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What is Losartan

Losartan is an angiotensin receptor blocker (ARB), additionally known as selective kind 1 angiotensin II receptor (AT1) antagonist, which antagonises the results of angiotensin II on blood strain, renal blood circulation, easy muscle cell proliferation and aldosterone launch. This results in vasodilation and lowered aldosterone secretion.

Losartan Drug Recommendation

Hypertension: Diuretics, β-blockers, calcium antagonists (dihydropyridines), angiotensin changing enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) successfully decrease blood strain and cut back the 10-year threat of cardiovascular mortality and morbidity. Comorbidity and particular affected person traits decide which teams and which brokers ought to be thought-about first. Medication with 24-hour efficacy are most well-liked. If one drug is insufficiently efficient on the really helpful dose, including a drug from one other group is simpler than growing the dose; it additionally limits dose-dependent negative effects. A hard and fast mixture within the right dose ratio is most well-liked for causes of compliance.

In case of systolic coronary heart failure, begin with an ACE inhibitor and in case of fluid retention with a diuretic, then, if the affected person is clinically steady, add a selective β-blocker. A mix of those brokers relieves the signs and may cut back early mortality and the chance of hospitalization for coronary heart failure. Regulate the affected person to the remedy based mostly on cautious dose titration and common monitoring of serum electrolytes and renal operate. ARBs are a substitute for ACE inhibitors if they don’t seem to be tolerated. As well as, ARBs can be utilized as an adjunct to remedy with a diuretic, ACE inhibitor and β-blocker for persistent signs of coronary heart failure (NYHA class II-IV).

Losartan Indications

  • Important hypertension in adults and in youngsters aged 6-18 years;
  • Hypertension with ECG-indicated left ventricular hypertrophy to scale back the chance of cerebrovascular accident (CVA) in adults;
  • Remedy of renal illness in adults with hypertension and sort 2 diabetes mellitus with proteinuria ≥ 0.5 g/day, as a part of antihypertensive remedy;
  • Persistent coronary heart failure in adults with impaired left ventricular operate (LVEF ≤ 40%), if remedy with ACE inhibitors is taken into account inappropriate as a consequence of any facet impact, significantly cough, or contraindication.

What Should You Discuss To Your Doctor Before Using This Medicine

  • Being pregnant
    • Teratogenesis: When ARBs are used within the 2nd and third trimester, the identical results are seen as when ACE inhibitors are used, together with neonatal lung hypoplasia, intrauterine development retardation, persistent ductus arteriosus, cranium hypoplasia, limb abnormalities and elevated mortality.
    • Pharmacological impact: Use of ARBs throughout the 2nd and third trimester might lead to foetal and/or neonatal toxicity resembling:
      • impaired renal operate
      • renal failure
      • oligohydramnion
      • hypotension
      • hyperkalaemia
    • Recommendation: Use throughout the first trimester just isn’t really helpful; use throughout the second and third trimesters is contraindicated.
    • Different: If you need youngsters and if you’re pregnant, it’s best to begin an alternate remedy; it’s advisable to tell the affected person of this at first of the remedy. If publicity has occurred from the two trimester onwards, carry out an ultrasound scan of the kidneys and cranium of the foetus. Intently monitor newborns for hypotension.

  • Lactation
    • Transition in breast milk: Unknown (in people), sure (in animals).
    • Recommendation: Don’t take this drugs or breast-feed.

  • Contraindications
    • Severely impaired liver operate.

Losartan Drug Interactions

Concomitant remedy with an ACE inhibitor and an ARB will increase the chance of hypotension, syncope, hyperkalaemia and deterioration of renal operate. If double blockade is taken into account completely vital, it ought to solely be used below the supervision of a specialized physician in individually outlined sufferers  in whom renal operate, blood strain and electrolyte ranges are recurrently monitored. In diabetic sufferers or with lowered renal operate the usage of losartan together with aliskiren is contraindicated. In different sufferers the mixture just isn’t really helpful; if the mixture is for use, periodic evaluation of renal operate, blood strain and serum electrolytes is really helpful.

  • Different antihypertensive medicines and medicines that may trigger hypotension
    • tricyclic antidepressants
    • antipsychotics
    • baclofen might improve the blood strain reducing impact. Extreme reducing of blood strain might induce a myocardial infarction or CVA in coronary coronary heart illness and cerebrovascular illness.
  • Potassium salts and potassium-sparing diuretics:
    • spironolactone
    • triamterene
    • amiloride, heparin and different plasma potassium growing medicinal merchandise
      • trimethoprim
      • tacrolimus
      • ciclosporin might potentiate the impact on serum potassium ranges and result in hyperkalaemia, significantly in renal dysfunction and coronary heart failure.
  • When mixed with lithium, the rise in blood lithium focus might trigger the poisonous threshold to be reached earlier; regulate with warning and monitor serum lithium throughout use.
  • Fluconazole (CYP2C9 inhibitor) and rifampicin might lower the focus of the energetic metabolite of losartan.
  • The antihypertensive impact could also be lowered by use of NSAIDs; there’s additionally an elevated threat of degradation of renal operate and of hyperkalaemia.

Losartan Dosage

  1. Hypertension:
    • Adults:
      • 50 mg 1×/day, enhance to 100 mg 1×/day within the morning if vital (after 3-6 w.). In case of intravascular quantity depletion, resembling when utilizing excessive doses of diuretics and in dialysis sufferers, take into account a beginning dose of 25 mg 1×/day.
    • Youngsters > 6 y.:
      • At a physique weight of 20-50 kg: 25 mg 1×/day, in distinctive circumstances 50 mg 1×/day.
      • At a physique weight > 50 kg: 50 mg 1×/day, in distinctive circumstances enhance to a most of 100 mg 1×/day.
      • Doses of > 1.4 mg/kg physique weight/day (or > 100 mg/day) haven’t been studied.

  2. Hypertension with left ventricular hypertrophy:
    • Adults:
      • 50 mg 1×/day, if vital add a low dose of hydrochlorothiazide in response to blood strain and/or enhance the dose of losartan to 100 mg 1×/day. In case of quantity depletion, resembling when utilizing excessive doses of diuretics and in dialysis sufferers: take into account a beginning dose of 25 mg 1×/day.

  3. Hypertension and diabetes mellitus kind 2 with proteinuria:
    • Adults:
      • 50 mg 1×/day, if vital enhance to 100 mg 1×/day after one month in response to blood strain. In case of quantity depletion, resembling when utilizing excessive doses of diuretics and in dialysis sufferers: take into account a beginning dose of 25 mg 1×/day.

  4. Persistent coronary heart failure:
    • Adults;
      • Beginning dose 12.5 mg 1×/day. If the affected person tolerates the remedy nicely, then double the dosage to 100 mg at weekly intervals. Dosage most 150 mg 1×/day.

  5. Think about a decrease dose in delicate to reasonable hepatic impairment, use in extreme hepatic impairment is contraindicated. Losartan just isn’t really helpful in youngsters with impaired liver operate.
  6. In renal impairment and haemodialysis, no adjustment of the beginning dose is required.
  7. Administration data: Swallow the pill complete with a glass of water.

Losartan Precautions

Warning in case of earlier angioedema; additionally in case of aortic stenosis, mitral valve stenosis and obstructive hypertrophic cardiomyopathy. Moreover, as a consequence of inadequate expertise, use warning in extreme coronary heart failure, coronary heart failure with concomitant severely impaired renal operate and in coronary heart failure with life-threatening arrhythmias.

  1. Particularly with quantity and/or sodium depletion and coronary heart failure, there’s a greater threat of a hypotensive response.
  2. Hypotension occurring throughout anaesthesia and surgical procedure as a consequence of blocked angiotensin II exercise; will be corrected by quantity enhance.
  3. Elevated threat of hyperkalaemia at an age > 70 years, diabetes mellitus, impaired or sudden deterioration of:
    • renal operate
    • dehydration
    • metabolic acidosis
    • acute coronary heart failure
    • cell breakdown
  4. Within the occasion of impaired renal operate, take account of an acute deterioration in renal operate and proceed to observe it. Right any electrolyte disturbances brought on by the renal operate dysfunction first. In case of bilateral stenosis of the renal arteries or unilateral stenosis with just one functioning kidney, additionally take into account (acute) decline in renal operate, which can be reversible after discontinuation.
  5. Think about decrease doses in delicate to reasonable hepatic impairment; it isn’t really helpful to offer losartan to youngsters with hepatic impairment.
  6. Additionally, as a consequence of comparatively restricted information, losartan just isn’t really helpful in youngsters < 6 years of age and in these with severely impaired renal operate (GFR < 30 ml/min/1.73 m²). There isn’t a expertise of use after a current kidney transplant.
  7. ACE inhibitors and ARBs are much less efficient in opposition to hypertension in individuals with darkish pores and skin than in these with gentle pores and skin.

Losartan Side Effects

  • Dizziness, vertigo
  • Anaemia.
  • Hyperkalaemia,
  • enhance in blood urea
  • serum creatinine focus
  • hypoglycaemia
  • Fatigue, asthenia
  • Renal impairment, renal failure
  • palpitations
  • angina pectoris
  • Cough
  • dyspnoea
  • Stomach ache, nausea, vomiting, constipation, diarrhoea
  • Headache, drowsiness, sleep problems
  • Urticaria, itching, rash
  • Anaphylactic response, angioedema, vasculitis
  • Syncope, atrial fibrillation, stroke, paraesthesia
  • Hepatitis
  • hepatic impairment
  • thrombocytopenia
  • hyponatraemia
  • pancreatitis
  • style dysfunction
  • urinary tract infections
  • flu-like signs
  • malaise
  • muscle ache
  • joint ache
  • rabdomyolysis
  • erectile dysfunction
  • melancholy
  • migraine
  • tinnitus
  • photosensitivity

Disclaimer

Information concerning psychotic disorders, included within the review of Losartan, is used for the informative features exclusively as well as should not be thought-about to alternative to licensed healthcare or referral of the well being treatment distributor.

 

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Frequently asked questions

  1. What is Losartan?

    Losartan is used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. 

  2. What to do if you miss a dose?

    If you miss a dose of Losartan, take it as quickly as potential. However, whether it is virtually time to your subsequent dose, skip the missed dose and return to your common dosing schedule. Do not double doses.

  3. What if u take too much Losartan?

    If an overdose happens, name your physician or call your nearest hospital. You might have pressing medical care. You might also contact the poison management at your local hospital.

  4. How to store Losartan?

    Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

  5. What Should I Avoid While Taking Losartan?

    Avoid consuming alcohol or utilizing unlawful medicine when you are taking Losartan. They might lower the advantages (e.g. worsen your confusion) and improve hostile results (e.g. sedation) of the remedy.

  6. What are the side effects of Losartan?

    Possible side effects includes diarrhea muscle cramps, dizziness, insomnia, nasal congestion, persistent cough, increased serum potassium, loss of appetite, dry mouth and angioedema.

  7. What are the Contraindication?

    Hypersensitivity, pregnancy breastfeeding, infancy, arterial hypotension, hyperpotassemia.


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