Hypertension: Losartan indicated for the treatment of hypertension. It may be used alone or in combination with other antihypertensive agents, including diuretics. Hypertensive patients with Left Ventricular Hypertrophy Losartan is indicated to reduce the risk of stroke in patients with hypertension & left ventricular hypertrophy. Nephropathy in Type 2 Diabetic Patients: Losartan is indicated for the treatment of diabetic nephropathy with an elevated serum creatinine & proteinuria (urinary albumin to creatinine ratio ≥300 mg/g) in patients with type 2 diabetes & a history of hypertension.
Angiotensin II Receptor antagonist
Losartan Potassium is the first non-peptide orally active angiotensin II receptor blocker. It binds to the AT1 receptor found in many tissues (e.g. vascular smooth muscle, adrenal gland, kidneys and the heart) and reduces several important biological actions including vasoconstriction and the release of aldosterone responsible for hypertension.
Adult hypertensive patients: The usual starting dose of Losartan is 50 mg once daily. 25 mg used in patients with possible depletion of intravascular volume (e.g., patients treated with diuretics) & patients with a history of hepatic Impairment. Losartan can be administered once or twice daily with total daily doses ranging from 25 mg to 100 mg. The effect of Losartan is substantially present within one week but in some studies the maximal effect occurred in 3-6 weeks. No initial dosage adjustment is necessary for elderly patients or for patients with renal impairment, including patients on dialysis. A lower dose should be considered for patients with a history of hepatic impairment. There is no therapeutic experience in patients with severe hepatic impairment. Therefore, Losartan is contraindicated in patients with severe hepatic impairment. Pediatric hypertensive patients ≥ 6 years of age: The usual recommended starting dose is 0.7 mg/kg once daily (up to 50 mg total) administered as a tablet or a suspension. Dosage should be adjusted according to blood pressure response. Doses above 1.4 mg/kg (or in excess of 100 mg) daily have not been studied in pediatric patients. Losartan is not recommended in pediatric patients less than 6 years of age or in pediatric patients with glomerular filtration rate less than 30 mL/ min/1.73 ml. Hypertensive patients with Left Ventricular Hypertrophy: The usual starting dose is 50 mgof Losartan once daily. Hydrochlorothiazide 12.5 mg daily should be added and/or the dose of Losartan should be increased to 100 mg once daily followed by an increase in Hydrochlorothiazide to 25 mg once daily based on blood pressure response. Nephropathy in Type 2 Diabetic Patients: The usual starting dose is 50 mg once daily. The dose should be increased to 100 mg once daily based on blood pressure response. Losartan may be administered with insulin & other commonly used hypoglycemic agents (e.g., sulfonylureas, glitazones & glucosidase inhibitors). Losartan may be administered with other antihypertensive agents & with or without food.
Rifampicin and fluconazole reduce levels of active metabolite of Losartan Potassium. Concomitant use of Losartan Potassium and hydrochlorothiazide may lead to potentiation of the antihypertensive effects. Concomitant use of potassium-sparing diuretics (eg, spironolactone, triamterene, amiloride), potassium supplements or salt substitutes containing potassium may lead to increases in serum potassium. The antihypertensive effect of losartan may be attenuated by the non-steroidal anti-inflammatory drug indomethacin. The use of ACE-inhibitor, angiotensin receptor antagonist, an anti-inflammatory drug and a thiazide diuretic at the same time increases the risk of renal impairment.
Losartan is contraindicated in patients who are hypersensitive to any component of this product. Do not co-administer aliskiren with Losartan in patients with diabetes. It is also contraindicated in severe hepatic impairment. In patients who are intravenously volume depleted (e.g. those treated with high-dose diuretics), symptomatic hypotension may occur. These conditions should be corrected prior to the administration of Losartan or a lower starting dose should be used. A lower dose should be considered for patients with a history of hepatic impairment. Losartan should not be used with Potassium-sparing diuretics.
Dizziness, rash, angioedema involving swelling of the face, lips and/or tongue & serious hypotension (particularly on initiating treatment in salt-depleted patients) or renal failure (mainly in patients with renal artery stenosis) may be encountered during Losartan potassium treatment.
Pregnancy Catagory D. Losartan Potassium should not be used in pregnancy & if pregnancy is detected Losartan potassium should be discontinued as soon as possible. Losartan Potassium should not be used in lactating mother.
keep in a dry place away from light and heat. Keep out of the reach of children.
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