Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Losartan is an oral medication that is used
for treating high blood pressure and
diabetic kidney disease. It belongs to a
class of drugs called angiotensin receptor blockers (ARBs) which also includes
irbesartan (Avapro), valsartan (Diovan), and candesartan (Atacand). Angiotensin,
formed in the blood by the action of angiotensin converting enzyme (ACE), is a
powerful chemical that attaches to angiotensin receptors found in many tissues
but primarily on smooth muscle cells of blood vessels. Angiotensin's attachment
to the receptors causes the blood vessels to narrow (vasoconstrict) which leads
to an increase in blood pressure (hypertension). Losartan (more specifically,
the chemical formed when the liver converts the inactive losartan into an active
chemical) blocks the angiotensin receptor. By blocking the action of angiotensin,
losartan dilates blood vessels and thereby reduces blood pressure. Losartan was
approved by the FDA in April 1995.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 25, 50 and 100 mg
STORAGE: Tablets should be stored at room temperature in a tightly
closed, light resistant container.
PRESCRIBED FOR: Losartan is used for treating high blood pressure,
reducing the risk of stroke in patients with
hypertension and left ventricular
hypertrophy (over developed heart muscle), and treating type 2 diabetic and
hypertensive patients with diabetic nephropathy (kidney disease). It may be used
alone or in combination with other drugs.
DOSING: The starting dose of losartan for adults is 25-50 mg daily.
The maximum dose is 100 mg daily. The total daily dose may be divided and
administered twice daily. Losartan may be given with or without food. The
starting dose of losartan for pediatric patients 6 years of age or older is 0.7
mg/kg up to 50 mg once daily. Doses more than 1.4 mg/kg or 100 mg daily have not
been evaluated in pediatric patients.
DRUG INTERACTIONS: Losartan may increase levels of blood potassium
which can lead to serious heart problems (arrhythmias). Therefore, concomitant
use of other substances that increase blood potassium-such as potassium-sparing
diuretics (for example, spironolactone (Aldactone), triamterene, and amiloride),
potassium supplements, or salt substitutes containing potassium, may lead to
dangerous increases in serum potassium. Combining losartan or other ARBs with
nonsteroidal anti-inflammatory drugs (NSAIDs) in patients who are elderly,
volume-depleted (including those on diuretic therapy), or with poor kidney
function may result in reduced kidney function, including kidney failure. These
effects usually are reversible. The antihypertensive effect of losartan may be
reduced by aspirin and other NSAIDs such as ibuprofen (Advil, Children's
Advil/Motrin, Medipren, Motrin, Nuprin, PediaCare Fever, etc.), indomethacin (Indocin,
Indocin-SR), and naproxen (Anaprox, Naprelan, Naprosyn, and Aleve).
PREGNANCY: When used in the second or third trimester of pregnancy ,
ARBs can cause injury and even death to the fetus. Losartan should not be used
during pregnancy. When pregnancy is first detected, losartan should be stopped.
High blood pressure, also known as hypertension, is a repeatedly
elevated blood pressure exceeding 140 over 90 mmHg -- a systolic pressure above
140 with a diastolic pressure above 90. There are two causes of high blood pressure, primary and secondary. Primary high blood pressure is much more common that secondary and its basic causes or underlying defects are not always known. It is known that a diet high in salt increases the risk for high blood pressure, as well as high cholesterol. Genetic factors are also a primary cause. Secondary high blood pressure is generally caused by another condition such as renal hypertension, tumors, and other conditions. Treatment for high blood pressure is generally lifestyle changes and if necessary, diet.
High blood pressure (hypertension) means high pressure (tension) in the arteries. Treatment for high blood pressure include lifestyle modifications (alcohol, smoking, coffee, salt, diet, exercise), drugs and medications such as ACE inhibitors, angiotensin receptor blockers, beta blockers, diuretics, calcium channel blockers (CCBs), alpha blockers, clonidine, minoxidil, and Exforge.
In the United States diabetes is the most common cause of kidney failure. High blood pressure and high levels of blood glucose increase the risk that a person with diabetes will eventually progress to kidney failure. Kidney disease in people with diabetes develops over the course of many years. albumin and eGFR are two key markers for kidney disease in people with diabetes. Controlling high blood pressure, blood pressure medications, a moderate protein diet, and compliant management of blood glucose can slow the progression of kidney disease. For those patients who's kidneys eventually fail, dialysis or kidney transplantation is the only option.
High blood pressure (HBP) or hypertension means high pressure (tension) in the arteries. Arteries are vessels that carry blood from the pumping heart to all the tissues and organs of the body. High blood pressure does not mean excessive emotional tension, although emotional tension and stress can temporarily increase blood pressure. Normal blood pressure is below 120/80; blood pressure between 120/80 and 139/89 is called "pre-hypertension", and a blood pressure of 140/90 or above is considered high.
The top number, the systolic blood pressure, corresponds to the pressure in the arteries as the heart contracts and pumps blood forward into the arteries. The bottom number, the diastolic pressure, represents the pressure in the arteries as the heart relaxes after the contraction. The diastolic pressure reflects the lowest pressure to which the arteries are exposed.
An elevation of the systolic and/or diastolic blood pressure increas...
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