There are several other angiotensin receptor blockers that work in the same way as losartan. Qualitative and quantitative composition, 4.2 Posology and method of administration, 4.4 Special warnings and precautions for use, 4.5 Interaction with other medicinal products and other forms of interaction, 4.7 Effects on ability to drive and use machines, 6.6 Special precautions for disposal and other handling, 9. There may be other treatments that are safer for you. In a clinical trial it was found that fluconazole (inhibitor of CYP2C9) decreases the exposure to the active metabolite by approximately 50%. Take it as instructed by your doctor. These will depend on how many weeks pregnant you are and the reason you need to take it. those treated with high-dose diuretics), a starting dose of 25 mg once daily should be considered (see section 4.4). Unless continued AIIRA therapy is considered essential, patients planning pregnancy should be changed to alternative antihypertensive treatments which have an established safety profile for use in pregnancy. For patients who can swallow tablets, the recommended dose is 25 mg once daily in patients >20 to <50 kg. Two large randomised, controlled trials (ONTARGET (ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial) and VA NEPHRON-D (The Veterans Affairs Nephropathy in Diabetes)) have examined the use of the combination of an ACE-inhibitor with an angiotensin II receptor blocker. The main side effects of losartan are dizziness and fatigue, but they're usually mild and shortlived. The observation of the ELITE I Study that compared with captopril, losartan reduced the mortality risk, was not confirmed in the subsequent ELITE II Study, which is described in the following. The use of losartan is not recommended during the first trimester of pregnancy (see section 4.4). Hypersensitivity to the active substance or to any of the excipients (see sections 4.4 and 6.1). However, losartan is not officially approved for migraine. Despite these increases, antihypertensive activity and suppression of plasma aldosterone concentration are maintained, indicating effective angiotensin II receptor blockade. If this happens to you, do not drive a car, ride a bike, or use tools or machinery until you feel better. Losartan is also called by the brand name Cozaar. Therefore, losartan should be used with caution in these patient groups. If you're bothered by side effects, your doctor may be able to prescribe you a different blood pressure-lowering medicine. Paediatric population. In addition to the active metabolite, inactive metabolites are formed. Should exposure to losartan have occurred from the second trimester of pregnancy, ultrasound check of renal function and skull is recommended. For Adult 76 years and over Initially 25 mg once daily for several weeks, then increased if necessary to 100 mg once daily. The difference in blood pressure increase as compared to placebo was largest in the middle dose group (6.70 mm Hg middle dose vs. 5.38 mmHg high dose). Losartan is used alone or together with other medicines to treat high blood pressure (hypertension). Discontinuation of losartan in hypertensive patients did not result in an abrupt rise in blood pressure (rebound). Losartan can reduce your blood pressure when it's used with general anaesthetics. Losartan is predominantly metabolised by cytochrome P450 (CYP) 2C9 to the active carboxy-acid metabolite. Losartan can make you feel dizzy - especially when you first start taking it or after taking a bigger dose. In both comparator-controlled (not placebo-controlled) clinical studies on patients with heart failure the tolerability of losartan was superior to that of captopril, measured on the basis of a significantly lower rate of discontinuations of therapy on account of adverse reactions and a significantly lower frequency of cough. Reduction in the risk of stroke in hypertensive patients with left ventricular hypertrophy documented by ECG. 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. If you get severe diarrhoea or vomiting for any reason, contact your doctor or a pharmacist. There are steps you can take that may reduce your risk of Alzheimer's. Conclusions: comparative data have shown losartan to be as effective as other antihypertensive agents in the treatment of elderly patients with hypertension. Overall, there was a dose-response. This is because they are high in potassium. You could also ask your pharmacist for advice on other ways of helping you remember your medicine. Increase in the PRA leads to an increase in angiotensin II in plasma. If it continues for a long time, the heart and arteries may not function properly. Angiotensin II binds to the AT1 receptor found in many tissues (e.g. Losartan won't affect any type of contraception. Drinking alcohol can increase the blood pressure-lowering effect of losartan, which can make you feel dizzy or light-headed. have had an allergic reaction to losartan or other medicines in the past, are trying to get pregnant, are already pregnant or you are breastfeeding, 50mg to 100mg once a day to treat high blood pressure and to protect their kidneys, 12.5mg to 150mg once a day for heart failure, feeling dizzy or having a spinning sensation (vertigo), severe stomach pain - this can be a sign of an inflamed pancreas, pale skin, feeling tired, faint or dizzy, purple spots, any sign of bleeding, sore throat and fever - these can be signs of blood or bone marrow disorder, weakness, an irregular heartbeat, pins and needles and muscle cramps - these can be signs of changes in the sodium and potassium levels in your blood, you get a skin rash that may include itchy, red, swollen, blistered or peeling skin, your mouth, face, lips, tongue or throat start swelling. I even got light-headed when I stood up quickly. Like all medicines, losartan can cause side effects although not everyone gets them. However, some types of hormonal methods of contraception, such as the combined contraceptive pill and contraceptive patch, aren't usually recommended for women with high blood pressure. Therefore, the plasma concentrations of potassium as well as creatinine clearance values should be closely monitored, especially patients with heart failure and a creatinine clearance between 30-50 ml/ min should be closely monitored. This is 10 times the recommended daily dose and is the upper safety limit advised by the NHS. If losartan doesn't bring your blood pressure down, your doctor may want to increase the dose. After the very first dose, you can take losartan at any time of day. vascular smooth muscle, adrenal gland, kidneys and the heart) and elicits several important biological actions, including vasoconstriction and the release of aldosterone. For a full list, see the leaflet inside your medicines packet. US Brand Name. Bradycardia could occur from parasympathetic (vagal) stimulation. There's no firm evidence to suggest that taking losartan will reduce fertility in either men or women. cardiac infarction, cardiovascular death) and especially stroke, than the black patients treated with atenolol. 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. This lowers your blood pressure and makes it easier for your heart to pump blood around your body. Each film-coated tablet contains 25.5 mg lactose monohydrate. Your doctor may prescribe losartan if you've tried taking similar blood pressure-lowering medicines such as ramipril and lisinopril in the past, but had to stop taking them because of side effects such as a dry, irritating cough. Your doctor will probably advise you to try other medicines first. The primary endpoint did not show any statistically significant difference between losartan and captopril in reducing all-cause mortality. 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. Limited data are available with regard to overdose in humans. You may also have blood tests to check how well your kidneys are working and the amount of potassium in your blood. Patients with proteinuria and a serum creatinine of 1.3 – 3.0 mg/dl were randomised to receive losartan 50 mg once a day, titrated if necessary, to achieve blood pressure response, or to placebo, on a background of conventional antihypertensive therapy excluding ACE-inhibitors and angiotensin II antagonists. Table 1. There are other types of blood pressure-lowering medicines: The blood pressure-lowering medicine you're prescribed depends on your age and ethnicity: Many people need to take a combination of different blood pressure-lowering medicines. Each film-coated tablet contains 12.75 mg lactose monohydrate. Your doctor will check how well your kidneys are working with regular blood tests. However, the dose is usually not more than 50 mg per day. For safety, tell your doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements. Remember, by keeping your blood pressure low, you're protecting yourself against having a heart attack or stroke in the future. In a clinical study conducted in type 2 diabetic patients with nephropathy, the incidence of hyperkalaemia was higher in the group treated with losartan as compared to the placebo group (see section 4.8). The dose may be increased to 100 mg once daily based on blood pressure response from one month onwards after initiation of therapy . Packs of 10, 14, 20, 21, 28, 28 (cal), 30, 50x1, 56, 60, 98, 98 (cal), 100, 210, 250, 280 tablets, HDPE bottle pack(s): HDPE bottles with silica gel desiccant contained in the polypropylene lid containing 100 and 250 film-coated tablets, 12 . Losartan, at doses as high as 1.4 mg/kg, was generally well tolerated in hypertensive children aged 6 months to 6 years after 12 weeks of treatment. If you need to go to your nearest hospital A&E department, do not drive yourself - get someone else to drive you or call for an ambulance. Hypertensive patients receiving losartan experienced a reduction from baseline proteinuria of -41.5% (95% CI -29.9;-51.1) versus +2.4% (95% CI -22.2; 14.1) in the amlodipine group. In patients with mild to moderate alcohol-induced hepatic cirrhosis, the plasma levels of losartan and its active metabolite after oral administration were respectively 5 and 1.7 times higher than in young male volunteers (see sections 4.2 and 4.4). The most likely manifestations of overdose would be hypotension and tachycardia. The results showed that the treatment with losartan (327 events) as compared with placebo (359 events) resulted in a 16.1 % risk reduction (p = 0.022) in the number of patients reaching the primary composite endpoint. When losartan is administered orally, about 4% of the dose is excreted unchanged in the urine, and about 6% of the dose is excreted in the urine as active metabolite. If you often forget doses, it may help to set an alarm to remind you. Your doctor may adjust your dose as needed. Usually, treatment with losartan is long term, and you may have to take it for the rest of your life. These are not all the side effects of losartan. 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). Consequently, there is no potentiation of undesirable bradykinin-mediated effects. An open label, dose-ranging clinical trial was conducted to study the safety and efficacy of losartan in paediatric patients aged 6 months to 6 years with hypertension. Co-medication is not advisable. Children aged 6 years and older can take it, but only to treat high blood pressure. 12.5 mg daily, 25 mg daily, 50 mg daily, 100 mg daily, up to a maximum dose of 150 mg once daily), as tolerated by the patient. Needs losartan, tell your doctor if you 're taking a bigger dose take effect be the. 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