Summary

More frequently reported side effects include: dizziness. Continue reading for a comprehensive list of adverse effects.

Applies to hydrochlorothiazide / losartan: oral tablet.

Serious side effects

Along with its needed effects, hydrochlorothiazide/losartan may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking hydrochlorothiazide / losartan:

Rare

• Black, tarry stools
• blood in the urine or stools
• cough or hoarseness accompanied by chills or fever, lower back or side pain, or painful or difficult urination
• fainting
• pinpoint red spots on the skin
• pounding heartbeat
• severe stomach pain, nausea, and vomiting
• skin rash
• swelling of the feet or lower legs
• unusual bleeding or bruising

Incidence not known

• Bleeding gums
• blistering, peeling, loosening of the skin
• blurred vision
• chest pain or tightness
• chills
• coma
• confusion
• cough
• dark-colored urine
• decreased frequency of urine
• decreased urine output
• diarrhea
• difficulty swallowing
• dizziness
• dry mouth
• fast, irregular, pounding, or racing heartbeat or pulse
• fever
• hives, itching skin, rash
• increased sensitivity of the skin to sunlight
• increased thirst
• irritability
• joint or muscle pain
• large, flat, blue, or purplish patches in the skin
• large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
• light-colored stools
• loss of appetite
• lower back or side pain
• muscle cramps, pain, spasms, stiffness, or twitching
• nausea or vomiting
• numbness or tingling in the hands, feet, or lips
• painful knees and ankles
• persistent non-healing sore
• pink growth
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• raised red swellings on the skin, the buttocks, legs, or ankles
• red, irritated eyes
• red skin lesions, often with a purple center
• reddish patch or irritated area
• redness or other discoloration of the skin
• restlessness
• seizures
• severe sunburn
• shiny bump
• sore throat
• sores, ulcers, or white spots in the mouth or on the lips
• swelling of the face, ankles, or hands
• trouble breathing
• upper right abdominal or stomach pain
• unusual tiredness or weakness
• weak or irregular heartbeat
• weight gain
• white, yellow or waxy scar-like area
• yellow eyes and skin

Other side effects

Some side effects of hydrochlorothiazide / losartan may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• Body aches or pain
• headache
• loss of voice
• sneezing
• sore throat
• stuffy or runny nose

Rare

• Dry cough

Incidence not known

• Acid or sour stomach
• belching
• change or loss of taste
• difficulty having a bowel movement (stool)
• general feeling of discomfort or illness
• heartburn
• inability to have or keep an erection
• indigestion
• loss in sexual ability, desire, drive, or performance
• trouble sleeping
• weight loss

For Healthcare Professionals

Applies to hydrochlorothiazide / losartan: oral tablet.

General

The most common adverse reaction was dizziness.^[Ref]

Nervous system

Common (1% to 10%): Dizziness, headache

Losartan:

Frequency not reported: Syncope, cerebrovascular accident, ataxia, hypesthesia, memory impairment, migraine, paresthesia, peripheral neuropathy, somnolence, vertigo, tremor, taste perversion, tinnitus^[Ref]

Respiratory

Common (1% to 10%): Cough, sinusitis, upper respiratory infection, bronchitis, pharyngitis

Hydrochlorothiazide:

Frequency not reported: Respiratory distress, pneumonitis, pulmonary edema

Losartan:

Frequency not reported: Dyspnea, epistaxis, nasal congestion, pharyngeal discomfort, respiratory congestion, rhinitis, sinus disorder

Postmarketing reports: Dry cough^[Ref]

Gastrointestinal

Common (1% to 10%): Abdominal pain, diarrhea, nausea

Hydrochlorothiazide:

Frequency not reported: Pancreatitis, sialadenitis, cramping, gastric irritation

Losartan:

Frequency not reported: Constipation, dental pain, dry mouth, dyspepsia, flatulence, gastritis, vomiting^[Ref]

Cardiovascular

Common (1% to 10%): Palpitation, essential hypertension

Uncommon (0.1% to 1%): Hypotension

Hydrochlorothiazide:

Frequency not reported: Vasculitis

Losartan:

Frequency not reported: Angina pectoris, arrhythmias, atrial fibrillation, sinus bradycardia, tachycardia, ventricular tachycardia, ventricular fibrillation, hypotension, myocardial infarction, second degree atrioventricular block, flushing

Postmarketing reports: Vasculitis^[Ref]

Other

Common (1% to 10%): Edema/swelling, asthenia/fatigue

Hydrochlorothiazide:

Frequency not reported: Weakness, fever

Losartan:

Frequency not reported: Chest pain, facial edema, fever, orthostatic effects, malaise^[Ref]

Dermatologic

Common (1% to 10%): Rash

Hydrochlorothiazide:

Frequency not reported: Purpura, photosensitivity, urticaria, cutaneous vasculitis, erythema multiforme, Stevens-Johnson syndrome, exfoliative dermatitis, toxic epidermal necrolysis

Losartan:

Common (1% to 10%): Rash

Frequency not reported: Angioedema, superficial peeling of palms, alopecia, dermatitis, dry skin, ecchymosis, erythema, photosensitivity, pruritus, sweating, urticaria

Postmarketing reports: Erythroderma^[Ref]

Musculoskeletal

Common (1% to 10%): Back pain

Hydrochlorothiazide:

Frequency not reported: Muscle spasm

Losartan:

Frequency not reported: Arm pain, arthralgia, arthritis, fibromyalgia, hip pain, joint swelling, knee pain, leg pain, muscle cramps, muscle weakness, musculoskeletal pain, myalgia, shoulder pain, stiffness

Postmarketing reports: Rhabdomyolysis^[Ref]

Renal

Uncommon (0.1% to 1%): Serum creatinine increased greater than 5 mg/dL, BUN increased

Hydrochlorothiazide:

Frequency not reported: Renal failure, renal dysfunction, interstitial nephritis

Losartan:

Common (1% to 10%): Serum creatinine increased greater than 5 mg/dL^[Ref]

Hepatic

Frequency not reported: Liver enzymes elevated, serum bilirubin elevated

Postmarketing reports: Hepatitis

Hydrochlorothiazide:

Frequency not reported: Intrahepatic cholestatic jaundice

Losartan:

Postmarketing reports: Hepatitis^[Ref]

Hematologic

Frequency not reported: Hemoglobin decreased, hematocrit decreased

Hydrochlorothiazide:

Frequency not reported: Aplastic anemia, agranulocytosis, leukopenia, hemolytic anemia, thrombocytopenia

Losartan:

Frequency not reported: Hemolysis, anemia^[Ref]

Metabolic

Postmarketing reports: Hyperkalemia

Hydrochlorothiazide:

Frequency not reported: Hyperglycemia, hyperuricemia

Losartan:

Frequency not reported: Anorexia, gout

Postmarketing reports: Hyperkalemia, hyponatremia^[Ref]

Ocular

Hydrochlorothiazide:

Frequency not reported: Transient blurred vision, xanthopsia

Losartan:

Frequency not reported: Blurred vision, burning/stinging in the eye, conjunctivitis, visual acuity decreased^[Ref]

Psychiatric

Hydrochlorothiazide:

Frequency not reported: Restlessness

Losartan:

Frequency not reported: Anxiety, anxiety disorder, confusion, dream abnormality, depression, insomnia, libido decreased, nervousness, panic disorder, sleep disorder^[Ref]

Genitourinary

Hydrochlorothiazide:

Frequency not reported: Glycosuria

Losartan:

Frequency not reported: Impotence, nocturia, urinary frequency, urinary tract infection^[Ref]

Immunologic

Losartan:

Postmarketing reports: Anaphylactic reactions^[Ref]