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Losartan

    Brands

    DEA Class; Rx

    Common Brand Names; Cozaar

    • ARBs

    Angiotensin II antagonist; used once daily for HTN, diabetic nephropathy, proteinuria, or CHF (off-label); additive efficacy with HCTZ; reverses potassium loss and rise in serum uric acid with HCTZ; does not inhibit ACE and accumulate bradykinin; less likely to cause cough or angioedema than ACE inhibitors; long-acting active metabolite, E-3174.

    Indicated for the treatment of hypertension.

    Indicated to reduce risk of stroke in patients with hypertension and left ventricular hypertrophy, but there is evidence that this benefit does not apply to Black patients

    Indicated for diabetic nephropathy with an elevated serum creatinine and proteinuria (urinary albumin to creatinine ratio ≥300 mg/g) in patients with type 2 diabetes and a history of hypertension

    For the treatment of heart failure.
    For the treatment of diabetic cardiovascular autonomic neuropathy.

    Hypersensitivity

    Coadministration with aliskiren in patients with diabetes mellitus

    • Cough (17-29%)
    • Upper respiratory tract infection (8%)
    • Dizziness (3%)
    • Nasal congestion (2%)
    • Back pain (2%)
    • Blood and lymphatic system disorders: Anemia
    • Psychiatric disorders: Depression
    • Nervous system disorders: Somnolence, headache, sleep disorders, paresthesia, migraine
    • Ear and labyrinth disorders: Vertigo, tinnitus
    • Cardiac disorders: Palpitations, syncope, atrial fibrillation, CVA
    • Respiratory, thoracic and mediastinal disorders: Dyspnea
    • Gastrointestinal disorders: Abdominal pain, constipation, nausea, vomiting
    • Skin and subcutaneous tissue disorders: Urticaria, pruritus, rash, photosensitivity
    • Musculoskeletal and connective tissue disorders: Myalgia, arthralgia
    • Reproductive system and breast disorders: Impotence
    • General disorders and administration site conditions: Edema
    • Digestive: Hepatitis
    • General disorders and administration site conditions: Malaise
    • Hematologic: Thrombocytopenia
    • Hypersensitivity: Angioedema, vasculitis, anaphylactic reactions
    • Metabolic and nutrition: Hyponatremia
    • Musculoskeletal: Rhabdomyolysis
    • Nervous system disorders: Dysgeusia
    • Skin: Erythroderma

    Use of drugs that act on the renin-angiotensin system during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death

    In volume- or salt-depleted patients (eg, those being treated with high doses of diuretics), symptomatic hypotension may occur after initiation of treatment; correct volume or salt depletion before administration

    Monitor serum potassium periodically and treat appropriately; dosage reduction or discontinuation of treatment may be required

    Can cause fetal harm when administered to a pregnant woman; use of drugs that act on the renin-angiotensin system during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death

    Unknown whether drug is excreted in human milk

    Adults

    100 mg/day PO.

    Geriatric

    100 mg/day PO.

    Adolescents

    1.4 mg/kg/day (Max: 100 mg/day) PO.

    Children

    6 to 12 years: 1.4 mg/kg/day (Max: 100 mg/day) PO.
    1 to 5 years: Safety and efficacy have not been established.

    Infants

    Safety and efficacy have not been established.

    Neonates

    Safety and efficacy have not been established.

    Losartan potassium

    tablet

    • 25mg
    • 50mg
    • 100mg