Losartan is one of the most effective antihypertensive medications in the pharmaceutical market. It may approach one’s high blood pressure, and at the same time, reduce the risks of suffering from a stroke. Learn more about this first-line modality in the pharmacists’ and doctors’ hands.
What is Losartan (Cozaar)
Losartan is a well-known prescription oral medication typically prescribed to treat hypertension. Originally, it belongs to the angiotensin 2 receptor antagonists group (ARBs). Today, it is available under the brand name of Cozaar and generic – Losartan. It comes only in a tablet form, which one should take orally.
It was first discovered in March 1986 by medical professionals who sought the modality to treat patients with high blood pressure. Losartan is considered to be the first antihypertensive drug.
Losartan medication can be occasionally prescribed as a second-line modality when other medications failed to respond or caused severe damage to one’s health. Beyond that, this medication may be taken alongside additional therapy with other modalities or drugs to treat hypertension more effectively.
If you believe this drug substance is a good fit for your particular case, speak to your healthcare provider about its applicability since it is not a good fit for everyone.
What Is Losartan Used For
Nowadays, Losartan uses are generally divided into three:
Treat high blood pressure
It blocks the activity of angiotensin II, a chemical that may occasionally narrow the blood vessels. Then, the drug substance lowers high blood pressure by allowing those blood vessels to relax.
Reduce your risk of a stroke
In some trials, Losartan has been reported to be effective in reducing the risk of stroke in patients with hypertension and left ventricular hypertrophy (LVH).
Treat diabetic nephropathy
Last but not least, Losartan medication has been linked to efficacy when reducing the rate of diabetic kidney disease progression in hypertensive azotemic patients with type 2 diabetes. Beyond that, a long-term application of the medication has beneficial effects on managing diabetic nephropathy in hypertensive type 1 diabetic patients.
What else is Losartan used for? Some patients may also be prescribed this drug for a long-term application to maintain their heart function after suffering from a heart attack/failure. It is believed to prolong their survival.
A doctor may find the drug effective for other related blood/heart conditions as well.
Losartan Drug Class
Speaking of Cozaar known classification, it is an angiotensin receptor blocker (ARBs). This group of drugs was originally designated to treat hypertension and heart failure. Furthermore, they may be prescribed to approach chronic kidney disease and be used for the post-treatment period of heart attacks to maintain survival.
The Losartan drug class – ARBs works by blocking the angiotensin 2 effect, which, in turn, is a natural chemical found in our bodies that narrows blood vessels. By blocking the chemical, our blood vessels widen, and blood may flow easily. It all results in lower blood pressure.
Nowadays, ARBs are the first-line choice for prescription among patients who cannot take ACE inhibitors.
How To Take This Drug
First off, you should obligatorily speak to your healthcare provider since it is a prescription medication that may not fit your particular case. Secondly, the Losartan doses may vary depending on the targeted health condition treatment. Below, you may find the manufacturer’s dosing instructions.
Dosage for high blood pressure (hypertension)
Patients diagnosed with hypertension are prescribed 50mg once per day. If no effect, a doctor may gradually increase it up to 100mg.
Hypertensive patients with left ventricular hypertrophy may also be prescribed 50mg once per day alongside 12.5mg of Hydrochlorothiazide.
Dosage for diabetic nephropathy
Patients diagnosed with neuropathy in Type 2 diabetes mellitus are prescribed the initial dose of 50mg once per day. A doctor may gradually increase the dosage up to 100mg once per day, based on a patient’s blood pressure response only.
Dosage to reduce stroke risk in people
Patients aged 18-64 years are prescribed 50mg once per day. A doctor may gradually increase the Losartan dosage up to 100mg.
Senior patients aged 65 and older are prescribed dosages based on their tolerance to the drug. There are no specific instructions for them. A doctor may first prescribe the initial dosage to start with and gradually increase it until the therapeutic effect is noticeable.
Special dosage considerations
The dosage may be occasionally lower in case a patient has lost body liquid recently, especially because of diarrhea or other health conditions typical for adult patients aged over 75.
Patients diagnosed with liver diseases are typically prescribed 25mg daily.
Upon starting the intake of Losartan, a doctor will regularly check a patient’s blood pressure. A patient will be checked on any side effects following the intake and assigned to blood tests to identify whether kidneys process potassium levels in blood well.
In case Losartan Cozaar fails to lower a patient’s blood pressure enough, a doctor may occasionally increase the dosage.
In case a pediatric patient needs the medication, their health condition will be taken into consideration individually, and a prescribed dosage will be based on a child’s weight. Nevertheless, children under 6 years should not take this drug substance since it does not fit their age group and may cause serious adverse reactions only.
If you miss a dose of Losartan hypertension-medication, take it as soon as you remember. Do not take a double dose to catch up with your regimen.
If you regularly forget your prescribed doses, you should set a designated alarm. You may also ask your healthcare provider about additional tips to help you remember about the intake.
Take it only as directed by your doctor. In case of any side effects, or overdose, seek emergency help immediately (call 911).
Common Side Effects
Like other medications, Losartan side effect events are common. They typically result from the wrong intake of the medication or interactions. The side effects may bear both temporary or long-term character, which a patient should address to their healthcare provider. As soon as a patient’s body gets used to the drug, side effects are rare or none.
The most common Losartan side effects include:
Upper respiratory infections
A person may occasionally develop the following symptoms of upper respiratory infections: fever, fatigue, headache, difficulty swallowing as well as wheezing. These symptoms should be immediately addressed to the doctor.
Some patients may be exposed to mild dizziness. In particular, they may experience vertigo, loss of balance, floating. You should not drive or operate heavy machinery to not get into an accident.
There are patients who also report stuffy noses, which result from inflamed blood vessels in the nose. This side effect usually bears a temporary character.
Back pain is also a common symptom among many patients assigned to this drug substance. You should spend more time lying without rapid and sudden movements. Ask your doctor about any healing creams to lower the pain.
Low blood sugar
Losartan Cozaar is linked to lowering blood sugar. You may develop trouble talking or confusion. Address this condition to your doctor since a very rapid drop in your blood sugar may become dangerous.
Alongside common side effects, there is a possibility of serious adverse reactions, which are usually rare.
The indicators of high potassium blood levels are the following:
- Problems with heart rhythm and heart rate
- Muscle weakness.
The indicators of allergic reactions are the following:
- Tongue, throat, face, and lips swelling.
The indicators of low blood pressure are the following:
- Fainting and dizziness.
The indicators of kidney failure are the following:
- Hands, feet, and ankles swelling
- Rapid weight gain.
You should immediately report your doctor or seek emergency help by calling 911 in case:
- Your skin and the whites of your eyes turned yellow. It may signal you about liver problems;
- Your stomach severely hurts. It may be a sign of inflamed pancreas;
- Your body becomes extremely tired, or you have a sore throat, fever, signs of bleeding. It may signal about bone/blood marrow disease;
- Your heartbeat becomes irregular, or you have recurring muscle cramps. These are the signs of potassium/sodium levels changes in your blood;
- Your skin has rashes, itchiness or it becomes swollen;
- Your chest and/or throat feels too tight;
- Your respiratory drive becomes problematic.
This is not a full list of all the side effects.
What Can I Take Instead of Losartan
There are some Losartan alternatives presented on the pharmaceutical market, which a patient may be prescribed when this drug substance fails to respond. All of them fit only certain cases, and a patient should not diagnose and prescribe himself the best modality without speaking to a doctor. So, what can I take instead of Losartan?
Brand name: Benicar
|It works by lowering a patient’s blood pressure. It also lowers cholesterol levels. Olmesartan belongs to the same group as Losartan – ARBs. Compared to Cozaar, it has the same indications; however, it also has some drawbacks in the form of precautions and side effects. The intake of Olmesartan may result in recurring diarrhea and rapid weight loss, which are believed to wear off as soon as you stop the intake. Then, it is not typically covered by most insurance plans.|
Brand name: Micardis
|It also works by lowering blood pressure and belongs to the group of ARBs. Alongside this application, Telmisartan may be occasionally prescribed to lower sugar levels as well as cholesterol levels. Similar to Olmesartan, it is unlikely to be covered by most insurance plans.|
Brand name: Prinivil, Zestril
|It works by relaxing blood vessels and improving blood flow. Unlike all the above-mentioned alternatives to Losartan, Lisinopril belongs to the drug class – ACE inhibitors. ACE inhibitors are medications typically prescribed to widen or dilate blood vessels, which result in increased amounts of heart pumps and lowered blood pressure. It is likely to be covered by most insurance plans; however, it is already an affordable solution.|
These are just examples of alternatives. If you want to learn more about medications for treating hypertension and related health conditions, you may address your inquiry to the pharmacist or your practicing doctor. Don’t take them without getting a doctor’s approval.
Warnings And Precautions
What is Cozaar warning instruction? Since the medication won Food and Drug Administration (FDA) approval for being prescribed to treat hypertension, it simultaneously got some warnings from the Administration. As of now,
Losartan warnings look as follows:
- It has a black box warning issued by the FDA. It is considered one of the most serious warnings that alert prescribing doctors about the dangers of the medication.
You should not take this medication in case you are pregnant or plan to become pregnant while taking the medication. Based on the existing research, its intake may harm the fetus or become fatal to it. If you become pregnant while taking this drug substance, immediately inform the doctor about it, and stop taking the drug.
The same concerns Cozaar’s modern nursing implications. It is unknown whether the drug may harm the nursing mother or be excreted to the breast milk. Still, its metabolites were identified during the tests. Therefore, it is not recommended for nursing mothers.
- It may cause severe allergic reactions
Some patients prescribed the drug may experience severe allergic reactions, including troubled respiratory drive, extreme swelling of tongue and/or throat, hives, among others. In case of noticing the first signs of these reactions, seek emergency help immediately since they may become fatal.
- Possible alcohol interactions
The drug substance taken alongside alcohol may result in extreme sedation. It is recommended to abstain from alcohol while you are on treatment with the medication. Beyond that, it is strictly forbidden to drive vehicles or operate heavy machinery.
Alongside these effects, alcohol is linked to increasing the effects of the drug substance. It means that your body may experience extremely lowered blood pressure.
- It may result in very low blood pressure
The drug substance may occasionally overreact, which means your blood pressure may go low extremely. If you feel dizziness or fainting, lay down or sit down immediately. If you still feel sick, call the doctor.
- Warnings for patients who have been diagnosed with specific health conditions
Patients with kidney diseases prescribed this drug substance should take it carefully since the medication may occasionally make their diseases worse. The signs of the deterioration of one’s medical condition are swelling of the extremities, rapid weight gain, among others.
- Warnings for senior patients
Senior patients prescribed the drug may experience fewer effects since their bodies process it slower. In case you do not experience any effects, do not increase the dosage on your own. Speak to your doctor to increase it gradually and maximize the therapeutic effect.
- Pediatric patients
This is not the first-line medication for children. Children below 6 years should not take it. If a child aged over 6 years is diagnosed with hypertension, a doctor is most likely to first try the alternatives that are less likely to cause side effects. If the first-line medications fail to respond, a child may be occasionally treated with this drug substance.
In all cases, a doctor will closely monitor the patient’s well-being after the prescription of the drug to evaluate whether it is effective and if there are any side effects. A patient is recommended to have a blood pressure monitor at home to overlook the functionality of the medication as well.
What are general precautions? Losartan is a prescription medication that fits long-term intake. You should take it only as directed by your doctor. If your doctor informed you about the schedule of the intake, you should not stop taking it without their notice.
The medication is typically taken following a certain timeline. If you miss to follow it, your blood pressure may get worse, and you will be exposed to the possibility of heart stroke.
In case you miss a dose, you should take it as soon as you remember about it. If the time comes for the second dosage intake, but you missed the first one – DO NOT take two doses since it may result in dangerous side effects.
In case you take two doses or more, you may be exposed to severe side effects or overdose. You should immediately call your doctor or seek emergency help by calling 911.
Are there any contraindications? Some medical conditions may make it impossible to take the medication, or extreme caution is required. Check below what conditions may exclude you from the regular intake of the drug.
The medication is contraindicated for patients with allergies to its active ingredients. Hepatic patients or those diagnosed with renal dysfunction and hypovolemia should take the drug substance with caution.
Beyond that, it concerns those patients who have a medical history of low blood pressure, some liver diseases, kidney impairment, as well as decreased blood volume. Patients with substance abuse disorder should speak to their doctors first.
Finally, as was said above, the same concerns pregnant women. All these groups of patients should seek alternative modalities to approach their hypertension.
As for general recommendations, to proceed with the intake of the drug, you may cut or crush the tablet. You should always store it at temperatures ranging between 15°C and 30°C. Keep it far from the cold temperatures, and do not freeze it. Keep it away from direct light. Ensure kids, pets, and seniors cannot reach it. It is better to keep the medication in a closed box.
In case of travels, you may keep the medication with you in carry-on luggage. On some occasions, you will be asked to demonstrate the label for your medication in the airport (which is a common procedure).
Since a medication is prescribed to treat your hypertension, you will need to regularly check your blood pressure. You may need to buy a designated monitor for your home. Ensure to check it regularly, and write down the timings for each check-up. It helps increase the efficacy of the medication.
Losartan Interactions With Other Medications
There are several Losartan interactions that you should be aware of. Below you may find the table covering some medications, which are contraindicated for interactions or should be avoided alongside Cozaar. Inform your doctor if you currently take any of them.
|Medications to lower blood pressure||Aliskiren, Enalapril, Captopril, Lisinopril, Ramipril|
|Some painkillers||Ibuprofen, Naproxen, Diclofenac, Celecoxib, Etoricoxib|
|Supplements containing potassium||Kaochlor 10%, Kaon CL, Klotrix|
|Diuretics||Lasix, Bumex, etc|
|Mental health medications/antidepressants||Lithium|
|Heart failure medications||Spironolactone|
Note, different interactions may have different outcomes. Some medications may only affect the efficacy of this drug substance, while some may cause dangerous symptoms.
It is strictly prohibited to take Cozaar alongside other ARBs to maximize the therapeutic effect or lower blood pressure. If you do not experience the effects of the medication, it should be addressed to your healthcare provider only. A doctor will gradually increase the dosage by avoiding the risks of overdosing.
You should abstain from grapefruit-based products, in particular grapefruit juices. You may choose an alternative of citrus drinks, for example, orange juice. If you continue to interact Losartan with grapefruit products, the latter may alter the efficacy of the medication.
For more information on all the possible interactions, address the inquiry to your healthcare provider. If you are not sure about the danger of interaction with your current medication protocol, inform your doctor as well. It all concerns various health supplements and herbs. They all may alter the efficacy of the medication.