIONS, SPECIAL INSTRUCTIONS).

Overdose

Symptoms. there are limited data on overdose lozartany. depending on degree of intoxication there can be such symptoms as arterial hypotension, tachycardia, bradycardia is possible.

Treatment. Treatment depends on duration of time, a past after administration of drug, the nature and weight of symptoms. Stabilization of function of a cardiovascular system has to be a priority measure. After oral overdose the use of activated carbon in the corresponding dose is shown. The recommended measures is stimulation of vomiting and gastric lavage. It is necessary to control often key indicators of activity of an organism later and to korrigirovat them if necessary. Lozartan and active metabolites are not removed at a hemodialysis.

Storage conditions

At a temperature up to 30 °C.