Prosan 12.5 mg + 100 mg Tablet

Prosan 12.5 mg + 100 mg tablet is a fixed-dose combination medicine from Beximco Pharmaceuticals Ltd. containing Losartan Potassium + Hydrochlorothiazide. It is used for high blood pressure that is not adequately controlled by a single medicine, and to reduce stroke risk in suitable patients.

The two ingredients complement each other. Losartan is an angiotensin receptor blocker (ARB) that stops the hormone angiotensin II from tightening blood vessels, keeping them relaxed and wide. Hydrochlorothiazide is a thiazide diuretic ("water tablet") that helps the kidneys remove extra salt and water from the body. Less fluid volume plus relaxed vessels means clearly lower blood pressure, and losartan helps balance the potassium loss the diuretic can cause.

• High blood pressure (hypertension) not controlled by one medicine alone
• Patients needing both an ARB and a diuretic in a single convenient tablet
• Reducing stroke risk in hypertensive patients with thickened heart muscle (left ventricular hypertrophy), as judged by the doctor

Your doctor will choose the strength of Prosan after seeing how your pressure responds to single medicines, and will adjust it at follow-up visits.

• Take once daily, preferably in the morning (the diuretic increases urination — a morning dose avoids night-time toilet trips).
• Can be taken with or without food; swallow with water.
• If you miss a dose, take it the same day when remembered; if it is almost the next day, skip it — never double up.

This is a long-term medicine. Never stop Prosan on your own, even when readings look normal — they are normal because the medicine is working, and stopping lets the pressure climb back silently.

Possible side effects include:

• Dizziness or light-headedness, especially on standing
• Increased urination (expected from the diuretic)
• Electrolyte changes — low sodium, low or high potassium; may cause weakness, cramps or irregular heartbeat
• Increased blood sugar or uric acid (may trigger gout)
• Sun sensitivity — skin burns more easily (hydrochlorothiazide)
• Headache, tiredness, back pain
• Dehydration with excessive thirst or very dark urine
• Rare but serious: sudden eye pain or vision loss (acute glaucoma reaction), severe skin rash, face/throat swelling — seek urgent care

• Your doctor will periodically check blood electrolytes (sodium, potassium), kidney function, sugar and uric acid — do not skip these tests.
• Sun protection: use an umbrella, hat or sunscreen and avoid long midday sun — the skin burns more easily on this medicine.
• In hot weather, fever, vomiting or diarrhoea, dehydration can develop quickly — drink fluids and contact your doctor if you feel weak or faint.
• Rise slowly from sitting or lying down.
• Tell your doctor if you have diabetes, gout, kidney or liver disease, or lupus.
• Avoid potassium supplements or salt substitutes unless prescribed.
• Report any sudden eye pain or blurred vision immediately.

• NSAID painkillers (ibuprofen, diclofenac, naproxen): blunt the pressure-lowering effect and strain the kidneys
• Lithium: both components raise lithium levels — combination usually avoided
• Potassium supplements / potassium-sparing diuretics: unpredictable potassium changes — only under medical supervision
• Other antihypertensives: additive effect; dizziness possible
• Diabetes medicines: hydrochlorothiazide may raise sugar — doses may need adjusting
• Corticosteroids: increase potassium loss
• ACE inhibitors or aliskiren: dual blockade generally avoided
• Gout medicines: doses may need review, as the diuretic raises uric acid

• Allergy to losartan, hydrochlorothiazide or sulfonamide-derived medicines
• Pregnancy — the losartan component can seriously harm the unborn baby
• Inability to pass urine (anuria)
• Severe liver impairment
• Refractory low potassium, low sodium or high calcium
• Use with aliskiren in diabetic patients

Pregnancy: This combination is contraindicated in pregnancy. The losartan component can damage the unborn baby's kidneys, reduce amniotic fluid and cause foetal death, especially in the second and third trimesters, and the diuretic can also affect the baby. Stop and contact your doctor immediately if you become pregnant or plan to conceive.

Lactation: Not recommended while breastfeeding — hydrochlorothiazide passes into milk and may reduce milk production, and losartan safety data are limited. Ask your doctor for a safer alternative.

Store below 30°C in a dry place, protected from light and moisture. Keep in the original pack and out of the reach of children. Do not use after the expiry date.