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Losartan

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Losartan, Cozaar, Hyzaar

  • See Also
  1. Angiotensin Receptor Blocker
  • Indications
  1. See Angiotensin Receptor Blocker
  2. Hypertension
  3. Cardiovascular Secondary Prevention
  4. Congestive Heart Failure (not FDA approved)
  5. Diabetic Nephropathy
  • Contraindications
  1. See Angiotensin Receptor Blocker
  • Mechanism
  1. See Angiotensin Receptor Blocker
  • Dosing
  • Adults
  1. Consider twice daily divided dosing (shorter acting than newer ARBs)
  2. Hypertension, Cardiovascular Secondary Prevention, Diabetic Nephropathy
    1. Start: 50 mg orally daily
    2. Start 25 mg daily if concurrent Diuretic use, elderly or hepatic Impairment
  3. Congestive Heart Failure (not FDA approved)
    1. Start 12.5 mg orally daily
    2. Target 50 mg orally daily
  4. Maximum 100 mg/day
  • Medications
  • Combinations
  1. Hydrochlorothiazide and Losartan (Hyzaar)
  • Adverse Effects
  1. See Angiotensin Receptor Blocker
  • Safety
  1. See Angiotensin Receptor Blocker
  2. Pregnancy Category X
  3. Unknown Safety in Lactation
  • Metabolism
  1. CYP3A4, CYP2C9 and CYP2C10 isoenzymes
    1. Sica (2005) Clin Pharmacokinet 44(8):797-814 +PMID: 16029066 [PubMed]
  • Drug Interactions
  1. Losartan drug levels may be increased by potent CYP3A4 Inhibitors (e.g. Fluconazole, Erythromycin)
  2. Losartan drug levels may be decreased by potent CYP3A4 Inducers (e.g. Rifampin)
  • Resources
  1. Losartan (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=1dadbe02-289c-4312-9e65-40f3314dcc31
  • References
  1. (2018) Presc Lett, Resource #340901, Angiotensin Receptor Blocker (ARB) Antihypertensive Dose Comparison
  2. (2020) Med Lett Drugs Ther 62(1598): 73-80
  3. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 66-7
  4. Hamilton (2020) Tarascon Pocket Pharmacopoeia