LOSARTAN TARBIS FARMA 25 mg FILM-COATED TABLETS

2. What you need to know before taking Losartan Tarbis Farma

Do not take Losartan Tarbis Farma:

• if you are allergic to losartan or any of the other ingredients of this medicine (listed in section 6),
• if you are more than 3 months pregnant (it is also better to avoid losartan at the beginning of pregnancy - see Pregnancy),
• if your liver function is severely impaired,
• if you have diabetes or kidney insufficiency and are being treated with a blood pressure-lowering medicine that contains aliskiren.

Warnings and precautions

Talk to your doctor if you experience abdominal pain, nausea, vomiting, or diarrhea after taking Losartan Tarbis Farma. Your doctor will decide on the treatment to follow. Do not stop taking Losartan Tarbis Farma on your own.

Consult your doctor, pharmacist, or nurse before starting to take losartan.

You must inform your doctor if you think you are pregnant (or might be). Losartan is not recommended at the beginning of pregnancy, and it must not be taken if you are more than 3 months pregnant, as it may cause serious harm to your baby if used at this stage (see section Pregnancy).

It is important that you inform your doctor before taking losartan:

• if you have a history of angioedema (swelling of the face, lips, tongue, and/or throat) (see also section 4 “Possible side effects”),
• if you have excessive vomiting or diarrhea, which causes excessive loss of fluid and/or salt from your body,
• if you are taking diuretics (medicines that increase the amount of water that passes through your kidneys) or if you are on a low-salt diet that causes excessive loss of fluids and salt in your body (see section 3 “Posology in special patient groups”),
• if you know you have narrowing or blockage of the blood vessels that supply your kidneys or if you have recently had a kidney transplant,
• if your liver function is impaired (see sections 2 “Do not take Losartan Tarbis Farma” and 3 “Posology in special patient groups”),
• if you have heart failure with or without kidney insufficiency or life-threatening heart rhythm disorders. Special attention is needed when you are being treated at the same time with a beta-blocker,
• if you have problems with the valves in your heart or with the heart muscle,
• if you have coronary heart disease (caused by reduced blood flow in the blood vessels of the heart) or cerebrovascular disease (caused by reduced blood circulation in the brain),
• if you have primary hyperaldosteronism (a syndrome associated with high secretion of the hormone aldosterone by the adrenal gland due to a disorder of this gland),
• if you are taking any of the following medicines used to treat high blood pressure:

• an angiotensin-converting enzyme inhibitor (ACE inhibitor) (e.g., enalapril, lisinopril, ramipril), especially if you have kidney problems related to diabetes.
• aliskiren.

Your doctor may need to monitor your kidney function, blood pressure, and blood electrolyte levels (e.g., potassium) at regular intervals.

See also the information under the heading “Do not take Losartan Tarbis Farma”.

• if you are taking other medicines that may increase serum potassium levels (see section 2 “Taking losartan with other medicines”).

Children and adolescents

Losartan has been studied in children. For more information, talk to your doctor.

Losartan is not recommended for use in children with kidney or liver problems, as there is limited data available in these patient groups. Losartan is not recommended for use in children under 6 years of age, as it has not been shown to work in this age group.

Taking losartan with other medicines

Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines.

Tell your doctor if you are taking potassium supplements, salt substitutes that contain potassium, or potassium-sparing medicines such as certain diuretics (amiloride, triamterene, spironolactone) or other medicines that may increase serum potassium levels (e.g., heparin, trimethoprim-containing medicines), as combination with losartan is not recommended.

While you are being treated with losartan, be particularly careful if you take any of the following medicines:

• other medicines that lower blood pressure, as they may cause additional lowering of blood pressure. Blood pressure may also be lowered by some of the following medicines/classes of medicines: tricyclic antidepressants, antipsychotics, baclofen, amifostine,
• non-steroidal anti-inflammatory medicines, such as indomethacin, including COX-2 inhibitors (medicines that reduce inflammation and can be used to relieve pain), as they may reduce the blood pressure-lowering effect of losartan.

Your doctor may need to adjust your dose and/or take other precautions:

If you are taking an angiotensin-converting enzyme inhibitor (ACE inhibitor) or aliskiren (see also the information under the headings “Do not take Losartan Tarbis Farma” and “Warnings and precautions”).

If your kidney function is impaired, concomitant use of these medicines may lead to worsening of kidney function.

Medicines that contain lithium should not be taken in combination with losartan without close supervision by your doctor. Special precautions may be necessary (e.g., blood tests).

Taking losartan with food and drinks

Losartan can be taken with or without food.

Pregnancy and breastfeeding

Pregnancy

You must tell your doctor if you think you are pregnant (or might be). Normally, your doctor will advise you to stop taking losartan before you become pregnant or as soon as you know you are pregnant and will advise you to take another medicine instead of losartan. Losartan is not recommended at the beginning of pregnancy, and it must not be taken if you are more than 3 months pregnant, as it may cause serious harm to your baby if used from the third month of pregnancy.

Breastfeeding

Tell your doctor if you are breastfeeding or about to start breastfeeding. Losartan is not recommended for mothers who are breastfeeding, and your doctor may choose another treatment if you wish to continue breastfeeding. Especially if your child is a newborn or was born prematurely.

Consult your doctor or pharmacist before using this medicine.

Driving and using machines

No studies have been performed on the effects on the ability to drive and use machines.

Losartan is unlikely to affect your ability to drive or use machines. However, as with many medicines used to treat high blood pressure, losartan may cause dizziness or drowsiness in some people. If you experience dizziness or drowsiness, consult your doctor before performing these activities.

Losartan contains lactose

This medicine contains lactose. If your doctor has told you that you have an intolerance to some sugars, consult your doctor before taking this medicine.

3. How to take Losartan Tarbis Farma

Follow exactly the administration instructions of this medicine given by your doctor or pharmacist. In case of doubt, consult your doctor or pharmacist again. Your doctor will decide the appropriate dose of losartan, depending on your condition and whether you are taking other medicines. It is important to keep taking losartan while your doctor prescribes it to you to maintain constant control of your blood pressure.

Adult patients with high blood pressure

Normally, treatment starts with 50 mg of losartan (one losartan 50 mg tablet) once a day. The maximum blood pressure-lowering effect should be achieved within 3-6 weeks of starting treatment. After that, in some patients, the dose may be increased to 100 mg of losartan (two losartan 50 mg tablets or one losartan 100 mg tablet) once a day.

If you think the effect of losartan is too strong or too weak, tell your doctor or pharmacist.

Use in children and adolescents

Children under 6 years

Losartan is not recommended for use in children under 6 years of age, as it has not been shown to work in this age group.

Children aged 6-18 years

The recommended starting dose in patients who weigh between 20 and 50 kg is 0.7 mg of losartan per kg of body weight, given once a day (up to 25 mg of losartan). The doctor may increase the dose if blood pressure is not controlled.

Other pharmaceutical forms of this medicine may be more suitable for children; ask your doctor or pharmacist.

Adult patients with high blood pressure and type 2 diabetes

Normally, treatment starts with 50 mg of losartan (one losartan 50 mg tablet) once a day. After that, the dose may be increased to 100 mg of losartan (two losartan 50 mg tablets or one losartan 100 mg tablet) once a day, depending on the response of your blood pressure.

Losartan can be given with other medicines that lower blood pressure (e.g., diuretics, calcium antagonists, alpha or beta blockers, and centrally acting agents), as well as with insulin and other medicines frequently used to lower blood glucose levels (e.g., sulfonylureas, glitazones, and glucosidase inhibitors).

Adult patients with heart failure

Normally, treatment starts with 12.5 mg of losartan (one losartan 12.5 mg tablet) once a day. Normally, the dose should be gradually increased, weekly (i.e., 12.5 mg per day during the first week, 25 mg per day during the second week, 50 mg per day during the third week, 100 mg per day during the fourth week, 150 mg per day during the fifth week), up to a maintenance dose determined by your doctor. A maximum dose of 150 mg of losartan (e.g., three losartan 50 mg tablets or one losartan 100 mg tablet and one losartan 50 mg tablet) can be used once a day.

In the treatment of heart failure, losartan is normally combined with a diuretic (a medicine that increases the amount of water that passes through your kidneys) and/or digitalis (a medicine that helps your heart be stronger and more efficient) and/or a beta-blocker.

Posology in special patient groups

Your doctor may recommend a lower dose, especially when starting treatment in certain patients, such as those treated with high-dose diuretics, patients with liver insufficiency, or patients over 75 years of age. Losartan is not recommended for use in patients with severe liver insufficiency (see section “Do not take losartan”).

Administration

The tablets should be swallowed whole with a glass of water. You should try to take your daily dose at approximately the same time each day. It is important that you keep taking losartan until your doctor tells you to stop.

The tablet can be divided into equal doses (only for 25 mg and 50 mg).

If you take more losartan than you should

If you accidentally take too many tablets, contact your doctor immediately. The symptoms of overdose are low blood pressure, increased heart rate, and possibly decreased heart rate.

In case of overdose or accidental ingestion, consult your doctor or pharmacist immediately or call the Toxicology Information Service, phone 91 562 04 20, indicating the medicine and the amount taken.

If you forget to take losartan

If you accidentally miss a dose, simply take the next dose as normal. Do not take a double dose to make up for missed doses. If you have any other questions about the use of this medicine, ask your doctor, pharmacist, or nurse.

4. Possible Adverse Effects

Like all medicines, this medicine can cause adverse effects, although not all people suffer from them.

If you experience the following, stop taking the losartan tablets and inform your doctor immediately or go to the emergency department of your nearest hospital:

A severe allergic reaction (rash, itching, swelling of the face, lips, mouth, or throat that can cause difficulty swallowing or breathing).

This is a serious but rare adverse effect, affecting more than 1 patient in 10,000, but less than 1 patient in 1,000. You may need urgent medical attention or hospitalization.

The following adverse effects have been reported with losartan:

Frequent(may affect up to 1 in 10 people):

• dizziness,
• low blood pressure (especially after excessive loss of water from the body within the blood vessels, e.g., in patients with severe heart failure or undergoing high-dose diuretic treatment),
• dose-related orthostatic effects, such as decreased blood pressure that occurs after standing up from lying down or sitting,
• weakness,
• fatigue,
• low blood sugar (hypoglycemia),
• high potassium levels in the blood (hyperkalemia),
• changes in renal function, including renal failure,
• reduced number of red blood cells (anemia),
• increased urea, creatinine, and potassium levels in the blood in patients with heart failure.

Uncommon(may affect up to 1 in 100 people):

• drowsiness,
• headache,
• sleep disorders,
• feeling of very rapid heartbeats (palpitations),
• severe chest pain (angina pectoris),
• difficulty breathing (dyspnea),
• abdominal pain,
• constipation,
• diarrhea,
• nausea,
• vomiting,
• hives (urticaria),
• itching (pruritus),
• rash,
• localized swelling (edema),
• cough.

Rare(may affect up to 1 in 1,000 people):

• hypersensitivity,
• angioedema,
• inflammation of the blood vessels (vasculitis, including Schönlein-Henoch purpura),
• numbness or tingling sensation (paresthesia),
• fainting (syncope),
• very rapid and irregular heartbeats (atrial fibrillation),
• stroke (cerebral attack),
• inflammation of the liver (hepatitis),
• elevation of alanine aminotransferase (ALT) levels in the blood, which usually resolves upon discontinuation of treatment.
• Intestinal angioedema: inflammation in the intestine that presents with symptoms such as abdominal pain, nausea, vomiting, and diarrhea.

Frequency Not Known(frequency cannot be estimated from available data):

• reduced platelet count,
• migraine,
• liver function abnormalities,
• muscle and joint pain,
• flu-like symptoms,
• back pain and urinary tract infection,
• increased sensitivity to sunlight (photosensitivity),
• muscle pain of unknown origin with dark-colored urine (rhabdomyolysis),
• impotence,
• inflammation of the pancreas (pancreatitis),
• low sodium levels in the blood (hyponatremia),
• depression,
• generally feeling unwell (malaise),
• ringing, buzzing, noise, or clicking in the ears (tinnitus),
• alteration of taste (dysgeusia).

Adverse effects in children are similar to those observed in adults.

Reporting of Adverse Effects

If you experience any type of adverse effect, consult your doctor, pharmacist, or nurse, even if it is a possible adverse effect not listed in this leaflet. You can also report them directly through the Spanish Pharmacovigilance System for Human Use Medicines: https://www.notificaram.es.

By reporting adverse effects, you can contribute to providing more information on the safety of this medicine.

5. Storage of Losartan Tarbis Farma

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiration date stated on the packaging after CAD. The expiration date is the last day of the month indicated.

This medicine does not require any special storage temperature.

Store in the original packaging to protect it from moisture.

Medicines should not be disposed of via wastewater or household waste. Deposit the packaging and medicines you no longer need at the SIGRE Point in your pharmacy. In case of doubt, ask your pharmacist how to dispose of the packaging and medicines you no longer need. This will help protect the environment.

6. Package Contents and Additional Information

Composition of Losartan Tarbis Farma

The active ingredient is losartan potassium.

Each 25mg losartan tablet contains 25mg of losartan potassium.

Each 50mg losartan tablet contains 50mg of losartan potassium.

Each 100mg losartan tablet contains 100mg of losartan potassium.

Other components are:

Microcrystalline cellulose (PH 102 & PH 200), lactose monohydrate, pregelatinized corn starch, low-substituted hydroxypropylcellulose, crospovidone (type A), magnesium stearate, hypromellose 2910 6cP (E-464), titanium dioxide (E-171), and carnauba wax.

Appearance of the Product and Package Contents

Losartan Tarbis Farma 25mg film-coated tablets EFG

White to off-white, oval, biconvex film-coated tablets, 8.3 x 4.5 mm (approx.), engraved with "I" on one side and "5" on the other side with a score line.

The tablet can be divided into equal doses.

Losartan Tarbis Farma 50mg film-coated tablets EFG

Oval, white to off-white film-coated tablets, 10.4 x 5.5 mm (approx.), engraved with "I" on one side and "6" on the other side with a score line.

The tablet can be divided into equal doses.

Losartan Tarbis Farma 100mg film-coated tablets EFG

White to off-white, tear-drop shaped film-coated tablets, 11.8 x 7.2 mm (approx.), engraved with "H" on one side and "145" on the other side.

Aluminum-PVC/PVdC blister pack containing 28, 30, 56, 90, 98, and 250 film-coated tablets.

Not all pack sizes may be marketed.

Marketing Authorization Holder

Tarbis Farma S.L.

Gran Vía Carlos III, 94

08028 Barcelona

Spain

Manufacturer

Amarox Pharma B.V.

Rouboslaan 32

Voorschoten, 2252TR

Netherlands

This medicine is authorized in the Member States of the European Economic Area under the following names:

Germany: Losartan-Kalium Amarox 25mg/50mg/100mg film-coated tablets

Spain: Losartán Tarbis Farma 25mg/50mg/100mg film-coated tablets EFG

Netherlands: Losartankalium Amarox 25mg/50mg/100mg film-coated tablets

Date of the Last Revision of this Leaflet:

December 2024

Detailed and updated information on this medicine is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es/