Description
Generic
Losartan Potassium
Indications
Losacor® (Loasartan) and Losacor® plus (Losartan &Hydrochlorothiazide) are indicated for the treatment of hypertension. Losacor® may be used alone or in combination with otheranti hypertensive agents.
Type 2 Diabetic Patients with Proteinuria and Hypertension Losacor® is also indicated to delay the progression of renal disease,end stage renal disease, and to reduce proteinuria. Hypertensive Patients with Left Venticular Hypertrophy Losacor® plus is indicated to reduce the risk of stroke in patients with hypertension and left ventricular hypertrophy.
Pharmacology
Losartan potassium is the first orally active non-peptide angiotensin II receptor blocker. Binds to AT1 receptors found in many tissues, including vascular smooth muscle, adrenal glands, kidneys, and heart, and reduces several important biological effects, including vasoconstriction and the release of aldosterone that causes high blood pressure. .
Dosage & Administration
The usual starting dose of losartan is 50 mg once daily, with 25 mg recommended for patients with intravascular volume depletion (e.g.patients treated with diuretic) and patients with hepatic impairment. Losartan can be administered at a total daily dose of 25 to 100 mg. Hydrochlorothiazide is effective in doses of 12.5 to 50 mg once daily and can be given at doses of 12.5 mg as Losacor ® plus. To minimize the dose dependent side effects, it is usually appropriate to begin the combination therapy only after a patient has failed to achieve the desired effect with monotherapy. Hypertensive Patients with Left Venticular Hypertrophy Treatment should be initiated with losartan 50 mg once daily. Hydrochlorothiazide 12.5 mg should be added if blood pressure reduction is inadequate. For further blood pressure reduction other antihypertensives should be added.
Interaction
No clinically significant pharmacokinetic interactions were observed when losartan was coadministered with hydrochlorothiazide, digoxin, warfarin, cimetidine and phenobarbital. Rifampin, an inducer of drug metabolism, decreased the concentrations of losartan and its active metabolite. Ketoconazole did not affect the conversion of losartan to the active metabolite.
Contraindications
Losacor ® and Losacor ® plus are contraindicated in patients who are hypersensitive to any component of this product. Because of the Hydrochlorothiazide component, this product is contraindicated in patients with anuria or hypersensitivity to other sulfonamide-derived drugs.
Side Effects
Side effects when using Losartan Potassium are mild and transient in nature. The most common side effects were dizziness, diarrhea, stuffy nose, cough, and upper respiratory tract infection. Other side effects are fatigue, edema, abdominal pain, chest pain, nausea, headache, and sore throat.
Pregnancy & Lactation
Due to the mechanism of action of angiotensin II antagonists, a risk for the fetus cannot be excluded. As for any drug that also acts directly on the renin-angiotensin-aldosterone system, losartan should not be used during pregnancy. If pregnancy is detected during therapy, it should be discontinued as soon as possible. It is not known whether losartan is excreted in human milk. Losartan and its active metabolites were shown to be present in rat milk. Thiazides appear in human milk. Because of the potential for adverseeffects on the nursing infant, a decision should be made whether to discontinue the drug taking into account the importance of the drug to the mother.
Precautions & Warnings
Renal Insufficiency
As a consequence of inhibiting the renin-angiotensin-aldosterone system, changes in renal function have been reported in susceptible individuals treated with losartan. These changes in renal function were reversible upon discontinuation of therapy. In patients whose renal function may depend on the activity of the renin-angiotensin-aldosterone system (e.g. patients with severe congestive heart failure), treatment with angiotensin-converting enzymes inhibitors has been associated with oliguria and/or progressive azotemia and rarely with acute renal failure. Similar outcome have been reported with losartan. Thiazides should be used with caution in severe renal disease. In patients with renal disease, thiazides may precipitate azotemia. Cumulative effects of the drug may develop in patients with impaired renal function.
Hepatic Insufficiency
Based on pharmacokinetic data it was found that there is significantly increased plasma concentrations of losartan and its active metabolite in cirrhotic patients. A lower dose should be considered for patients with hepatic impairment, or a history of hepatic impairment.
Therapeutic Class
Angiotensin-ll receptor blocker
Storage Conditions
Store in a cool and dry place below 30°C. Protect from light.
Pharmaceutical Name
Healthcare Pharmaceuticals Ltd.