Losartan

Administration

• Type: Antihypertensive, ARB
• Dosage Forms: Tablet; 25mg, 50mg, 100mg
• Routes of Administration: oral
• Common Trade Names: Cozaar

Adult Dosing

Hypertension

• 25-150mg PO daily
• Occasionally outpatient will prescribe BID dosing of losartan for potential continuous BP control (or lisinopril)
  • 2020 large scale Kaiser study concluded no increased efficacy
  • There is potential for risk for AKI and hyperkalemia with lisinopril, but not losartan -- hypotension was not investigated

Pediatric Dosing

• 0.1 to 1.4 mg/kg daily

Special Populations

• Pregnancy Rating: D
• Lactation risk: Infant risk cannot be ruled out
• Renal dosing: no adjustment
• Hepatic dosing: starting dose 25mg daily

Contraindications

• Allergy to class/drug
• Concomitant use with aliskiren in diabetes

Adverse Reactions

Serious

• Acute kidney injury
• Rhabdomyolysis
• Syncope
• Stroke
• Angioedema

Common

• Backache
• Dizziness
• Cough, URI symptoms

Pharmacology

• Half-life: 2-6 hours
• Metabolism: Hepatic;P450 CYP2C9 and CYP3A4
• Excretion: Fecal, renal

Mechanism of Action

• Reversible angiotensin II inhibitor

See Also

• Hypertension
• Angiotensin II receptor antagonists