Neo-Lotan Plus (Losartan Potassium, Hydrochlorothiazide)

Neo-Lotan Plus, a combined angiotensin II receptor blocker and thiazide diuretic, is indicated for conditions related to elevated blood pressure.

• Essential hypertension: lowers systolic and diastolic pressure and reduces cardiovascular risk.
• Stage 2 hypertension: adds diuretic effect to achieve target blood pressure when monotherapy is insufficient.
• Hypertension with fluid retention: combines vasodilation and diuresis for improved blood‑pressure control.

• Losartan potassium selectively blocks AT1 angiotensin II receptors, preventing vasoconstriction and aldosterone release, which leads to vessel relaxation and reduced sodium‑water retention. Hydrochlorothiazide inhibits sodium‑chloride reabsorption in the distal convoluted tubule, promoting diuresis and decreasing plasma volume. The combined actions result in a synergistic reduction of arterial pressure.

Common Side Effects

• Dizziness: feeling light‑headed, especially after standing.
• Headache: mild to moderate pain in the head region.
• Fatigue: general tiredness or lack of energy.
• Increased urination: more frequent need to void due to diuretic action.
• Low potassium (hypokalemia): reduced serum potassium levels.
• Mild gastrointestinal upset: nausea or abdominal discomfort.

Serious or Rare Side Effects

• Severe allergic reaction (anaphylaxis): rash, swelling, difficulty breathing.
• Acute kidney injury: sudden decrease in renal function.
• Hyperkalemia: dangerously high potassium levels.
• Severe hypotension: markedly low blood pressure causing fainting.
• Pancreatitis: inflammation of the pancreas with abdominal pain.

Neo-Lotan Plus should be used with careful clinical monitoring.

• Blood pressure monitoring: check regularly to avoid excessive hypotension.
• Renal function assessment: evaluate serum creatinine and eGFR before and during therapy.
• Electrolyte surveillance: monitor potassium and sodium levels, especially in patients on other diuretics.
• Pregnancy avoidance: contraindicated in pregnancy due to fetal toxicity risk.
• Elderly caution: start at lower dose and monitor for orthostatic effects.
• Store at ambient temperature: keep in the original container, protect from moisture and direct sunlight.

Neo-Lotan Plus may interact with several medicines; clinical judgment is required.

Major Interactions (Avoid)

• ACE inhibitors or aliskiren: risk of additive hyperkalemia and renal impairment.
• Potassium supplements or potassium‑sparing diuretics: may cause dangerous hyperkalemia.
• Lithium: increased lithium concentrations leading to toxicity.
• NSAIDs (e.g., ibuprofen, naproxen): can reduce antihypertensive efficacy and affect renal function.
• Strong CYP2C9 inhibitors (e.g., fluconazole): may raise losartan levels.

Moderate Interactions (Monitor Closely)

• Other antihypertensives (beta‑blockers, calcium channel blockers): additive blood‑pressure lowering effect.
• Additional thiazide or loop diuretics: may cause excessive diuresis and electrolyte disturbances.
• Antidiabetic agents: hydrochlorothiazide can raise blood glucose, requiring dose adjustment.