INTRODUCTION
GIFTAN HC is a combination of Hydrochlorothiazide and Losartan which belongs to the group of medicines called Thiazide like diuretics and Angiotensin II receptor antagonists respectively. GIFTAN HC is indicated for the treatment of essential hypertension. Essential hypertension (also known as high blood pressure) is a medical condition in which the force of the blood exerted against the walls of the artery remains very high, and as a result it may lead to severe damage to the blood vessels of several organs, thus causing heart attack, heart or kidney failure, stroke, or even blindness.
Losartan is an Angiotensin-receptor blocker which effectively reduces blood pressure by blocking the actions of Angiotensin – II (a substance that causes narrowing of blood vessels and increase in blood pressure) and hydrochlorothiazide is a diuretic which acts by increasing urine output, thus leading to a decrease in blood pressure. During treatment with GIFTAN HC your doctor might regularly monitor your blood pressure, kidney function and electrolyte levels at regular intervals to avoid any untoward side effects.
GIFTAN HC is not suitable for use in children (aged less than 18 years) and in adult patients with severe kidney or liver impairment. Long-term use of GIFTAN HC may increase the risk of some types of skin and lip cancer, and therefore always protect your skin from sun rays and UV exposure. GIFTAN HC is not recommended for use in breast-feeding women and pregnant women (especially after 3 months of gestation), as it may cause potential harm to the unborn baby. The most common side effects of GIFTAN HC are cough, diarrhea, stomach pain, dizziness, tiredness, and headache. Consult your doctor if any of the symptom bothers you.
USES OF GIFTAN HC
- Treats essential hypertension
HOW GIFTAN HC WORKS
GIFTAN HC reduces elevated blood pressure, where hydrochlorothiazide works by making the kidneys pass more water and salt (i.e., urine) and losartan works by inhibiting the binding of angiotensin II (a substance produced in the kidneys which causes narrowing of blood vessels) to its receptors, thus causing the blood vessels to relax which in turn decreases elevated blood pressure.
DIRECTIONS FOR USE
Take GIFTAN HC as advised by your physician. Swallow GIFTAN HC with a glass of water. Do not crush or chew the medicine. Your doctor will decide the correct dose and duration for you depending upon your age, body weight and disease condition.
SIDE EFFECTS OF GIFTAN HC
COMMON
- Cough
- Respiratory problems (infections in upper airway, nasal congestion, or sinusitis)
- Diarrhea, stomach pain, nausea, indigestion
- Muscle pain or cramps
- Pain in legs and back
- Lack of sleep (insomnia)
- Headache
- Dizziness
- Tiredness or weakness
- Chest pain
- Signs of increased potassium levels (muscle weakness, irregular heartbeat, chest pain)
- Altered kidney function
- Signs of low blood sugar (dizziness, shaking, sweating, tiredness, and fast heartbeat)
UNCOMMON
- Anemia
- Red or brownish spots on the skin
- Clotting problems
- Loss of appetite
- Gout (increased uric acid levels)
- Signs of increased blood sugar levels (increased thirst, blurred vision, weakness)
- Abnormal blood electrolyte levels
- Anxiety, nervousness, panic disorder
- Confusion, depression, abnormal dreams
- Sleep disorders, sleepiness, memory impairment
- Tingling or prickling sensation in arms, hands, legs, or feet
- Trembling, migraine, fainting
- Blurred vision, burning or stinging in the eyes, conjunctivitis
- Worsening eyesight, seeing things in yellow
- Ringing, buzzing, roaring or clicking in the ears
- Vertigo (spinning sensation)
- Low blood pressure associated with postural changes (feeling light-headed or weak when you stand up)
- Inflammation of blood vessels (associated with skin rash or bleeding)
- Sore throat, breathlessness, bronchitis, pneumonia
- Nosebleed, runny nose, congestion
- Constipation, obstipation
- Wind, stomach upsets, stomach spasms, vomiting, dry mouth
- Inflammation of a salivary gland, toothache
- Jaundice (yellowing of the eyes and skin)
- Itching, inflammation of skin, rash, redness of the skin, sensitivity to light, dry skin, flushing, sweating, hair loss
- Joint swelling, stiffness, muscle weakness
- Frequent urination including at night, urinary infection
- Sugar in urine (glycosuria)
- Decreased sexual appetite, impotence
- Swelling of the face, localized swelling (oedema)
- Fever
RARE
Stop taking GIFTAN HC and contact your doctor immediately if you experience the following side effects:
- Severe allergic reactions (such as skin rash, itching, swelling of the face, lips, mouth or throat, and difficulty in swallowing or breathing)
- Kidney failure
- Bleeding or bruising, repeated infections (due to low white blood cells)
- Heart problems (such as an abnormal heartbeat, cerebrovascular accident or heart attack)
- Fluid accumulation in the lungs
- Pancreatitis (inflammation of pancreas which results in severe pain in the back and abdomen)
- Toxic epidermal necrolysis (skin rash with blisters and skin peeling)
- Hepatitis (inflammation of the liver)
HOW TO MANAGE SIDE EFFECTS
Nausea:
Take GIFTAN HC with or just after meals. Stick to simple meals and avoid eating rich or spicy food. If the symptom did not improve, consult your doctor.
Indigestion:
Eat smaller and frequent meals. Try to eat and drink slowly and follow a regular physical activity. If the symptom did not improve, consult your doctor.
Diarrhea:
Drink lots of fluids, such as water, fruit juice or electrolytes to keep yourself hydrated. Avoid taking medicine on your own to treat diarrhea. Consult your doctor if the symptom did not improve on its own.
Stomach pain:
Try to rest and relax. Try to eat and drink slowly or have smaller and frequent meals. Keep a heat pad on your stomach and avoid eating rich or spicy food. If the symptom did not improve, consult your doctor.
Headache:
Rest and relax. Drink plenty of fluids such as water or electrolytes. Apply a pain-relieving balm on the head if required. Do not consume too much of alcohol. Consult your doctor if the symptom did not improve.
WARNING & PRECAUTIONS
PREGNANCY
GIFTAN HC is not recommended for use in pregnant women and should not be used if you are more than 3 months pregnant, as it may cause serious harm to your baby. Consult your doctor before taking GIFTAN HC.
BREASTFEEDING
GIFTAN HC is not recommended for use in breast-feeding mothers. Your doctor may choose another treatment if you wish to breast-feed. Consult your doctor before taking GIFTAN HC.
DRIVING AND USING MACHINES
Do not drive or operate any machines if your ability is affected after taking GIFTAN HC.
ALCOHOL
Avoid consumption of alcohol while taking GIFTAN HC because it may aggravate your existing condition and increases the effect of GIFTAN HC.
KIDNEY
GIFTAN HC is not recommended for use in patients with severe kidney impairment or kidneys not producing any urine. It should be used with caution in patients having renal artery stenosis (narrowing of renal arteries) or functioning of one kidney or have had a recent kidney transplant. Consult your doctor before taking GIFTAN HC.
LIVER
GIFTAN HC is not recommended for use in patients with severe liver impairment. It should be used with caution in patients having history of mild to moderate liver impairment. Consult your doctor before taking GIFTAN HC.
ALLERGY
Do not take GIFTAN HC if you are allergic to Hydrochlorothiazide or Losartan or other sulfonamide-derived substances (Ex. other thiazides and some antibacterial drugs such as co-trimoxazole).
LUNGS
GIFTAN HC should be used with caution in patients with asthma and in patients those who experienced breathing or lung problems following hydrochlorothiazide intake in the past. Consult your doctor before taking GIFTAN HC.
HEART DISEASE
GIFTAN HC should be used with caution if you have heart problems (such as heart failure, atherosclerosis (narrowing of the arteries), angina pectoris, aortic or mitral valve stenosis (narrowing of valves of the heart) or hypertrophic cardiomyopathy (thickening of heart muscle)). Consult your doctor before taking GIFTAN HC.
OTHERS
GIFTAN HC is not recommended for use if you have:
- Untreatably low sodium or potassium levels in blood
- Untreatably high calcium levels in blood
- Gout
- Diabetes with impaired kidney function (treated with blood pressure lowering medicine containing aliskiren)
Before taking GIFTANHC, inform your physician if you:
- Have or had skin cancer
- Have any previous allergic reactions (like swelling of the face, lips, throat, or tongue)
- Are on low-sodium or -potassium diet
- Have or had severe vomiting with or without diarrhea
- Have or had allergic condition or systemic lupus erythematosus that causes skin rashes, fever and joint pain
- Need to have an anesthetic for any upcoming surgery
- Are scheduled for parathyroid function tests
- Have primary hyperaldosteronism (increased secretion of aldosterone by adrenal glands)
Use in pediatrics:
GIFTAN HC is not recommended for use in children. Consult your doctor for advice.
Use in geriatrics:
GIFTAN HC should be taken with caution in elderly patients (aged 65 years or above). Consult your doctor before taking GIFTANHC.
INTERACTIONS
A. Drug-Drug interactions:
Before taking GIFTAN HC inform to your doctor, if you are taking any of these medicines:
- Other medicine used to reduce elevated blood pressure (such as diuretics (Ex. furosemide), aliskiren, ACE inhibitors (Ex. captopril, enalapril), methyldopa)
- Lithium (used to treat mental illness)
- Potassium supplements, potassium sparing diuretics such as spironolactone (used to increase potassium levels in blood)
- Medicines used to treat gout (Ex. colchicine, indomethacin)
- Medicines used to treat abnormal heart rhythm (Ex. digoxin, quinidine, amiodarone)
- Medicines used to treat diabetes (Ex. insulin, metformin, glimepiride, teneligliptin)
- Corticosteroids (used to treat pain and inflammation) Ex. dexamethasone
- Medicines used to treat cancer (Ex.5-flurouracil, doxorubicin, capecitabine)
- Non-steroidal anti-inflammatory medicines (Ex. aspirin, ibuprofen)
- Medicines used to treat fungal infections (Ex. ketoconazole, fluconazole, itraconazole)
- Medicines used to treat arthritis (Ex. methotrexate)
- Medicines used to control high cholesterol levels in blood (such as cholestyramine)
- Skeletal muscle relaxants (used to relieve muscle pain) Ex. tubocurarine
- Medicines which induce sleep (Ex. barbiturates such as amobarbital, diazepam, clonazepam)
- Opioid medicines (used to treat pain) such as morphine
- Medicines that can cause an increase in blood pressure such as pressor amines (Ex. adrenaline)
- Carbamazepine (a medicine used to treat epilepsy)
- Calcium salts
- Antipsychotics (used to treat psychosis) Ex. aripiprazole, clozapine, olanzapine, risperidone, or quetiapine
- Antidepressants (used to treat depression) Ex. amitriptyline, clomipramine, imipramine, doxepin
- Erythromycin IV (used to treat bacterial infection)
- Vincamine IV (used to treat primary degenerative and vascular dementia)
- Halofantrine (used to treat malaria)
- Anticholinergic agents such as atropine (used to reduce bronchial secretion before surgery)
- Pentamidine (used to treat serious lung infection)
- Mizolastin or terfenadine (used to treat allergic symptoms such as watery eyes, running nose, sneezing)
- Ciclosporin (a medicine used to prevent graft rejection and other auto-immune reactions)
- ACTH (used to control metabolic disorders)
- Glycyrrhizin (used to treat bronchitis or other digestive problems)
B. Drug-Food interaction:
While taking GIFTAN HC avoid excessive consumption of dietary salt as it may counteract the effect of this medicine.
Overdosage:
If you or anyone else take too much of GIFTAN HC, contact your doctor immediately or go to a hospital straight away. Overdosage symptoms of GIFTAN HC include drop in blood pressure, palpitations, slow pulse, changes in blood composition and dehydration.
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