Acusan 50 mg (Tablet)

Indications

• Treatment of hypertension
• Renal protection in type-2 diabetic patients with proteinuria

Pharmacology

• Non-peptide orally active angiotensin II receptor blocker
• Binds to the AT1 receptor in various tissues
• Reduces vasoconstriction and aldosterone release

Dosage & Administration

• Usual starting and maintenance dose of 50 mg once daily
• Antihypertensive effect may be inadequate with 50 mg, hence 25 mg twice daily is recommended
• Starting dose of 25 mg once daily for patients with intravascular volume-depletion
• Total daily dose ranges from 25 mg to 100 mg
• Lower starting dose of 25 mg once daily recommended for patients over 75 years

Interaction

• Rifampicin and fluconazole reduce levels of active metabolite
• Concomitant use with hydrochlorothiazide may lead to potentiation of antihypertensive effects
• Concomitant use with potassium-sparing diuretics, potassium supplements, or salt substitutes containing potassium may lead to increases in serum potassium
• Attenuation of antihypertensive effect by non-steroidal anti-inflammatory drug indomethacin
• Increased risk of renal impairment with the use of ACE-inhibitor, angiotensin receptor antagonist, an anti-inflammatory drug, and a thiazide diuretic at the same time

Contraindications

• Contraindicated in pregnant women
• Contraindicated in patients hypersensitive to any component
• Should not be administered with Aliskiren in patients with diabetes

Side Effects

• Mild and transient side effects
• Common side effects include dizziness, diarrhea, nasal congestion, cough, upper respiratory infection
• Other side effects include fatigue, edema, abdominal pain, chest pain, nausea, headache, pharyngitis

Pregnancy & Lactation

• Pregnancy Category D
• Risk to fetus increases if administered during the second or third trimesters
• Unknown excretion in human milk, potential for adverse effects on nursing infant

Precautions & Warnings

• Reduces fetal renal function and increases fetal and neonatal morbidity and death during the second and third trimesters of pregnancy
• Symptomatic hypotension may occur in intravascularly volume-depleted patients
• Significant increase in plasma concentration in cirrhotic patients
• Changes in renal function including renal failure reported in renal impaired patients

Use in Special Populations

• No initial dosage adjustment necessary in patients with mild renal impairment
• Lower starting dose recommended for moderate to severe renal impairment or patients on dialysis
• Lower dose consideration for patients with a history of hepatic impairment
• Use in patients with intravascular volume depletion requires a lower starting dose
• Contra-indicated in pregnancy and in patients hypersensitive to losartan

Therapeutic Class

• Angiotensin-ll receptor blocker

Storage Conditions

• Keep in a dry place away from light and heat
• Keep out of the reach of children

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