losartan, Cozaar

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Pharmacy Author:

Omudhome Ogbru, PharmD

Omudhome Ogbru, PharmD

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.

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Medical and Pharmacy Editor:

Jay W. Marks, MD

Jay W. Marks, MD

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.

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GENERIC NAME: losartan

BRAND NAME: Cozaar

DRUG CLASS AND MECHANISM: Losartan is an oral medication that belongs to a class of drugs called angiotensin receptor blockers (ARBs). Other ARBs include 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 muscle cells to contract and 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 its active form) blocks the angiotensin receptor. By blocking the action of angiotensin, losartan relaxes muscle cells and dilates blood vessels thereby reducing 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 hypertension, reducing the risk of stroke in patients with hypertension, and left ventricular hypertrophy (over developed heart muscle), and treating people with type 2 diabetes, and hypertensive patients with diabetic nephropathy (kidney disease). Losartan 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 two doses 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 (hyperkalemia), which can lead to serious heart problems (arrhythmias). Therefore, concomitant use of other drugs or substances that increase blood-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, fluid-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, 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.

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