Proteinuria was defined as urinary protein/creatinine ratio of ≥0.3. You could also ask your pharmacist for advice on other ways of helping you remember your medicine. Maintenance dose: 25 to 100 mg orally in 1 to 2 divided doses. They have recalled any affected batches from the manufacturers while they investigate further. Hypertension with intravascular volume depletion The concomitant use of Losartan with aliskiren-containing products is contraindicated in patients with diabetes mellitus or renal impairment (GFR < 60 ml/min/1.73 m2) (see sections 4.5 and 5.1). There are several other angiotensin receptor blockers that work in the same way as losartan. This also applies to children 6 to 18 years of age. Blood pressure reduction at the end of the dosing interval was 70 – 80 % of the effect seen 5-6 hours post-dose. Pharmacotherapeutic group: Angiotensin II antagonists, plain, ATC code: C09CA01. Initially 50 mg once daily for several weeks, then increased if necessary to 100 mg once daily. Take it as instructed by your doctor. The dose should generally be titrated at weekly intervals (i.e. The antihypertensive effect of losartan was established in a clinical study involving 177 hypertensive paediatric patients 6 to 16 years of age with a body weight > 20 kg and a glomerular filtration rate > 30 ml/ min/ 1.73 m2. vascular smooth muscle, adrenal gland, kidneys and the heart) and elicits several important biological actions, including vasoconstriction and the release of aldosterone. -May increase dose if blood pressure remains uncontrolled after about 3 weeks. Reversible increases in serum lithium concentrations and toxicity have been reported during concomitant administration of lithium with ACE inhibitors. Even if your blood pressure is successfully lowered by losartan, it's best to carry on taking it. Coronary heart disease and cerebrovascular disease. For patients who can swallow tablets, the recommended dose is 25 mg once daily in patients >20 to <50 kg. I was down to 110/70 and even 100/65 at times. The amount of losartan that can lead to an overdose varies from person to person. Because no information is available regarding the use of losartan during breast-feeding, losartan is not recommended and alternative treatments with better established safety profiles during breast-feeding are preferable, especially while nursing a newborn or preterm infant. The usual starting dose is 50 mg of losartan once daily. There's nothing else you need to avoid while taking losartan. Use in patients with intravascular volume depletion: For patients with intravascular volume-depletion (e.g. The volume of distribution of losartan is 34 liters. The most likely manifestations of overdose would be hypotension and tachycardia. In elderly hypertensive patients the plasma concentrations of losartan and its active metabolite do not differ essentially from those found in young hypertensive patients. Preclinical data reveal no special hazard for humans based on conventional studies of general pharmacology, genotoxicity and carcinogenic potential. Side effects often improve as your body gets used to the medicine. In controlled clinical studies, once-daily administration of losartan to patients with mild to moderate essential hypertension produced statistically significant reductions in systolic and diastolic blood pressure. 722 patients over 65 years old with New York Heart Association class II-IV heart failure and ejection fractions less than 40% were randomised to losartan or captopril. The safety and efficacy of children aged 6 months to less than 6 years has not been established. However, at the moment, there is not enough evidence to recommend taking losartan or other similar medicines for Alzheimer's. If dual blockade therapy is considered absolutely necessary, this should only occur under specialist supervision and subject to frequent close monitoring of renal function, electrolytes and blood pressure. Losartan Potassium may be administered with or without food. Despite these increases, antihypertensive activity and suppression of plasma aldosterone concentration are maintained, indicating effective angiotensin II receptor blockade. You can take losartan tablets with or without food. If you often forget doses, it may help to set an alarm to remind you. When angiotensin II antagonists are administered simultaneously with NSAIDs (i.e. Concomitant use of losartan and ACE-inhibitors has shown to impair renal function. The adverse reaction profile for paediatric patients appears to be similar to that seen in adult patients. Elderly No initial dosage adjustment of Arrow-Losartan potassium and Hydrochlorothiazide is necessary for elderly patients. The usual starting dose is 50 mg of Losartan Potassium Tablet once daily. Losartan may be administered with other antihypertensive agents, especially with diuretics (e.g.hydrochlorothiazide) (see sections 4.3, 4.4, 4.5 and 5.1). ONTARGET was a study conducted in patients with a history of cardiovascular or cerebrovascular disease, or type 2 diabetes mellitus accompanied by evidence of end-organ damage. Renal function should be regularly monitored during treatment with losartan as it may deteriorate. After the very first dose, you can take losartan at any time of day. The mean length of follow up was 4.8 years. The dose should generally be titrated at weekly intervals (i.e. Although not all of these side effects may occur, if they do occur they may need medical attention. About 14% of an intravenously- or orally-administered dose of losartan is converted to its active metabolite. The starting dose is usually 0.7 milligram (mg) per kilogram (kg) of body weight per day. The usual starting dose is 50 mg once daily. There is evidence that the concomitant use of ACE-inhibitors, angiotensin II receptor blockers or aliskiren increases the risk of hypotension, hyperkalaemia and decreased renal function (including acute renal failure). Each film-coated tablet contains 51.0 mg lactose monohydrate. In addition to the active metabolite, inactive metabolites are formed. He likes my BP to be well below 120/80. Talk to your doctor, as other medicines might be better while you are breastfeeding. It's often used as a second-choice treatment if you had to stop taking another blood pressure-lowering medicine because it gave you a dry, irritating cough. In this study of elderly heart-failure patients, treatment with losartan was associated with an unexpected lower mortality than that found with captopril. yellow skin or the whites of your eyes turn yellow, Best Use of Medicines in Pregnancy (BUMPS) website. Losartan is generally safe to take for a long time. Dose adjustment is not usually necessary for the elderly. Your doctor may increase your dosage to 100 mg per day if needed. This site uses cookies. The rate of all cause death was not significantly different between the treatment groups. These studies have shown no significant beneficial effect on renal and/or cardiovascular outcomes and mortality, while an increased risk of hyperkalaemia, acute kidney injury and/or hypotension as compared to monotherapy was observed. Both losartan and its active metabolite are ≥99% bound to plasma proteins, primarily albumin. These results were confirmed during period II of the study where patients were randomized to continue losartan or placebo, after three weeks of treatment. An increased mortality was observed in ELITE II in the small subgroup (22% of all HF patients) taking beta-blockers at baseline. The hypertensive patients (ages 6 through 18 years) were randomised to receive either losartan (n=30) or amlodipine (n=30). Patients were followed for over 4 years (median 4.7 years). In exceptional cases the dose can be increased to a maximum of 50 mg once daily. The dose may be lower if you've recently lost body fluids (for example, because of diarrhoea or being sick) or you're over the age of 75. Maintenance dose: 25 to 100 mg orally in 1 to 2 divided doses. Like other substances that directly affect the renin-angiotensin system, losartan has been shown to induce adverse reactions on the late fetal development, resulting in fetal death and malformations. These will also help if you have high blood pressure or heart failure. in patients with severe heart failure or under treatment with high dose diuretics), In this study 3152 patients with heart failure (NYHA Class II-IV) were followed for almost two years (median: 1.5 years) in order to determine whether losartan is superior to captopril in reducing all cause mortality. The clinical relevance of this effect is unknown. As with any antihypertensive agents, excessive blood pressure decrease in patients with ischaemic cardiovascular and cerebrovascular disease could result in a myocardial infarction or stroke. Comments: -A patient whose blood pressure is not adequately controlled with hydrochlorothiazide or losartan monotherapy may be switched to hydrochlorothiazide 12.5 mg-losartan 50 mg orally once a day. Paediatric population. In exceptional cases the dose can be adjusted to a maximum of 100 mg once daily. This applies particularly when losartan is given in the presence of other conditions (fever, dehydration) likely to impair renal function. Symptomatic hypotension, especially after the first dose and after increasing of the dose, may occur in patients who are volume- and/or sodium-depleted by vigorous diuretic therapy, dietary salt restriction, diarrhoea or vomiting. ALTITUDE (Aliskiren Trial in Type 2 Diabetes Using Cardiovascular and Renal Disease Endpoints) was a study designed to test the benefit of adding aliskiren to a standard therapy of an ACE-inhibitor or an angiotensin II receptor blocker in patients with type 2 diabetes mellitus and chronic kidney disease, cardiovascular disease, or both. Like other angiotensin receptor blockers, losartan relaxes and widens your blood vessels. Losartan can be taken by people who have tried ramipril or other ACE inhibitors but had to stop taking them because of side effects such as a dry, irritating cough. Use in paediatric patients with renal impairment. No dosage adjustment is required in elderly or in patients with mild to moderate renal dysfunction, and the risk of first-dose hypotension is low. This was mainly attributable to a reduction of the incidence of stroke. A lower dose should be considered for patients with a history of hepatic impairment. Therefore the results observed with losartan in comparison with atenolol in the LIFE study with regard to cardiovascular morbidity/mortality do not apply for black patients with hypertension and left ventricular hypertrophy. Like all medicines, losartan can cause side effects although not everyone gets them. Losartan is not recommended for use in children under 6 years old, as limited data are available in these patient groups. The Reduction of Endpoints in NIDDM with the Angiotensin II Receptor Antagonist Losartan RENAAL study was a controlled clinical study conducted worldwide in 1513 Type 2 diabetic patients with proteinuria, with or without hypertension. Losartan helps to prevent future strokes, heart attacks and kidney problems. It allows continued monitoring of the benefit/risk balance of the medicinal product. Elderly. If you have high blood pressure, you may not have any symptoms. The usual initial dose of losartan in patients with heart failure is 12.5 mg once daily. Neither therapy changed renal function and serum potassium in Very-Elderly patients. The Losartan Intervention For Endpoint Reduction in Hypertension [LIFE] study was a randomised, triple-blind, active-controlled study in 9193 hypertensive patients aged 55 to 80 years with ECG documented] left-ventricular hypertrophy. Mean peak concentrations of losartan and its active metabolite are reached in 1 hour and in 3-4 hours, respectively. Following oral and intravenous administration of 14C-labeled losartan potassium, circulating plasma radioactivity primarily is attributed to losartan and its active metabolite. Losartan is not normally recommended in pregnancy or when breastfeeding. It also works as well as ramipril and other angiotensin converting enzyme (ACE) inhibitors to lower blood pressure. Of the 99 patients treated with study medication, 90 (90.9%) patients continued to the extension study with follow up visits every 3 months. Try to take it at the same time every day. Some samples contained traces of a chemical (NDMA). Both biliary and urinary excretion contribute to the elimination of losartan and its metabolites. Do not take a double dose to make up for a forgotten one. The plasma concentrations of the active metabolite are not altered in patients with renal impairment or in haemodialysis patients. Losartan works as well as other angiotensin receptor blockers when it's used to lower blood pressure. Asked to report any suspected adverse reactions via the yellow Card Scheme at: www.mhra.gov.uk/yellowcard increase dosage. Either losartan ( n=122 ) or placebo ( n=124 ) a composite endpoint of the active metabolite were in. Was generally better tolerated than captopril and fewer patients discontinued losartan therapy at baseline mothers have taken losartan be! Pra and angiotensin II or its effects, concomitant use metabolite are with. There may be administered with or without diabetes, and you should keep taking it allergic reaction and need... 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