Indications
Losartan is an angiotensin II receptor blocker (ARB) indicated for:
- Treatment of hypertension, to lower blood pressure in adults and children greater than 6 years old. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions.
- Reduction of the risk of stroke in patients with hypertension and left ventricular hypertrophy. There is evidence that this benefit does not apply to Black patients.
- Treatment of diabetic nephropathy with an elevated serum creatinine and proteinuria in patients with type 2 diabetes and a history of hypertension.
Therapeutic Class
Pharmacology
Dosage & Administration
Hypertension:
- Usual adult dose: 50 mg once daily.
- Usual pediatric starting dose: 0.7 mg per kg once daily (up to 50 mg).
Hypertensive Patients with Left Ventricular Hypertrophy:
- Usual starting dose: 50 mg once daily.
- Add hydrochlorothiazide 12.5 mg and/or increase Losartan to 100 mg followed by an increase to hydrochlorothiazide 25 mg if further blood pressure response is needed.
Nephropathy in Type 2 Diabetic Patients:
- Usual dose: 50 mg once daily.
- Increase dose to 100 mg once daily if further blood pressure response is needed.
Use in elderly:
- Patients up to 75 years: No initial dosage adjustment is necessary for this group of patients.
- Patients over 75 years: A lower starting dose of 25 mg once daily is recommended.
Interaction
Contraindications
Side Effects
Pregnancy & Lactation
Although there is no experience with the use of Losartan in pregnant women, animal studies with Losartan potassium have demonstrated fetal and neonatal injury and death, the mechanism of which is believed to be pharmacologically mediated through effects on the renin angiotensinaldosterone system. Losartan should not be used in pregnancy and if pregnancy is detected Losartan should be discontinued as soon as possible.
It is not known whether Losartan is excreted in human breast milk. However, significant level of Losartan found in rat milk which suggests that the drug should not be used in lactating mother.
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