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Losartan information from DrugsUpdate  

See Available Brands of Losartan in India

P - Contraindicated in pregnancy
L - Contraindicated in lactation

Losartan is an angiotensin II receptor antagonist drug used mainly to treat high blood pressure (hypertension). Losartan was the first angiotensin II receptor antagonist to be marketed. It is currently marketed by Merck & Co. under the trade name Cozaar.

Pharmacodynamics

Pharmacokinetics

Losartan is an angiotensin II receptor antagonist. The drug and its active metabolite selectively block the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively antagonising its binding to AT1 receptors.

Absorption

Readily absorbed from GI tract with peak plasma concentrations of losartan after around 1 hour and its active metabolite after 3-4 hours.

Distribution

98% plasma protein bound.

Metabolism

Hepatic metabolism principally by isoenzymes CYP3A4 and 2C9.

Excretion

Excreted in faeces and urine as metabolites and unchanged drug. Terminal elimination half life of 2 hours (losartan) and 6-9 hours (active metabolite)

Losartan Indications / Losartan Uses

Information Not Available

Losartan Adverse Reactions / Losartan Side Effects

Headache, dizziness, back pain, myalgia, respiratory tract disorders, asthenia/fatigue, first dose hypotension, rash, angioedema, neutropenia, GI disturbances, transient elevation of liver enzymes, impaired renal function, taste disturbances and hyperkalaemia.

Precautions

Information Not Available

Special Precautions

Volume-depleted patients including patients on diuretics and salt restriction; renal artery stenosis; elderly; renal or hepatic impairment. Monitor serum-potassium concentration.

Other Drug Interactions

Hypotensive effect of losartan potentiated by diuretics and other antihypertensives. Risk of hyperkalaemia increases with concomitant ACE inhibitors, ciclosporin, potassium-sparing diuretics and K supplements. Hypotensive effect may be antagonised and increased risk of renal impairment when used with NSAIDs.

Potentially Fatal: Risk of lithium toxicity with losartan use.

Other Interactions

Information Not Available

Dosage

Oral
Hypertension
Adult: 50 mg once daily, increased to 100 mg daily as a single dose or in 2 divided doses if needed.
Child: ≥6 years: Initially 700 mcg/kg increased to a maximum of 50 mg once daily if needed.
Elderly: >75 years: Initally, 25 mg once daily.

CrCl (ml/min)              Dosage Recommendation
<20                            Initially 25 mg once daily.
Hepatic impairment:     Initially, 25 mg once daily

Oral
Diabetic nephropathy in Type 2 diabetes mellitus
Adult: 50 mg once daily, increased to 100 mg daily as a single dose or in 2 divided doses if needed.
Elderly: >75: Initially 25 mg once daily.

Renal impairment:
CrCl <20 ml/min:        Initially 25 mg once daily.
CrCl (ml/min)             Dosage Recommendation
<20                           Initially 25 mg once daily.
Hepatic impairment:    Initially 25 mg once daily.

Special Populations
Patients with intravascular fluid depletion: Initially, 25 mg once daily.

Food(before/after)

May be taken with or without food.

List of Contraindications

Losartan and Pregnancy

Contraindicated in pregnancy

Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

in 2nd & 3rd trimesters.
                   
Category D: There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).

Losartan and Lactation

Contraindicated in lactation

Losartan and Children

Studies on losartan have been done only in adult patients, and there is no specific information comparing use of losartan in children younger than 6 years of age with use in other age groups.

Losartan and Geriatic

Losartan has been tested in a limited number of patients 65 years of age or older and has not been shown to cause different side effects or problems in older people than it does in younger adults.

Losartan and Other Contraindications

Pregnancy, lactation; children with CrCl <30 ml/min/1.73m2.

Storage

Information Not Available

Lab interference

Information Not Available

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