Classes
DEA Class; Rx
Common Brand Names; Cozaar
- ARBs
Description
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.
Indications
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
Contraindications
Hypersensitivity
Coadministration with aliskiren in patients with diabetes mellitus
Adverse Effects
- 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
Warnings
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
Pregnancy and Lactation
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
Maximum Dosage
100 mg/day PO.
100 mg/day PO.
1.4 mg/kg/day (Max: 100 mg/day) PO.
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.
Safety and efficacy have not been established.
Safety and efficacy have not been established.
How supplied
Losartan potassium
tablet
- 25mg
- 50mg
- 100mg