| name | Losartan |
| classification | Angiotensin II Receptor Blocker (ARB) |
| pharmacokinetics | Losartan is primarily metabolized by the liver. It's extensively protein bound (approximately 99%). The primary active metabolite, EXP3174, is also an ARB. The drug's half-life is approximately 2 hours, but the effects can last much longer due to the active metabolite. Renal impairment may affect the elimination of both the drug and its metabolites, potentially leading to increased blood levels. |
| suggested dosage | | male patient 25 70kg | | typical initial dose | 50mg once daily | | typical maintenance dose | 50mg to 100mg once daily | | max dose | 100mg once daily | | important note | Individual dosage may need adjustment based on patient response, blood pressure control, and renal function. Always consult a physician for appropriate dosage. |
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| indications | | 1 | Hypertension | | 2 | Diabetic nephropathy (in patients with type 2 diabetes and albuminuria) | | 3 | Heart failure (in combination with other therapies) |
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| safety in pregnancy | Category D. Losartan is not recommended for use during pregnancy, especially in the first trimester, due to potential risks to the developing fetus. Consult with a physician about alternative therapies if pregnancy is planned or suspected. |
| safety in breastfeeding | Limited data is available regarding losartan excretion in human breast milk. Due to the potential for adverse effects in the infant, the use of losartan in breastfeeding mothers is not recommended, and alternative therapies should be considered. |
| side effects | | 1 | Dizziness | | 2 | Headache | | 3 | Fatigue | | 4 | Lightheadedness | | 5 | Hyperkalemia (potassium levels elevated in blood, possible but less common) | | 6 | Renal impairment in patients with pre-existing renal disease | | 7 | Angioedema (swelling of face, tongue, or throat) - a serious reaction but rare | | 8 | Hypotension (low blood pressure), especially in volume-depleted patients |
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| alternatives | |
| contraindications | | 1 | Hypersensitivity to losartan or other ARBs | | 2 | Bilateral renal artery stenosis (narrowing of arteries to the kidneys) | | 3 | Severe renal impairment | | 4 | Pregnancy (Category D) | | 5 | Severe hepatic impairment | | 6 | Concurrent use of aliskiren in patients with diabetes or renal impairment |
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| interactions | | 1 | Lithium | | 2 | Potassium-sparing diuretics (e.g., spironolactone) | | 3 | NSAIDs (can decrease the effectiveness of blood pressure lowering) | | 4 | ACE inhibitors (Caution is crucial to avoid potential for severe hypotension, especially in volume-depleted states or in patients with severe renal impairment) | | 5 | Other medications that can affect kidney function |
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| warnings and precautions | | 1 | Monitor blood pressure closely and adjust dosage as needed | | 2 | Monitor renal function, particularly in patients with pre-existing kidney problems | | 3 | Monitor potassium levels, especially in patients taking potassium-sparing diuretics | | 4 | Avoid abrupt discontinuation of the medication without physician supervision | | 5 | Patients with heart failure should be carefully monitored | | 6 | Start with lower doses in patients with pre-existing hypotension or volume depletion |
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| additional informations | Losartan is generally well-tolerated. Regular monitoring by a physician is crucial, especially for patients with pre-existing kidney or liver conditions. Lifestyle modifications, such as a healthy diet and regular exercise, are often recommended in conjunction with medication for better hypertension management. |
| patient specific details | |
