Indications

Anin is indicated for the treatment of:

• Hypertension: It can be used alone or in combination with other antihypertensive agents, like thiazide diuretics.
• Renal Protection in Type 2 Diabetes: For hypertensive patients with type 2 diabetes who have proteinuria (urinary albumin to creatinine ratio >300 mg/g), Anin is used to slow down the progression of kidney disease.

Pharmacology

Anin contains Losartan Potassium, the first orally active, non-peptide angiotensin II receptor blocker. It works by binding to the AT1 receptor, found in various tissues, including vascular smooth muscle, adrenal glands, kidneys, and the heart. This binding blocks the effects of angiotensin II, a hormone that causes blood vessels to constrict and stimulates the release of aldosterone, both of which contribute to high blood pressure.

Dosage & Administration

• Standard Dose: For most patients, the usual starting and maintenance dose is 50 mg once daily. If the blood pressure response is not adequate, the dose can be increased to 25 mg twice daily before considering a higher total daily dose, up to a maximum of 100 mg.
• Intravascular Volume-Depletion: Patients who are volume-depleted (e.g., those on high-dose diuretics) should start with a lower dose of 25 mg once daily to avoid a drop in blood pressure.
• Elderly Patients: No initial dosage adjustment is needed for patients up to 75 years of age. For patients over 75, a lower starting dose of 25 mg once daily is recommended due to limited clinical experience.
• Anin can be taken with or without food.

Interaction

• Drug Levels: Rifampicin and fluconazole can lower the levels of Anin's active metabolite.
• Antihypertensive Effects: Concurrent use with hydrochlorothiazide can increase the blood pressure-lowering effect.
• Potassium Levels: Using Anin with potassium-sparing diuretics (e.g., spironolactone), potassium supplements, or salt substitutes containing potassium may lead to elevated potassium levels in the blood.
• NSAIDs: The antihypertensive effect of losartan can be reduced by the non-steroidal anti-inflammatory drug indomethacin.
• Renal Risk: Combining an ACE inhibitor, an angiotensin receptor antagonist, an anti-inflammatory drug, and a thiazide diuretic increases the risk of kidney impairment.

Contraindications

Anin is contraindicated in pregnant women and in individuals who are hypersensitive to any of its components. It should not be used with Aliskiren in patients with diabetes.

Side Effects

Side effects are generally mild and temporary. The most common ones are dizziness, diarrhea, nasal congestion, cough, and upper respiratory infection. Other side effects can include fatigue, swelling (oedema), abdominal pain, chest pain, nausea, headache, and pharyngitis.

Pregnancy & Lactation

This medication is classified as Pregnancy Category D. Using Anin during the second or third trimesters of pregnancy can cause harm or even death to the fetus by reducing fetal kidney function. It is not known if losartan is excreted in human milk. A decision should be made to either stop nursing or stop the drug, based on its importance to the mother.

Precautions & Warnings

• Pregnancy: Use during the second and third trimesters of pregnancy is associated with significant risks to the fetus.
• Volume-Depletion: Patients who are volume-depleted (e.g., from high-dose diuretics) may experience symptomatic low blood pressure.
• Hepatic Impairment: Plasma concentrations of losartan are significantly higher in patients with liver cirrhosis. Therefore, a lower dose should be considered for patients with a history of liver impairment.
• Renal Impairment: Changes in kidney function, including renal failure, have been reported. A lower starting dose of 25 mg is recommended for patients with moderate to severe kidney impairment or those on dialysis. Similar effects have been noted in patients with bilateral renal artery stenosis.

Therapeutic Class

Anin is an Angiotensin-II receptor blocker.

Storage Conditions

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