Treat patients w/ HTN. Decrease risk of stroke in patients w/ HTN & left ventricular hypertrophy. Protect kidney in hypertensive type 2 diabetic patients w/ proteinuria.
Dosage/Direction for Use
Adult HTN Initially 50 mg once daily, may be increased to 100 mg once daily (in the morning) in some patients. HTN & left ventricular hypertrophy Initially 50 mg once daily. Depending on how well losartan works, low-dose hydrochlorothiazide may be added &/or dose of losartan K increased to 100 mg once daily. HTN w/ type 2 diabetes & proteinuria Initially 50 mg once daily, may be increased to 100 mg once daily depending on BP response. Childn 6-16 yr w/ HTN weighing >50 kg Initially 50 mg once daily, can be increased to max 100 mg once daily, 20-50 kg 25 mg once daily, can be increased to 50 mg once daily. Patient w/ kidney disease, or elderly >75 yr 25 mg once daily.
Administration
May be taken with or without food: Swallow w/ water.
Contraindications
Hypersensitivity. Concomitant use w/ aliskiren-containing products in patients w/ DM or renal impairment (GFR <60 mL/min/1.73 m2). Planning to become pregnant. Pregnancy & lactation.
Special Precautions
Caution in patients w/ liver or kidney problems; recent kidney transplantation; excessive vomiting or diarrhoea; heart valve problems; hyperkalaemia or dietary salt restriction; narrowing or blockage of blood vessels leading to kidneys. Dual blockade of renin-angiotensin-aldosterone system (RAAS) through combined use of ACE inhibitors, ARBs or aliskiren is not recommended. Frequent close monitoring of renal function, electrolytes & BP if dual blockade therapy is considered absolutely necessary. Do not concomitantly use ACE inhibitors & ARBs in patients w/ diabetic nephropathy. Contains lactose.
Adverse Reactions
Liver problems (eg, jaundice), flu-like symptoms; diarrhoea; muscle & joint pains; tiredness, shortness of breath; migraine; urticaria, pruritus; dose-related orthostatic effects eg, BP lowering when rising from a lying or sitting position.
Possible interaction w/ rifampicin; antifungals (eg, fluconazole); lithium-containing medicines; medicines which retain K or may increase K levels (eg, K supplements, K-containing salt substitutes or K-sparing diuretics). Reduced BP-lowering effect w/ NSAIDs eg, naproxen, COX-2 inhibitors. Concomitant use w/ NSAIDs may lead to worsening of kidney function in patients w/ renal impairment. Increased risk of hypotension, hyperkalaemia & decreased renal function (including acute renal failure) w/ dual blockade of RAAS through combined use of ACE inhibitors, ARBs or aliskiren.
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