LOSARTAN/HYDROCHLOROTHIAZIDE SANDOZ 100mg/25mg FILM-COATED TABLETS

2. What you need to know before taking Losartan/Hydrochlorothiazide Sandoz

Do not take Losartan/Hydrochlorothiazide Sandoz:

• if you are allergicto losartan, to hydrochlorothiazideor to any of the other ingredients of this medicine (listed in section 6),
• if you are allergicto other sulfonamide-derived substances(e.g. other thiazides, some antibacterial medicines such as cotrimoxazole, ask your doctor if you are not sure),
• if you are more than 3 months pregnant. (It is also better to avoid losartan/hydrochlorothiazide at the beginning of pregnancy – see section Pregnancy),
• if you have severe liver failure,
• if you have severe kidney failureor your kidneys do not produce urine,
• if you have low levels of potassium, sodium or high levels of calcium that cannot be corrected with treatment,
• if you suffer from gout,
• if you have diabetesor kidney failure and are being treated with a blood pressure-lowering medicine that contains aliskiren.

If you think any of the above conditions apply to you, consult your doctor or pharmacist.

Warnings and precautions

Consult your doctor or pharmacist before starting to take Losartan/Hydrochlorothiazide Sandoz.

You must inform your doctor if you think you are pregnant (or might become pregnant). Losartan/hydrochlorothiazide is not recommended at the beginning of pregnancy and should not be used 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/Hydrochlorothiazide Sandoz:

• if you have previously suffered from swelling of the face, lips, tongue or throat,
• if you are taking diuretics(medicines to urinate),
• if you are on a low-salt diet,
• if you have had excessive vomitingand/or diarrhea,
• if you have heart failure,
• if your liver function is impaired (see section 2 “Do not take Losartan/Hydrochlorothiazide Sandoz”),
• if you have narrowed arteries to the kidneys(renal artery stenosis), if you only have one functioning kidneyor if you have recently had a kidney transplant,
• if you are on hemodialysis,
• if you have arterial narrowing(arteriosclerosis), angina pectoris(chest pain due to poor heart function),
• if you have “aortic or mitral valve stenosisnarrowing of the heart valves) or “hypertrophic cardiomyopathythickening of the heart valves),
• if you are diabetic,
• if you have had gout,
• if you have or have had an allergic disorder, asthmaor a condition that causes joint pain, skin rashes, and fever(systemic lupus erythematosus), if you have had respiratory or lung problems(such as inflammation or fluid in the lungs) after taking hydrochlorothiazide in the past. If you experience shortness of breath or severe difficulty breathing after taking losartan/hydrochlorothiazide, seek medical attention immediately,
• if you have high levels of calciumor potassiumor if you are on a low-potassium diet,
• if you need to have anesthesia(even at the dentist) or before surgery, or if you are going to have tests to determine your parathyroid function, you should inform your doctor or healthcare professional that you are taking losartan/hydrochlorothiazide tablets,
• if you have primary hyperaldosteronism(a syndrome associated with an increase in the secretion of the hormone aldosterone by the adrenal gland, caused by an alteration in the gland),
• if you have had skin canceror if you develop an unexpected skin lesionduring treatment. Treatment with hydrochlorothiazide, in particular its long-term use at high doses, may increase the risk of certain types of skin and lip cancer (non-melanoma skin cancer). Protect your skin from sun exposure and UV rays while taking Losartan/Hydrochlorothiazide Sandoz,
• if you experience vision loss or eye pain, they could be symptoms of fluid accumulation in the vascular layer of the eye (choroidal effusion) or an increase in eye pressure and can occur within hours to a week after taking losartan/hydrochlorothiazide. This can lead to permanent vision loss if not treated. If you have had an allergy to sulfonamides or penicillins, you may be at greater risk of developing it,
• if you are taking any of the following medicines used to treat high blood pressure:
• • An ACE inhibitor(e.g. enalapril, lisinopril, ramipril), particularly if you have kidney problems related to diabetes,
  • Aliskiren.

Consult your doctor if you experience abdominal pain, nausea, vomiting, or diarrhea after taking losartan/hydrochlorothiazide. Your doctor will decide whether to continue treatment. Do not stop taking losartan/hydrochlorothiazide on your own.

Your doctor may 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/Hydrochlorothiazide Sandoz”.

Children and adolescents

The safety and efficacy of losartan/hydrochlorothiazide in children and adolescents under 18 years of age have not been established. Losartan/hydrochlorothiazide should not be given to children and adolescents.

Ask your doctor if you are subject to doping control, as losartan/hydrochlorothiazide contains an active substance that may test positive in a doping control.

Other medicines and Losartan/Hydrochlorothiazide Sandoz

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

Your doctor may need to change your dose and/or take other precautions if you are taking:

• lithium (a medicine for the treatment of depressionor mania),
• potassium supplements,
• potassium-containing salt substitutes,
• potassium-sparing medicines,
• other diuretics(water pills),
• certain laxatives,
• medicines for the treatment of gout,
• medicines to control heart rate,
• medicines for diabetes(oral medicines or insulins),
• medicines to lower your blood pressure,
• corticosteroids,
• medicines used to treat cancer,
• medicines for pain relief,
• medicines for arthritis,
• medicines to treat fungal infections,
• resins used for high cholesterol, (e.g. colestyramine),
• medicines that relax muscles,
• sleeping pills,
• opioid medicines(e.g. morphine),
• medicines called vasopressors(e.g. adrenaline),
• licorice root(contains glycyrrhizin).
• An ACE inhibitoror aliskiren(see also the information under the headings “Do not take Losartan/Hydrochlorothiazide Sandoz” and “Warnings and precautions”.

Please inform your doctor if you are taking losartan/hydrochlorothiazide and are going to undergo a radiographic procedure and need to take iodinated contrast media.

Losartan/Hydrochlorothiazide Sandoz with food and drinks

Excessive salt in the diet may counteract the effect of losartan/hydrochlorothiazide.

Losartan/hydrochlorothiazide can be taken with or without food.

Pregnancy and breastfeeding

Pregnancy

You must inform your doctor if you think you are pregnant (or might become pregnant). Normally, your doctor will advise you to stop taking losartan/hydrochlorothiazide before you become pregnant or as soon as you know you are pregnant and will advise you to take a different medicine instead of losartan/hydrochlorothiazide. Losartan/hydrochlorothiazide is not recommended at the beginning of pregnancy and should not be used 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

Consult your doctor if you are breastfeeding or plan to start breastfeeding. Losartan/hydrochlorothiazide is not recommended for breastfeeding mothers and your doctor may choose a different treatment if you want to breastfeed.

If you are pregnant or breastfeeding, or think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

Driving and using machines

When starting treatment with this medicine, you should not perform tasks that require special attention (e.g. driving a car or using hazardous machinery) until you know how your medicine affects you.

Losartan/Hydrochlorothiazide Sandoz contains lactose.

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

3. How to take Losartan/Hydrochlorothiazide Sandoz

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/hydrochlorothiazide depending on your condition and whether you are taking other medicines. It is important to keep taking losartan/hydrochlorothiazide as long as your doctor prescribes it to maintain constant control of your blood pressure.

Take the tablet with a glass of water. It can be taken with or without food.

Use in adults

The usual dose of losartan/hydrochlorothiazide 100 mg/25 mg is one tablet once a day.

Use in elderly patients

Generally, no dose adjustment is necessary in elderly patients.

Use in hemodialysis and renal failure

In case of moderate kidney problems, it is generally not necessary to adjust the dose. Do not take losartan/hydrochlorothiazide if you have severe kidney failure. Losartan/hydrochlorothiazide is not recommended in patients on hemodialysis.

Use in liver failure

Losartan/hydrochlorothiazide should be used with caution in patients with mild to moderate liver failure.

Do not take losartan/hydrochlorothiazide if your liver function is severely impaired (see section 2 “Do not take Losartan/Hydrochlorothiazide Sandoz”).

Use in children and adolescents

Losartan/hydrochlorothiazide should not be administered to children and adolescents under 18 years of age.

Use in black patients

A dose adjustment may be necessary as efficacy may be reduced in black patients compared to non-black patients.

If you take more Losartan/Hydrochlorothiazide Sandoz than you should

In case of overdose, contact your doctor immediately for immediate medical attention. Overdose may cause a drop in blood pressure, palpitations, slow pulse, changes in blood composition, and dehydration. If you have taken more Losartan/Hydrochlorothiazide Sandoz than you should, consult your doctor, pharmacist, or call the Toxicology Information Service, phone: 91 562 04 20, indicating the medicine and the amount used.

If you forget to take Losartan/Hydrochlorothiazide Sandoz

Do not take a double dose to make up for forgotten doses. Take your next dose as usual.

If you stop taking Losartan/Hydrochlorothiazide Sandoz

Always consult your doctor if you want to stop taking this medicine. Although you may feel well, you may need to continue taking this medicine.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

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 losartan/hydrochlorothiazide tablets and inform your doctor immediately or go to the emergency department of your nearest hospital:

A severe allergic reaction(skin 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 in 10,000 patients, but less than 1 in 1,000 patients. It may require urgent medical attention or hospitalization.

Acute respiratory distress (symptoms include severe respiratory distress, fever, weakness, and confusion), this is a very rare adverse reaction (may affect up to 1 in 10,000 people).

The following adverse effects have been reported:

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

• cough, upper respiratory tract infection, nasal congestion, sinusitis, nasal disorder,
• diarrhea, abdominal pain, nausea, indigestion,
• muscle pain or cramps, leg pain, back pain,
• insomnia, headache, dizziness,
• weakness, fatigue, chest pain,
• high potassium levels (which can cause an abnormal heart rhythm), decreased hemoglobin levels,
• changes in renal function including renal failure,
• low blood sugar levels (hypoglycemia).

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

• anemia, red or brown spots on the skin (sometimes especially on the feet, legs, arms, and buttocks, with joint pain, swelling of the hands and feet, and abdominal pain), hematoma, reduced white blood cell count, coagulation disorders, reduced platelet count,
• loss of appetite, high uric acid levels or gout, high blood sugar levels, altered blood electrolyte levels,
• anxiety, nervousness, panic disorders (recurrent panic attacks), confusion, depression, unusual dreams, sleep disorders, somnolence, memory impairment,
• tingling or similar sensations, pain in the limbs, tremor, migraine, fainting,
• blurred vision, itching or burning in the eyes, conjunctivitis, worsening vision, seeing things in yellow,
• tinnitus, buzzing, noises, or clicking in the ears, vertigo,
• low blood pressure that may be associated with postural changes (feeling dizzy or weak when standing up), angina (chest pain), abnormal heartbeats, stroke (transient ischemic attack, "mini-stroke"), heart attack, palpitations,
• inflammation of blood vessels that is often associated with a skin rash or hematoma,
• throat itching, shortness of breath, bronchitis, pneumonia, fluid in the lungs (which can cause difficulty breathing), nasal bleeding, runny nose, congestion,
• constipation, obstructive constipation, gas, stomach disorders, stomach spasms, vomiting, dry mouth, inflammation of a salivary gland, toothache,
• jaundice (yellowing of the eyes and skin), pancreatitis,
• urticaria, itching, skin inflammation, skin rash, redness of the skin, sensitivity to light, Lyell syndrome (skin with a burned appearance and peeling), dry skin, flushing, sweating, hair loss,
• pain in the arms, shoulders, hips, knees, or other joints, joint swelling, stiffness, muscle weakness,
• frequent urination even at night, altered renal function including kidney inflammation, urinary tract infection, sugar in the urine,
• decreased sexual appetite, impotence,
• swelling of the face, localized swelling (edema), fever.

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

• hepatitis (inflammation of the liver), abnormal liver function tests,
• intestinal angioedema: swelling in the intestine that presents symptoms such as abdominal pain, nausea, vomiting, and diarrhea.

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

• flu-like symptoms,
• muscle pain of unknown origin with dark-colored urine (tea-colored urine) (rhabdomyolysis),
• low sodium levels in the blood (hyponatremia)
• generally feeling unwell (malaise),
• alterations in taste (dysgeusia),
• skin and lip cancer (non-melanoma skin cancer),
• myopia,
• decreased vision or eye pain due to increased pressure (possible signs of fluid accumulation in the vascular layer of the eye (choroidal effusion) or acute angle-closure glaucoma).

Reporting of Adverse Effects

If you experience any type of adverse effect, consult your doctor or pharmacist, even if it is a possible adverse effect that is 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/Hydrochlorothiazide Sandoz

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

Do not use Losartan/Hydrochlorothiazide Sandoz after the expiration date stated on the packaging after CAD. The expiration date is the last day of the month indicated.

Alu/Alu Blister: store below 30 °C.

Aclar/Alu Blister: store below 30 °C

Bottle: keep the bottle tightly closed 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 collection point in your pharmacy. If in 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/Hydrochlorothiazide Sandoz

• The active ingredients are losartan potassium and hydrochlorothiazide. Each Losartan/Hydrochlorothiazide Sandoz 100 mg/25 mg tablet contains 100 mg of losartan potassium and 25 mg of hydrochlorothiazide.

• The other ingredients are:

Core:lactose monohydrate, microcrystalline cellulose, pregelatinized corn starch, magnesium stearate, anhydrous colloidal silica.

Coating:hypromellose, hydroxypropylcellulose, yellow iron oxide (E172), titanium dioxide (E171), macrogol (400), talc.

Appearance of the Product and Package Contents

Losartan/Hydrochlorothiazide Sandoz 100 mg/25 mg is presented as film-coated tablets, which are light yellow in color, round, biconvex, and have a diameter of 10 mm.

They are packaged in blisters with an aluminum foil or in plastic bottles with or without a child-resistant screw cap.

Blister: 7, 10, 14, 28, 30, 50, 56, 60, 84, 90, 98, and 100 film-coated tablets.

Blister (unit dose): 50 film-coated tablets.

Bottle: 100 and 250 film-coated tablets.

Only some package sizes may be marketed.

Marketing Authorization Holder and Manufacturer

Marketing Authorization Holder

Sandoz Farmacéutica, S.A.

Centro Empresarial Parque Norte

Edificio Roble

C/ Serrano Galvache, 56

28033 Madrid

Spain

Manufacturer

Lek Pharmaceuticals d.d.

Verovskova 57

SI-1526 Ljubljana

Slovenia

or

Lek S.A.,

Ul. Domaniewska 50 C

02-672 Warsaw

Poland

or

Salutas Pharma GmbH

Otto von Guericke Allee 1

39179 Barleben, Germany

or

Salutas Pharma GmbH

Dieselstrasse 5

70839 Gerlingen

Germany

This medicine is authorized in the Member States of the European Economic Area and in the United Kingdom (Northern Ireland) under the following names:

Germany: Losartan-HCT Sandoz 100 mg/25 mg Filmtabletten

Austria: Losartan-HCT Sandoz 100 mg/25 mg Filmtabletten

Belgium: Co-Losartan Sandoz 100 mg/25 mg filmomhulde tabletten

Denmark: Ancozan Comp

France: LOSARTÁN/ HYDROCHLOROTHIAZIDE Sandoz 100 mg/25 mg, comprimé pelliculé

Netherlands: KaliumLosartán/Hydrochloorthiazide Sandoz 100/25 mg, filmomhulde tabletten

Italy: LOSARTÁN IDROCLOROTIAZIDE SANDOZ 100 mg + 25 mg compresse rivestite con film

Portugal: Losartán + Hidroclorotiazida Sintano

United Kingdom (Northern Ireland): Losartan Potassium/Hydrochlorothiazide 100 mg/25 mg Film-coated Tablets

Czech Republic: Sangona COMBI 100 mg/25 mg

Sweden: Losartan/Hydrochlorothiazide Sandoz 100 mg/25 mg filmdragerade tabletter

Date of the Last Revision of this Leaflet: February 2025

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