The decision to perform surgery is based on the size of the aorta, expected normal size of the aorta, rate of aortic growth, age, height, gender, and family history of aortic dissection. Surgery involves replacing the dilated portion of the aorta with a graft, a piece of man-made material that is inserted to replace the damaged or weak area of the blood vessel. Hydrochlorothiazide decreases urinary calcium excretion and may cause elevations of serum calcium. Monitor calcium levels. Instruct patient to lie or sit down if they experience dizziness or light-headedness when standing. Cardiac disorders: Palpitation, tachycardia.
Losartan Potassium and Hydrochlorothiazide tablets and certain other medicines may interact with each other. Medicines are sometimes prescribed for conditions that are not mentioned in patient information leaflets. Do not use Losartan Potassium and Hydrochlorothiazide tablets for a condition for which it was not prescribed. Do not give Losartan Potassium and Hydrochlorothiazide tablets to other people, even if they have the same symptoms that you have. There are no dosage adjustments provided in the manufacturer's labeling. Other diagnostic tests for Marfan syndrome include a slit lamp in which the doctor will check for dislocated lenses.
But not all high specifically block the AGTR1 receptor. Those with dilation of the aorta will be asked to avoid high intensity team sports, contact sports, and isometric exercises such as . Ask your cardiologist about activity guidelines for you. About FAERS: The FDA Adverse Event Reporting System FAERS is used by FDA for activities such as looking for new safety concerns that might be related to a marketed product, evaluating a manufacturer's compliance to reporting regulations and responding to outside requests for information. Reporting of adverse events is a voluntary process, and not every report is sent to FDA and entered into FAERS.
Neonates with a history of in utero exposure to Losartan Potassium and Hydrochlorothiazide: If oliguria or hypotension occurs, direct attention toward support of blood pressure and renal perfusion. Take Losartan Potassium and Hydrochlorothiazide tablets exactly as prescribed by your doctor. Your doctor may change your dose if needed. Pentoxifylline: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Of the randomized patients, 4963 54% were female and 533 6% were Black.
Enzalutamide: May decrease the serum concentration of CYP2C9 Substrates. Management: Concurrent use of enzalutamide with CYP2C9 substrates that have a narrow therapeutic index should be avoided. Use of enzalutamide and any other CYP2C9 substrate should be performed with caution and close monitoring. Tetrahydrocannabinol: CYP2C9 Inhibitors Moderate may increase the serum concentration of Tetrahydrocannabinol. They may harm them. Losartan Potassium and Hydrochlorothiazide. As a result, a greater proportion of the patients on Losartan Potassium and Hydrochlorothiazide reached the target diastolic blood pressure 17. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Losartan belongs to a class of drugs called ARBs. It works by relaxing blood vessels so that blood can flow more easily. AR antagonists, and the patient should be hemodynamically stable. Ideally, patients at risk for excessive hypotension should initiate AR antagonist therapy under close medical supervision, preferably with a lower dose, and followed closely for the first 2 weeks of treatment and whenever the dosage of AR antagonist or diuretic is increased. But if there were a study in which losartan were given only to women with breast cancers linked to overexpression of AGTR1, it would be much easier to detect an effect. Before such a trial can be set up, however, scientists must first develop a way to easily detect AGTR1 overexpression. Perform serial ultrasound examinations to assess the intra-amniotic environment. If oligohydramnios is observed, discontinue Losartan Potassium and Hydrochlorothiazide, unless it is considered lifesaving for the mother. Fetal testing may be appropriate, based on the week of pregnancy. Patients and physicians should be aware, however, that oligohydramnios may not appear until after the fetus has sustained irreversible injury. Molsidomine: May enhance the hypotensive effect of Blood Pressure Lowering Agents.
Dabrafenib: May decrease the serum concentration of CYP2C9 Substrates. Management: Seek alternatives to the CYP2C9 substrate when possible. If concomitant therapy cannot be avoided, monitor clinical effects of the substrate closely particularly therapeutic effects. Emotional considerations. Learning you have Marfan syndrome may cause you to feel angry, frightened or sad. You may need to make changes in your lifestyle and adjust to having careful medical follow-up the rest of your life. You may have financial concerns. You also need to consider the risk to your future children. The National Marfan Foundation can provide support. Losartan potassium was negative in the microbial mutagenesis and V-79 mammalian cell mutagenesis assays and in the in vitro alkaline elution and in vitro and in vivo chromosomal aberration assays. In addition, the active metabolite showed no evidence of genotoxicity in the microbial mutagenesis, in vitro alkaline elution, and in vitro chromosomal aberration assays. Advise women to notify health care provider if pregnant, planning to become pregnant, or breastfeeding. Drugs that act on the renin-angiotensin system can cause injury and death to the developing fetus. Discontinue as soon as possible once pregnancy is detected. The use of drugs which act on the renin-angiotensin system are associated with oligohydramnios. Oligohydramnios, due to decreased fetal renal function, may lead to fetal lung hypoplasia and skeletal malformations. Losartan potassium was not carcinogenic when administered at maximally tolerated dosages to rats and mice for 105 and 92 weeks, respectively. Elevated systolic or diastolic pressure causes increased cardiovascular risk, and the absolute risk increase per mmHg is greater at higher blood pressures, so that even modest reductions of severe hypertension can provide substantial benefit. Relative risk reduction from blood pressure reduction is similar across populations with varying absolute risk, so the absolute benefit is greater in patients who are at higher risk independent of their hypertension for example, patients with diabetes or hyperlipidemia and such patients would be expected to benefit from more aggressive treatment to a lower blood pressure goal. Discuss specific use of drug and side effects with patient as it relates to treatment. HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Advise patient to take daily or bid as prescribed, without regard to meals, but to take with food if stomach upset occurs. Nervous system disorders: Dysgeusia, headache, migraine, paraesthesias. Hydrochlorothiazide USP is a white or practically white, practically odorless, crystalline powder with a molecular weight of 297. What Is Losartan and How Does It Work? Bosentan: CYP2C9 Inhibitors Moderate may increase the serum concentration of Bosentan. Management: Concomitant use of both a CYP2C9 inhibitor and a CYP3A inhibitor or a single agent that inhibits both enzymes with bosentan is likely to cause a large increase in serum concentrations of bosentan and is not recommended. See monograph for details. Sodium Phosphates: Angiotensin II Receptor Blockers may enhance the nephrotoxic effect of Sodium Phosphates. Specifically, the risk of acute phosphate nephropathy may be enhanced. Management: Consider avoiding this combination by temporarily suspending treatment with ARBs, or seeking alternatives to oral sodium phosphate bowel preparation. If the combination cannot be avoided, maintain adequate hydration and monitor renal function closely. USP and 25 mg of hydrochlorothiazide USP. Inactive ingredients are colloidal silicon dioxide, hydroxypropyl cellulose, hypromellose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, pregelatinisedstarchmaize and titanium dioxide. lopressor
After oral administration of hydrochlorothiazide, diuresis begins within 2 hours, peaks in about 4 hours, and lasts about 6 to 12 hours. Metabolism: Losartan is an orally active agent that undergoes substantial first-pass metabolism by cytochrome P450 enzymes. It is converted, in part, to an active carboxylic acid metabolite that is responsible for most of the angiotensin II receptor antagonism that follows losartan treatment. About 14% of an orally-administered dose of losartan is converted to the active metabolite. In addition to the active carboxylic acid metabolite, several inactive metabolites are formed. In vitro studies indicate that cytochrome P450 2C9 and 3A4 are involved in the biotransformation of losartan to its metabolites. How often did hospital staff describe possible side effects in a way you could understand? To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position. The antihypertensive effect of angiotensin II receptor antagonists, including losartan, may be attenuated by NSAIDs, including selective COX-2 inhibitors. Ora-Plus and Ora-Sweet SF and shake for 1 min to disperse ingredients. Hypotension 7%; orthostatic hypotension 4%. CYP2C9 Inducers Strong: May increase the metabolism of CYP2C9 Substrates. Management: Consider an alternative for one of the interacting drugs. Some combinations may be specifically contraindicated. Consult appropriate manufacturer labeling. zithromax online kaufen rezeptfrei zithromax
Angioedema: Angioedema has been reported rarely with some angiotensin II receptor antagonists ARBs and may occur at any time during treatment especially following first dose. It may involve the head and neck potentially compromising airway or the intestine presenting with abdominal pain. Patients with idiopathic or hereditary angioedema or previous angioedema associated with angiotensin-converting enzyme ACE inhibitor therapy may be at an increased risk. Prolonged frequent monitoring may be required, especially if tongue, glottis, or larynx are involved, as they are associated with airway obstruction. Patients with a history of airway surgery may have a higher risk of airway obstruction. Discontinue therapy immediately if angioedema occurs. Aggressive early management is critical. Intramuscular IM administration of epinephrine may be necessary. Do not readminister to patients who have had angioedema with ARBs. What are Losartan Potassium and Hydrochlorothiazide tablets? Others may need or surgery. Levodopa: Blood Pressure Lowering Agents may enhance the hypotensive effect of Levodopa. Cough 11%; bronchitis 10%; upper respiratory tract infection 8%; sinusitis 6%; dry cough postmarketing. Medications are typically not used to treat Marfan syndrome. However, your doctor may prescribe a beta-blocker, which decreases the forcefulness of the heartbeat and the pressure within the arteries, thus preventing or slowing the enlargement of the aorta. Beta-blocker therapy is usually started when the person with Marfan syndrome is young. WebMD User Reviews should not be considered as medical advice and are not a substitute for professional medical advice, diagnosis, or treatment. Never delay or disregard seeking professional medical advice from your physician or other qualified healthcare provider because of something you have read on WebMD. You should always speak with your doctor before you start, stop, or change any prescribed part of your care plan or treatment. WebMD understands that reading individual, real-life experiences may be a helpful health information resource but they are never a substitute for professional medical advice from a qualified healthcare provider.
Losartan Potassium and Hydrochlorothiazide. Monitor renal function periodically in these patients. Skin and subcutaneous tissue disorders: Rash, pruritus, purpura, toxic epidermal necrolysis, urticaria, photosensitivity, cutaneous lupus erythematosus. American Heart Association with specific antibiotic guidelines. Quinagolide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Obinutuzumab: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Management: Consider temporarily withholding blood pressure lowering medications beginning 12 hours prior to obinutuzumab infusion and continuing until 1 hour after the end of the infusion. opala.info procyclidine
In patients who are hypersensitive to any component of this product. Eye problems. One of the medicines in Losartan Potassium and Hydrochlorothiazide tablets can cause eye problems that, if left untreated, may lead to vision loss. Symptoms of eye problems can happen within hours to weeks of starting Losartan Potassium and Hydrochlorothiazide tablets. Diazoxide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Hypotension-Associated Agents: Blood Pressure Lowering Agents may enhance the hypotensive effect of Hypotension-Associated Agents. Neither losartan nor its active metabolite can be removed by hemodialysis. If you are using the liquid form of this medication, shake the bottle well before each dose. Symptomatic Hypotension: Advise patients that lightheadedness can occur, especially during the first days of therapy, and to report this symptom to a healthcare provider. Inform patients that dehydration from inadequate fluid intake, excessive perspiration, vomiting, or diarrhea may lead to an excessive fall in blood pressure. Talk to your doctor about other ways to lower your blood pressure if you plan to become pregnant. Drugs that act on the renin-angiotensin system can cause injury and death to the developing fetus. Discontinue as soon as possible once pregnancy is detected. Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day. It is important to continue taking this medication even if you feel well. Most people with high blood pressure do not feel sick. Aurobindo Pharma USA, Inc. Take this medication by mouth as directed by your doctor, usually once daily with or without food. The dosage is based on your medical condition and response to treatment. order topiramate pills online
Psychiatric disorders: Insomnia, restlessness. Instruct patient to immediately discontinue drug and notify health care provider if any of the following occur: swelling of the face, lips, eyelids, or tongue, difficulty breathing, or difficulty swallowing. Barbiturates: May enhance the hypotensive effect of Blood Pressure Lowering Agents. How should I take Losartan Potassium and Hydrochlorothiazide tablets? Losartan pharmacokinetics have been investigated in the elderly 65 to 75 years and in both genders. Plasma concentrations of losartan and its active metabolite are similar in elderly and young hypertensives. Plasma concentrations of losartan were about twice as high in female hypertensives as male hypertensives, but concentrations of the active metabolite were similar in males and females. After 6 weeks of therapy, more patients who received the combination regimen reached target diastolic blood pressure than those who received the monotherapy regimen 29. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure JNC. Hydrochlorothiazide was not genotoxic in vitro in the Ames mutagenicity assay of Salmonella typhimurium strains TA 98, TA 100, TA 1535, TA 1537, and TA 1538 and in the Chinese Hamster Ovary CHO test for chromosomal aberrations, or in vivo in assays using mouse germinal cell chromosomes, Chinese hamster bone marrow chromosomes, and the Drosophila sex-linked recessive lethal trait gene. Are There Physical Traits in People With Marfan Syndrome? Long arms, legs, fingers, and toes and flexible joints. CYP3A4 Inducers Moderate: May decrease the serum concentration of CYP3A4 Substrates. At the end of study or at the last visit before a primary endpoint, 77% of the group treated with losartan and 73% of the group treated with atenolol were still taking study medication. If surgery is needed, you should consult with a surgeon who is experienced in surgery for Marfan syndrome. People who have surgery for Marfan syndrome still require life-long follow-up care to prevent future complications associated with the disease. Nonsteroidal Anti-Inflammatory Agents. Specifically, the combination may result in a significant decrease in renal function. Nonsteroidal Anti-Inflammatory Agents may diminish the therapeutic effect of Angiotensin II Receptor Blockers. The combination of these two agents may also significantly decrease glomerular filtration and renal function. Do not use a household spoon because you may not get the correct dose. Vascular disorders: Dose-related orthostatic effects, necrotizing angiitis vasculitis, cutaneous vasculitis.
Chronic kidney disease CKD and hypertension: Regardless of race or diabetes status, the use of an ACE inhibitor ACEI or angiotensin receptor blocker ARB as initial therapy is recommended to improve kidney outcomes. In the general nonblack population without CKD including those with diabetes, initial antihypertensive treatment should consist of a thiazide-type diuretic, calcium channel blocker, ACEI, or ARB. In the general black population without CKD including those with diabetes, initial antihypertensive treatment should consist of a thiazide-type diuretic or a calcium channel blocker instead of an ACEI or ARB. Instruct patient to continue taking other BP medications as prescribed by health care provider. Injury or death of unborn babies. See “What is the most important information I should know about Losartan Potassium and Hydrochlorothiazide tablets? Prostacyclin Analogues: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Tell your doctor if you get any side effect that bothers you or that won't go away. This is not a complete list of side effects. For a complete list, ask your doctor or pharmacist. Fluconazole: May decrease the serum concentration of Losartan. Specifically, fluconazole may decrease the serum concentration of E3174, the more potent active metabolite of losartan. Losartan Potassium and Hydrochlorothiazide. Correct volume or salt depletion prior to administration of Losartan Potassium and Hydrochlorothiazide. Do not use Losartan Potassium and Hydrochlorothiazide as initial therapy in patients with intravascular volume depletion. Hypersensitivity reactions to hydrochlorothiazide may occur in patients with or without a history of allergy or bronchial asthma, but are more likely in patients with such a history. Canadian labeling: Use is not recommended. flomax online payment buy now
Dabrafenib: May decrease the serum concentration of CYP3A4 Substrates. Management: Seek alternatives to the CYP3A4 substrate when possible. If concomitant therapy cannot be avoided, monitor clinical effects of the substrate closely particularly therapeutic effects. Trimethoprim: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. HFSA, 2010; Konstam, 2009. In these cases, surgery to replace or repair the is necessary. If surgery is performed early, before the valves are damaged, the aortic or mitral valve may be repaired and preserved. If the valves are damaged, they may need to be replaced. Nitroprusside: Blood Pressure Lowering Agents may enhance the hypotensive effect of Nitroprusside. Hypotension: Symptomatic hypotension may occur upon initiation in patients who are salt or volume depleted eg, those treated with high-dose diuretics; correct volume depletion prior to administration. This transient hypotensive response is not a contraindication to further treatment with losartan. Digestive: Hepatitis has been reported rarely in patients treated with losartan. Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. Losartan Potassium and Hydrochlorothiazide tablets are indicated for the treatment of hypertension, to lower blood pressure. Lowering blood pressure lowers the risk of fatal and non-fatal cardiovascular CV events, primarily strokes and myocardial infarction. These benefits have been seen in controlled trials of antihypertensive drugs from a wide variety of pharmacologic classes including losartan and hydrochlorothiazide. Who should not take Losartan Potassium and Hydrochlorothiazide tablets? pharmacy leflunomide malaysia
Nicergoline: May enhance the hypotensive effect of Blood Pressure Lowering Agents. CYP2C9 Inhibitors Moderate: May decrease the metabolism of CYP2C9 Substrates. Instruct patient in BP and pulse measurement skills. These could cause you to have low blood pressure. Hydrochlorothiazide, a sulfonamide, can cause an idiosyncratic reaction, resulting in acute transient myopia and acute angle-closure glaucoma. Symptoms include acute onset of decreased visual acuity or ocular pain and typically occur within hours to weeks of drug initiation. Untreated acute angle-closure glaucoma can lead to permanent vision loss. The primary treatment is to discontinue hydrochlorothiazide as rapidly as possible. Prompt medical or surgical treatments may need to be considered if the intraocular pressure remains uncontrolled. Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. When unstented bilateral renal artery stenosis is present, use is generally avoided due to the elevated risk of deterioration in renal function unless possible benefits outweigh risks. Siltuximab: May decrease the serum concentration of CYP3A4 Substrates. Tell your doctor if your condition does not improve or if it worsens for example, your blood pressure readings increase. The administration of a non-steroidal anti-inflammatory agent including a selective COX-2 inhibitor can reduce the diuretic, natriuretic, and antihypertensive effects of loop, potassium-sparing and thiazide diuretics. Therefore, when Losartan Potassium and Hydrochlorothiazide and non-steroidal anti-inflammatory agents including selective COX-2 inhibitors are used concomitantly, observe closely to determine if the desired effect of the diuretic is obtained. In patients who experience a decline in renal function, discontinuation of AR antagonist therapy is usually not required provided there is symptomatic improvement of the heart failure and renal deterioration is well-tolerated. Transient hypotension is also not a contraindication to further treatment with AR antagonists, since therapy can usually be reinstated without difficulty after blood pressure stabilizes. Persistent dry cough has been associated with ACE-inhibitor use and in practice can be a cause of discontinuation of ACE-inhibitor therapy. Two prospective, parallel-group, double-blind, randomized, controlled trials were conducted to assess the effects of losartan on the incidence of cough in hypertensive patients who had experienced cough while receiving ACE-inhibitor therapy. II receptor blocker acting on the AT 1 receptor subtype and a diuretic, hydrochlorothiazide. The goal of surgery for Marfan syndrome is to prevent aortic dissection or rupture and to treat problems affecting the heart's valves, which control the flow of blood in and out of the heart and between the heart's chambers. Ceritinib: May increase the serum concentration of CYP2C9 Substrates. Thiazides cross the placental barrier and appear in cord blood. There is a risk of fetal or neonatal jaundice, thrombocytopenia, and possibly other adverse reactions that have occurred in adults.
Blocks vasoconstriction and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the angiotensin II receptor AT 1 receptor in vascular smooth muscle and the adrenal gland. The terminal half-life of losartan is about 2 hours and of the metabolite is about 6 to 9 hours. After single doses of losartan administered orally, about 4% of the dose is excreted unchanged in the urine and about 6% is excreted in urine as active metabolite. Biliary excretion contributes to the elimination of losartan and its metabolites. Following oral 14C-labeled losartan, about 35% of radioactivity is recovered in the urine and about 60% in the feces. Following an intravenous dose of 14C-labeled losartan, about 45% of radioactivity is recovered in the urine and 50% in the feces. Neither losartan nor its metabolite accumulate in plasma upon repeated once-daily dosing. Renal and urinary disorders: Glycosuria, renal dysfunction, interstitial nephritis, renal failure. When used in pregnancy during the second and third trimesters, drugs that act directly on the renin-angiotensin system can cause injury and even death to the developing fetus. When pregnancy is detected, discontinue therapy as soon as possible. DULoxetine: Blood Pressure Lowering Agents may enhance the hypotensive effect of DULoxetine. Amphetamines: May diminish the antihypertensive effect of Antihypertensive Agents. If you take too much Losartan Potassium and Hydrochlorothiazide tablets, call your doctor or Poison Control Center, or go to the nearest hospital emergency room right away. Hypoglycemia 14%; hyperkalemia 7%; weight gain 4%; hyponatremia postmarketing. cardura
CYP3A4 Inducers Strong: May increase the metabolism of CYP3A4 Substrates. Management: Consider an alternative for one of the interacting drugs. Some combinations may be specifically contraindicated. Consult appropriate manufacturer labeling. Renal impairment: Use with caution with preexisting renal insufficiency. Check your blood pressure regularly while taking this medication. Learn how to monitor your own blood pressure, and share the results with your doctor. Deferasirox: May decrease the serum concentration of CYP3A4 Substrates. How Does Marfan Sydrome Affect Lifestyle Choices? The pharmacodynamic consequences of concomitant use of losartan and inhibitors of P450 2C9 have not been examined. Subjects who do not metabolize losartan to active metabolite have been shown to have a specific, rare defect in cytochrome P450 2C9. These data suggest that the conversion of losartan to its active metabolite is mediated primarily by P450 2C9 and not P450 3A4. chantix
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The antihypertensive effect of losartan may be blunted. Sticklers syndrome. How Is Marfan Syndrome Treated? Losartan Potassium and Hydrochlorothiazide can pass into your milk and may harm your baby. You and your doctor should decide if you will take Losartan Potassium and Hydrochlorothiazide tablets or breastfeed. You should not do both. Losartan Potassium and Hydrochlorothiazide is available for oral administration in three tablet combinations of losartan and hydrochlorothiazide. Plasma concentrations may be increased by losartan, resulting in an increase in the pharmacologic and adverse effects of lithium.
No carcinogenicity studies have been conducted with the losartan potassium-hydrochlorothiazide combination. Dapoxetine: May enhance the orthostatic hypotensive effect of Angiotensin II Receptor Blockers. If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Absorption: Following oral administration, losartan is well absorbed and undergoes substantial first-pass metabolism. The systemic bioavailability of losartan is approximately 33%. Mean peak concentrations of losartan and its active metabolite are reached in 1 hour and in 3 to 4 hours, respectively. While maximum plasma concentrations of losartan and its active metabolite are approximately equal, the AUC area under the curve of the metabolite is about 4 times as great as that of losartan.
Use is not recommended. Food and Drug Administration. WebMD does not endorse any specific product, service or treatment. If you miss a dose, take it as soon as you remember. If it is close to your next dose, do not take the missed dose. Just take the next dose at your regular time. MiFEPRIStone: May increase the serum concentration of CYP2C9 Substrates. Management: Use CYP2C9 substrates at the lowest recommended dose, and monitor closely for adverse effects, during and in the 2 weeks following mifepristone treatment.
Losartan Potassium and Hydrochlorothiazide tablets. See a complete list of ingredients in Losartan Potassium and Hydrochlorothiazide tablets at the end of this leaflet. Ames microbial mutagenesis assay and the V-79 Chinese hamster lung cell mutagenesis assay. In addition, there was no evidence of direct genotoxicity in the in vitro alkaline elution assay in rat hepatocytes and in vitro chromosomal aberration assay in Chinese hamster ovary cells at noncytotoxic concentrations. Heparin Low Molecular Weight: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers.