Losartan

Angiotensin-II Antagonist · Angiotensin II antagonist

Indications

Hypertension. Diabetic nephropathy in type 2 diabetes mellitus.

Dosage

Adults: Hypertension: 50 mg once daily. If necessary increase to max 100 mg once daily. With intravascular volume depletion (adults 18-75 yrs), 25 mg once daily for several wks, increased up to 100 mg once daily if necessary. Elderly: Over 75 yr, initially 25 mg once daily. Children: Under 6 yr, not recommended. Hypertension: 6-18 yr, body-weight less than 50 kg, initially 700 mcg/kg (max 25 mg) once daily (lower dose in intravascular volume depletion), adjusted according to response, max 50 mg once daily; Body-weight 50 kg and over, initially 50 mg once daily (initially 25 mg once daily in intravascular volume depletion), adjusted according to response, max 1.4 mg/kg (max 100 mg) once daily. Diabetic nephropathy in type 2 diabetes mellitus: Adults: 18-75 yrs: 50 mg once daily for several wks, increased to 100 mg once daily if required. =76 yrs: 25 mg once daily for several wks,…

Adverse Effects

Dizziness, orthostatic effects, diarrhoea, liver function abnormalities, myalgia, migraine, urticaria, pruritus, rash. Rarely, anaphylactic reactions, angioedema, vasculitis, hepatitis, cough, anaemia, hypotension, renal impairment, increased blood urea, creatinine, potassium.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Renal arteries stenosis, severe hepatic impairment. Precautions: History of angioedema. Hepatic impairment, renal impairment, intravascular volume depletion, renal artery stenosis, kidney transplantation, primary aldosteronism, severe heart failure, arrhythmias, obstructive valvular disease, aortic stenosis, outflow obstruction, cardiomyopathy. Monitor serum potassium in the elderly and in renal impairment.

Interactions

K+ -sparing diuretics, K+ supplements, rifampicin, fluconazole, NSAIDs, other antihypertensives, lithium, heparin.

Advice to Patient

Take with or without meals. Preferably, it should be taken on empty stomach 1 hour before or 2 hours after meals. Contact prescriber if there is prolonged diarrhoea, nausea or vomiting, chest pain, palpitations, unrelieved headache, back pain, muscle pain, weakness, delusions, depression or swelling of face/mouth/tongue/throat. Do not take potassium supplements or salt substitutes without consulting prescriber. Avoid exercising in hot weather, avoid excessive intake of alcohol. Change position slowly when climbing stairs and from lying or sitting to standing position.

Pharmacokinetics

Onset of action: Approx. 6 hrs. Absorption: Well absorbed; slowed with food. Metabolism: Hepatic. Bioavailability: Approx. 33%. Half-life elimination: Losartan: Children 6-16 yrs: 2.3 ± 0.8 hrs. Adults: 2.1 ± 0.7 hrs. E-3174 (active metabolite): Children 6-16 yrs: 5.6 ± 1.2 hrs. Adults: 7.4 ± 2.4 hrs. Time to peak, serum: Losartan: Children: 2 hrs. Adults: 1 hr. E-3174 (active metabolite): Children: 4.1 hrs. Adults: 3.5 hrs. Excretion: Urine (35%). Faeces (Approx. 60%).

Brands with this active ingredient

Compiled by Healify Pharmacy from published drug references. How we compile it →

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