losartan, Cozaar (cont.)

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Medical and Pharmacy Editor:
Medical and Pharmacy Editor:

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).

Combining ARBs, ACE inhibitors, or aliskiren (Tekturna) increases risk of hypotension (low blood pressure), hyperkalemia, and reduces kidney function compared to each drug used alone and there is no additional benefit on preventing end stage kidney disease or death.

Aliskiren and losartan should not be combined in patients with diabetes or with renal impairment.

Increases in blood lithium (Eskalith, Lithobid) levels and lithium toxicity have occurred when lithium and ARBa or hydrochlorothiazide were combined. Blood lithium levels should be monitored.

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.

NURSING MOTHERS: It is not known whether losartan is excreted in breast milk, but losartan and its active form are excreted in rat milk. Due to the possibility of harm to the nursing infant, if possible, losartan should be discontinued by females who are nursing.

Reference: FDA Prescribing Information


Medically Reviewed by a Doctor on 12/18/2014


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