Brief information about the drug
The drug for high blood pressure Bloktran belongs to the pharmacological group of angiotensin 2 receptor antagonist drugs. It is produced in Russia.
Release form
The blood pressure medicine Blocktran is presented on the pharmaceutical market in a convenient tablet form. The manufacturer produces tablets packaged in blisters of 10 pieces. You can purchase either 1 blister or a box containing 2, 3, 5 or 6 blisters.
Packaging of Blocktran tablets
Composition of tablets
The main active component of the drug is potassium losartan, presented in a dose of 12.5 mg or 50 mg.
The composition of the tablets also includes additional ingredients: starch, sodium carboxymethyl starch, magnesium stearate, lactose monohydrate, povidone, silicon dioxide, microcrystalline cellulose.
Terms and conditions of storage
The tablets should be stored in a place inaccessible to children and pets, protected from moisture and direct sunlight. The recommended storage temperature should not exceed +30°C.
The maximum shelf life of the drug is 2 years.
Terms of sale
It is possible to purchase medication in pharmacy chains only after presenting an appropriate medical prescription.
Price
The cost of the drug is influenced by factors such as the dosage of the main active ingredient and the number of tablets in the package. The approximate price for Blocktran varies from 150 rubles to 400 rubles.
Pharmacological characteristics
The drug Bloktran has a pronounced antihypertensive pharmacological effect.
Release form and composition
- film-coated tablets, 12.5 mg;
- film-coated tablets, 50 mg: round, convex on both sides, light pinkish-orange in color.
Packing of tablets: 10 pcs. in blister packs, in a cardboard pack of 1, 2, 3, 5 or 6 packs.
Composition of tablets:
- active substance: losartan potassium – 12.5 or 50 mg;
- auxiliary components (kernel composition): potato starch, microcrystalline cellulose, lactose monohydrate, aerosil (colloidal silicon dioxide), magnesium stearate, low molecular weight polyvinylpyrrolidone (povidone), sodium carboxymethyl starch (sodium starch glycolate);
- shell composition: copolyvidone, hydroxypropyl methylcellulose (hypromellose), Tween-80 (polysorbate-80), talc, titanium dioxide E171, water-soluble sunset yellow dye E110 (sykovit yellow-orange 85 and Indacol sunset yellow).
Pharmacodynamics - increases or decreases blood pressure
Blood pressure tablets Blocktran suppress specific angiotensin receptors localized in the area of blood vessels, adrenal glands, heart and kidney apparatus.
Blocktran lowers blood pressure. Since the drug has a cumulative effect, the hypotensive effect becomes most noticeable after a month of the therapeutic course.
Bloktran is effective when used as a course
Increases renin levels in the blood without negatively affecting the production and functioning of other hormones responsible for the normal functioning of the cardiovascular system, which avoids a number of side effects characteristic of most antihypertensive drugs.
Helps increase life expectancy in patients suffering from cardiac ventricular hypertrophy and hypertension.
Pharmacokinetics of the drug
Blocktran reduces blood pressure 6 hours after taking the tablets. The therapeutic effect lasts throughout the day, avoiding the need for frequent medication use. The maximum concentration of the active substances of the drug in the blood is observed after 3-4 hours.
The medicine is eliminated from the body within 9 hours, through the gastrointestinal tract (60%), another 35% of the medicine is excreted through the renal apparatus, along with urine.
BLOCKTRANS GT
Interaction
May be prescribed with other antihypertensive drugs.
Losartan
There were no clinically significant pharmacokinetic interactions of the drug with drugs such as hydrochlorothiazide, digoxin, warfarin, cimetidine, phenobarbital, ketoconazole and erythromycin. Rifampicin reduces the concentration of the active metabolite. The clinical significance of this interaction has not been established. As with other agents that block the formation of angiotensin II and its effects, concomitant administration of potassium-sparing diuretics (spironolactone, triamterene, amiloride, eplerenone), potassium supplements and potassium-containing salts may lead to an increase in serum potassium. As with the use of other drugs that affect sodium excretion, treatment with losartan may be accompanied by a decrease in excretion and an increase in the serum concentration of lithium, therefore, during simultaneous treatment with lithium preparations, its serum concentration should be monitored.
Nonsteroidal anti-inflammatory drugs (NSAIDs), including selective COX-2 inhibitors, may reduce the effect of diuretics and other antihypertensive drugs. Therefore, the antihypertensive effect of angiotensin II receptor antagonists may be weakened by concomitant use of NSAIDs, including selective COX-2 inhibitors.
In some patients with impaired renal function who have been treated with NSAIDs, including selective COX-2 inhibitors, co-administration of angiotensin II receptor antagonists may cause a further deterioration of renal function, including acute renal failure. Usually this effect is reversible. Double blockade of the RAAS - the combined use of an angiotensin II receptor blocker with an ACE inhibitor - leads to a significant increase in the frequency of adverse events, such as arterial hypotension, fainting, hyperkalemia, renal dysfunction, acute renal failure. The highest risk is in patients with an established diagnosis of atherosclerosis, heart failure, diabetes mellitus (with any complication). The use of dual blockade of the RAAS (for example, by simultaneous administration of an ACE inhibitor and an angiotensin II receptor antagonist) should be decided on a case-by-case basis with careful monitoring of renal function.
Fluconazole, an inhibitor of the CYP2C9 isoenzyme, reduces plasma concentrations of the active metabolite and increases the concentrations of losartan, however, the pharmacodynamic significance of this phenomenon has not been established. It has been shown that individuals who do not metabolize losartan into the active metabolite have a very rare and specific defect in the CYP2C9 isoenzyme.
Hydrochlorothiazide
When used simultaneously with barbiturates, narcotic analgesics, and ethanol, orthostatic hypotension may develop. When used simultaneously with hypoglycemic drugs (for oral administration and insulin), dose adjustment of the hypoglycemic drugs may be required. Due to the risk of lactic acidosis due to possible renal impairment when using hydrochlorothiazide, metformin should be used with caution.
When used simultaneously with other antihypertensive drugs, an additive effect is observed.
Avoid simultaneous use with lithium salts (renal clearance of lithium decreases and its toxicity increases).
When used simultaneously with corticosteroids, adrenocorticotropic hormone, glycyrrhizic acid (found in licorice root), amphotericin B, a marked decrease in the content of electrolytes, especially potassium, occurs.
When used simultaneously with non-depolarizing muscle relaxants (tubocurarine), their effect may be enhanced.
NSAIDs, including selective COX-2 inhibitors, may reduce the diuretic, natriuretic and antihypertensive effects of hydrochlorothiazide. A single dose of cholestyramine or colestipol can reduce the absorption of hydrochlorothiazide in the gastrointestinal tract by 85 and 43%, respectively. With simultaneous use of the drug with pressor amines (norepinephrine, epinephrine), a slight decrease in the effect of pressor amines is possible. Medicines used to treat gout (probenecid, sulfinpyrazone and allopurinol) - dose adjustment may be required (increasing the dose of probenecid and sulfinpyrazone) as hydrochlorothiazide may increase serum uric acid concentrations. Concomitant use of thiazide diuretics may increase the incidence of hypersensitivity reactions to allopurinol. Anticholinergics (for example, atropine, biperiden) - increase the bioavailability of thiazide diuretics by reducing gastrointestinal motility and the rate of gastric emptying.
Thiazide diuretics may reduce the renal excretion of cytotoxic drugs (eg, cyclophosphamide, methotrexate) and enhance their myelosuppressive effect.
Thiazide diuretics may enhance the toxic effects of salicylates on the central nervous system when used in high doses.
Isolated cases of hemolytic anemia have been reported with the simultaneous use of hydrochlorothiazide and methyldopa.
Concomitant treatment with cyclosporine may increase the risk of hyperuricemia and gout.
Hypokalemia or hypomagnesemia caused by the use of thiazide diuretics can contribute to the development of arrhythmias when used simultaneously with cardiac glycosides.
Concomitant use of thiazide diuretics with antiarrhythmic drugs (quinidine, hydroquinidine, disopyramide, amiodarone, sotalol, dofetilide, ibutilide), some antipsychotic drugs (neuroleptics) (thioridazine, chlorpromazine, levomepromazine, trifluoperazine, cyamemazine, sulpiride, sultopride, amisulpride, tiapride, pi mosid, haloperidol, droperidol) and other drugs (bepridil, cisapride, difemanil, erythromycin, halofantrine, mizolastine, pentamidine, terfenadine, vincamine) may be accompanied by the development of hypokalemia, which, in turn, can cause the development of ar.
Thiazide diuretics can lead to hypercalcemia as a result of decreased excretion, so it is necessary to monitor serum calcium levels. Due to the effect of thiazide diuretics on calcium metabolism, their use may distort the results of studies of the function of the parathyroid glands.
When used simultaneously with carbamazepine, there is a risk of developing symptomatic hyponatremia.
With the development of dehydration during the use of diuretics, there is a possibility of developing acute renal failure, especially when used simultaneously with iodine preparations.
Indications for use of Bloktran
Doctors strongly recommend that patients take Blocktran for high blood pressure in case of the following health problems:
- Arterial hypertension;
- Chronic heart failure;
- Hypertonic disease;
- Hypertrophy of the left cardiac ventricle.
Tablets are prescribed to patients with diagnosed heart failure if there are contraindications to therapy with ACE inhibitors or if such treatment is not adequately effective. Blocktran can be used both as an independent medication and as one of the components of complex therapy.
The drug is indicated for hypertension and chronic heart failure
Directions for use and dosage
Bloktran is indicated for oral use. Tablets should be taken once a day, regardless of meals.
The average daily dose for arterial hypertension is 50 mg. If it is necessary to obtain a greater effect, in some cases the daily dose can be increased to 100 mg (in 1 or 2 doses).
For chronic heart failure, treatment begins with a daily dose of 12.5 mg. It is recommended to further increase the dose by titration, i.e. increasing gradually at weekly intervals: first to 25 mg, then to 50 mg. The average maintenance dose is 50 mg 1 time per day.
In the case of simultaneous use of diuretics in high doses, Blocktran is prescribed 25 mg.
Elderly people and patients with impaired renal function (including those on hemodialysis) do not need to adjust the dose.
Lower doses should be prescribed to patients with impaired liver function.
When use is contraindicated
Medical specialists categorically prohibit drinking Blocktran for high blood pressure in patients who have the following clinical contraindications:
- Dehydration;
- Hypotonic disease (stably reduced blood pressure);
- Hyperkalemia;
- Individual intolerance and hypersensitivity to substances included in the tablets.
With particular caution, the drug is prescribed to persons with diagnosed liver failure or renal dysfunction. Treatment of this category of patients requires strict medical supervision, individual dosing and constant monitoring of health status.
Instructions for use and dosage
Instructions for use of Bloktran recommend taking the tablets once a day, regardless of your meal schedule. The optimal dosage, as well as the duration of the therapeutic course, are determined by a specialist individually, depending on the diagnosis and other features of a particular clinical case.
It is important to note that since in patients with liver cirrhosis the concentration of the active ingredients of the drug in the blood is much higher than in other people, they will be prescribed tablets in minimal doses.
For arterial hypertension
Blocktran for hypertension is started at a dosage of 50 mg per day. If necessary, the daily dose of the drug can be increased to 100 mg, divided into two equal doses.
For heart failure
For patients suffering from heart failure, Blocktran therapy begins with a dosage of 1.25 mg throughout the day. Gradually, after each week of treatment, the daily dose of the medication is increased to 25 mg or 50 mg (depending on the severity of the disease, the age and health of the patient, and the reaction of his body to the proposed treatment).
If a patient with heart failure takes diuretics, then the starting daily dose of Bloktran is 25 mg.
The dosage is determined by the doctor depending on the condition of the individual patient.
Blocktran, 50 mg, film-coated tablets, 60 pcs.
Hypersensitivity reactions
In patients with a history of angioedema (swelling of the face, lips, pharynx/larynx and/or tongue), monitoring of the use of the drug is necessary (see “Side effects”).
Embryotoxicity
The use of drugs that affect the RAAS during the second and third trimester of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and mortality. The development of oligohydramnios may be associated with fetal lung hypoplasia and skeletal deformities. Possible adverse events in neonates include calvarial hypoplasia, anuria, hypotension, renal failure and death. When diagnosing pregnancy, the drug Blocktran® should be taken immediately.
Arterial hypotension and water-electrolyte imbalance or decreased circulating blood volume
In patients with reduced blood volume (for example, those receiving treatment with large doses of diuretics), symptomatic arterial hypotension may occur. Correction of such conditions must be carried out before prescribing Bloktran® or starting treatment with a lower dose of Bloktran® (see “Dosage and Administration”). Fluid and electrolyte imbalance is common in patients with impaired renal function with or without diabetes mellitus, so careful monitoring of these patients is necessary.
Losartan in patients with type 2 diabetes mellitus with proteinuria increases the incidence of hyperkalemia.
During treatment with Bloktran®, it is not recommended to take potassium-sparing diuretics, potassium supplements or potassium-containing salt substitutes.
Aortic or mitral stenosis, hypertrophic obstructive cardiomyopathy
Like all drugs that have a vasodilating effect, ARA II should be prescribed with caution to patients with aortic or mitral stenosis or hypertrophic obstructive cardiomyopathy.
Coronary heart disease and cerebrovascular diseases
Like all drugs that have a vasodilating effect, ARA II should be prescribed with caution to patients with coronary heart disease or cerebrovascular diseases, since an excessive decrease in blood pressure in this group of patients can lead to the development of myocardial infarction or stroke.
Chronic heart failure
As with the use of other drugs that act on the RAAS, in patients with CHF and with or without impaired renal function, there is a risk of developing severe hypotension or acute renal impairment.
Since there is insufficient experience with the use of losartan in patients with heart failure and concomitant severe renal impairment, in patients with severe heart failure (NYHA functional class IV), as well as in patients with heart failure and symptomatic life-threatening arrhythmias, the drug Blocktran® should be prescribed with caution to patients in these groups.
Primary hyperaldosteronism
Since patients with primary hyperaldosteronism, as a rule, do not have a positive response to therapy with antihypertensive drugs that act by inhibiting the RAAS, the use of Bloktran® is not recommended in this group of patients.
Liver dysfunction
Data from pharmacokinetic studies indicate that the concentration of losartan in the blood plasma in patients with cirrhosis of the liver increases significantly, therefore patients with a history of impaired liver function should be prescribed Bloktran® at a lower dose. There is no experience with the use of losartan in patients with severe liver dysfunction, so the drug should not be used in this group of patients (see “Pharmacological properties” (Pharmacokinetics); “Contraindications”; “Dosage and administration”).
Renal dysfunction
Due to inhibition of the RAAS, changes in renal function, including the development of renal failure, have been observed in some susceptible patients. These changes in renal function may return to normal after treatment is stopped.
Some drugs that affect the RAAS may increase blood urea and serum creatinine concentrations in patients with bilateral renal artery stenosis or renal artery stenosis of a solitary kidney. Similar effects have been reported with losartan. Such renal dysfunction may be reversible after discontinuation of therapy. Losartan should be used with caution in patients with bilateral renal artery stenosis or renal artery stenosis of a solitary kidney.
Concomitant use of angiotensin II receptor antagonists with drugs containing aliskiren is contraindicated in patients with diabetes mellitus and/or with moderate or severe renal impairment (GFR less than 60 ml/min/1.73 m2 body surface area) and is not recommended in other patients ( see section "Contraindications").
Concomitant use of angiotensin II receptor antagonists with ACE inhibitors is contraindicated in patients with diabetic nephropathy and is not recommended in other patients (see section "Contraindications").
Special patient groups
Race
Losartan, compared with atenolol, reduces cardiovascular morbidity and mortality in patients with hypertension and left ventricular hypertrophy of all races except blacks.
Children and teenagers
The effectiveness and safety of losartan in children and adolescents under 18 years of age have not been established.
If oliguria or arterial hypotension develops in newborns whose mothers took losartan during pregnancy, symptomatic therapy aimed at maintaining blood pressure and renal perfusion is necessary. Blood transfusions or dialysis may be required to prevent hypotension and/or maintain renal function.
Elderly patients
Clinical studies have not revealed any particularities regarding the safety and effectiveness of losartan in elderly patients (over 65 years of age).
Impact on the ability to drive vehicles and machinery
During the treatment period, caution should be exercised when driving and engaging in other potentially hazardous activities, since some of the side effects observed with the use of losartan, such as dizziness, drowsiness, may adversely affect the ability to drive a vehicle and perform potentially hazardous activities requiring increased concentration of attention and speed of psychomotor reactions.
Manifestations of side effects
Treatment with Blocktran tablets can cause the following adverse reactions:
- Arterial hypotension (excessive decrease in blood pressure);
- Pulse abnormalities (tachycardia or bradycardia);
- Decreased sexual desire;
- Erectile dysfunction in male patients;
- Rhinitis;
- Convulsive syndrome;
- Increased urge to empty the bladder;
- Cough syndrome;
- Conjunctivitis;
- Noise and ringing in the ears;
- Deterioration of visual function;
- Diarrhea or constipation;
- Dyspeptic disorders;
- Bronchitis;
- Dizziness;
- Migraine attacks;
- Depressive states;
- Nausea and vomiting;
- Toothache;
- Permanent lack of appetite, up to anorexia;
- Painful sensations localized in the sternum, lower extremities, back, knee joint, shoulder region;
- Skin itching;
- Rash on the skin like urticaria;
- Anemia;
- Tremor;
- Problems with sleep (insomnia or increased sleepiness);
- Chronic fatigue syndrome, weakness, asthenia, decreased performance;
- Hair loss;
- Increased sweating;
- Excessive dryness of the skin;
- Memory impairment;
- Psycho-emotional instability, causeless nervousness, anxiety, restlessness.
In most cases, the drug is well tolerated, and possible side effects disappear on their own after a few days of treatment. If the condition worsens, you should definitely inform your doctor about it!
Lack of appetite may be a side effect of taking the pills
Side effects
Blocktran is well tolerated in most cases. The side effects that occur are usually transient and do not require discontinuation of therapy. The connection between adverse reactions noted in less than 1% of patients and the use of losartan has not been reliably established.
The drug may cause the following side effects:
- allergic reactions: <1% – itching, rash, urticaria, angioedema (including face, lips, pharynx and/or tongue);
- from the cardiovascular system: palpitations, angina pectoris, orthostatic hypotension of a dose-dependent nature, arrhythmias, tachycardia, bradycardia, anemia;
- from the respiratory system: ≥ 1% – nasal congestion, cough, upper respiratory tract infections (sore throat, fever, sinusopathy, pharyngitis, sinusitis); < 1% – rhinitis, bronchitis, dyspnea;
- from the genitourinary system: <1% – weakened libido, urinary tract infections, imperative urge to urinate, impaired renal function, impotence;
- from the musculoskeletal system: ≥ 1% – pain in the chest, back and legs, myalgia, convulsions; < 1% – shoulder and knee pain, arthralgia, fibromyalgia, arthritis;
- from the gastrointestinal tract: ≥ 1% – abdominal pain, diarrhea, nausea, dyspepsia; <1% – dry mouth, flatulence, anorexia, constipation, gastritis, vomiting, toothache;
- from the nervous system and sensory organs: ≥ 1% – fatigue, asthenia, insomnia, headache, dizziness; <1% – tinnitus, vision changes, conjunctivitis, taste disturbance, memory disorders, anxiety, syncope, ataxia, hypoesthesia, paresthesia, sleep disturbance, drowsiness, migraine, tremor, peripheral neuropathy, depression;
- from the skin: <1% – flushing, dry skin, increased sweating, erythema, alopecia, photosensitivity;
- other: hyperkalemia (serum potassium level more than 5.5 mmol/l).
Symptoms of overdose: tachycardia, marked decrease in blood pressure, bradycardia. Hemodialysis is ineffective; treatment includes forced diuresis and symptomatic therapy.
Important Notes
During the therapeutic course, it is necessary to regularly monitor potassium levels in the blood, especially if we are talking about elderly people or patients with diagnosed renal dysfunction.
Before starting treatment, it is recommended to correct dehydration. If this cannot be done for certain reasons, then therapy begins with minimal dosages of the drug.
In patients suffering from dehydration, tablets can provoke the development of a hypotensive crisis.
special instructions
Before prescribing therapy with Bloktran, it is necessary to correct dehydration or prescribe the drug at a lower initial dose.
During treatment, the concentration of potassium in the blood should be monitored, especially in the elderly and patients with impaired renal function.
Like other drugs that affect the renin-angiotensin system, Bloktran may increase blood urea concentrations and serum creatinine levels in patients with bilateral renal artery stenosis or solitary renal artery stenosis.
Is it possible to drive a car?
Possible side effects of Bloktran include dizziness, increased drowsiness, and asthenia. For this reason, in the first days of the therapeutic course you should refrain from driving. In the future (if the condition is normal and there are no undesirable reactions from the central nervous system), the patient can get behind the wheel, using extreme caution.
Driving a car while taking Blocktran is possible in the absence of adverse reactions to the drug
Drug interactions
Combination with potassium-containing drugs and diuretics increases the likelihood of developing hyperkalemia.
Tablets can be combined with other antihypertensive medications, diuretics, beta-blockers, but in smaller doses, due to an increased hypotensive effect.
You should ask your doctor about compatibility with other drugs.
