Drug Detail:Losartan (Losartan [ loe-sar-tan ])
Drug Class: Angiotensin receptor blockers
Usual Adult Dose for Diabetic Nephropathy
Initial dose: 50 mg orally once a day
Maximum dose: 100 mg orally once a day
Comments:
- If hypertensive patients with left ventricular hypertrophy or type 2 diabetic nephropathy patients require titration from initial dose, increase to 100 mg orally once a day.
- Antihypertension is substantially present within 1 week but in some studies the maximal effect occurred in 3 to 6 weeks.
Uses:
- Treatment of hypertension.
- To reduce the risk of stroke in patients with hypertension and left ventricular hypertrophy.
- Treatment of diabetic nephropathy with an elevated serum creatinine and proteinuria (urinary albumin to creatinine ratio 300 mg/g or greater) in patients with type 2 diabetes and a history of hypertension.
Usual Adult Dose for Hypertension
Initial dose: 50 mg orally once a day
Maximum dose: 100 mg orally once a day
Comments:
- If hypertensive patients with left ventricular hypertrophy or type 2 diabetic nephropathy patients require titration from initial dose, increase to 100 mg orally once a day.
- Antihypertension is substantially present within 1 week but in some studies the maximal effect occurred in 3 to 6 weeks.
Uses:
- Treatment of hypertension.
- To reduce the risk of stroke in patients with hypertension and left ventricular hypertrophy.
- Treatment of diabetic nephropathy with an elevated serum creatinine and proteinuria (urinary albumin to creatinine ratio 300 mg/g or greater) in patients with type 2 diabetes and a history of hypertension.
Usual Pediatric Dose for Hypertension
6 Years or Older:
Initial dose: 0.7 mg/kg orally once a day (up to 50 mg total)
Comments:
- May be given as a tablet or suspension.
- Doses above 1.4 mg/kg (or 100 mg) daily have not been studied in pediatric patients.
Renal Dose Adjustments
Adult:
No adjustment recommended
Pediatric:
GFR less than 30 mL/min/1.73 m2: Not recommended
If a clinically significant decrease in renal function develops during therapy: Consider withholding or discontinuing this drug.
Liver Dose Adjustments
Mild to moderate liver dysfunction: Initial dose: 25 mg orally once a day
Severe liver dysfunction: Data not available
Dose Adjustments
Patients with possible intravascular volume depletion:
- Initial dose: 25 mg orally once a day
Precautions
US BOXED WARNING:
- FETAL TOXICITY: If pregnancy is detected, discontinue this drug as soon as possible. Drugs that act directly on the renin angiotensin system (RAS) can cause injury and death to the developing fetus.
Safety and efficacy have not been established in patients younger than 6 years.
Consult WARNINGS section for additional precautions.
Dialysis
No adjustment recommended
Other Comments
Administration advice: Pediatric dose may be administered as a tablet or suspension.
Storage requirements: Prepared suspension should be refrigerated at 2 to 8C (36 to 46F) and can be stored for up to 4 weeks.
Reconstitution/preparation techniques: The manufacturer product information should be consulted.
Monitoring:
- Monitor renal function periodically.
- Closely monitor potassium and CrCl, especially in patients with heart failure or CrCl 30 to 50 mL/min.
Patient advice:
- Females of childbearing age should be informed of the consequences of exposure to this drug during pregnancy; ask these patients to report pregnancies as soon as possible.
- Advise patients against using potassium-sparing diuretics, potassium supplements or potassium-containing salt substitutes without consulting their physician.
Frequently asked questions
- Does Losartan block the receptor used by the Coronavirus?
- Can you eat bananas when taking losartan?
- Losartan vs Valsartan - What's the difference between them?
- Does losartan cause rapid heart rate, irregular heartbeat or low blood pressure?
- Are losartan and losartan potassium the same or different drugs?
