Losartan instructions for use and for what. Losartan: instructions for use and what it is needed for, price, reviews, analogues

Angiotensin II receptor antagonist

Active substance

Losartan potassium (losartan)

Release form, composition and packaging

Film-coated tablets yellow, round, biconvex; On a cross section, the core is white or almost white.

Excipients: lactose monohydrate - 115 mg, microcrystalline cellulose - 40 mg, croscarmellose sodium - 11.2 mg, (low molecular weight polyvinylpyrrolidone) - 9 mg, colloidal silicon dioxide - 2 mg, magnesium stearate - 2.8 mg.

Film shell composition:(hypromellose - 4.8 mg, talc - 1.6 mg, titanium dioxide - 0.826 mg, macrogol 4000 (polyethylene glycol 4000) - 0.72 mg, iron oxide yellow (iron oxide) - 0.054 mg) or (dry mixture for film coating containing hypromellose (60 %), talc (20%), titanium dioxide (10.33%), macrogol 4000 (polyethylene glycol 4000) (9%), iron oxide yellow (iron oxide) (0.67%)) - 8 mg.

15 pcs. - contour cellular packaging (aluminum/PVC) (2) - cardboard packs.
30 pcs. - contour cellular packaging (aluminum/PVC) (1) - cardboard packs.

pharmachologic effect

Losartan is a specific angiotensin II receptor (AT1 type) antagonist for oral administration. Angiotensin II selectively binds to AT1 receptors found in many tissues (vascular smooth muscle, adrenal glands, kidneys and heart) and performs several important biological functions, including vasoconstriction and aldosterone release. Angiotensin II also stimulates the proliferation of smooth muscle cells.

Losartan and its pharmacologically active metabolite (E 3174) both in vitro and in vivo block all physiological effects of angiotensin II, regardless of the source or route of synthesis. Losartan selectively binds to AT1 receptors: it does not bind to or block the receptors of other hormones and ion channels that play an important role in regulating the function of the cardiovascular system. In addition, losartan does not inhibit angiotensin-converting enzyme (ACE), which promotes the degradation of bradykinin, so side effects indirectly related to bradykinin (for example, angioedema) are rare.

When using losartan, the absence of negative feedback influence on renin secretion leads to an increase in blood renin activity. An increase in renin activity leads to an increase in the concentration of angiotensin II in the blood plasma. However, antihypertensive activity and a decrease in plasma aldosterone concentrations persist, indicating effective blockade of angiotensin II receptors. After discontinuation of losartan, plasma renin activity and angiotensin II concentration decreased within 3 days to the initial values ​​observed before starting the drug.

Losartan and its active metabolite have a high affinity for angiotensin II receptors (type AT1).

Plasma concentrations of losartan and its active metabolite, as well as the antihypertensive effect of losartan, increase with increasing dose of the drug.

The maximum antihypertensive effect develops 3-6 weeks after starting the drug.

In patients with arterial hypertension, proteinuria (more than 2 g per day), without diabetes, the use of the drug significantly reduces proteinuria, excretion and immunoglobulin G (IgG).

In postmenopausal women with arterial hypertension who took losartan at a dose of 50 mg/day for 4 weeks, there was no effect of therapy on the renal and systemic levels of prostaglandins.

Losartan does not affect autonomic reflexes and does not have a long-term effect on plasma levels.

In patients with arterial hypertension, losartan in doses up to 150 mg per day does not cause clinically significant changes in the concentration of triglycerides, total cholesterol and high-density lipoprotein cholesterol. At the same doses, losartan has no effect on fasting blood concentrations. Losartan caused a decrease in serum uric acid concentration (usually less than 0.4 mg/dL), which persisted during long-term therapy. In controlled clinical studies involving patients with arterial hypertension, there were no cases of drug withdrawal due to an increase in creatinine or potassium in the blood serum.

Pharmacokinetics

Suction

When taken orally, losartan is well absorbed from the gastrointestinal tract. The systemic bioavailability of losartan is approximately 33%; food intake does not affect the bioavailability of losartan. Average maximum concentrations of losartan and its active metabolite are reached after 1 hour and after 3-4 hours, respectively.

Distribution

Losartan and its active metabolite are more than 99% bound to plasma proteins (mainly albumin). The volume of distribution of losartan is 34 liters. Losartan practically does not penetrate the blood-brain barrier.

Metabolism

Losartan undergoes a first pass effect through the liver and is metabolized with the participation of the cytochrome P450 isoenzyme CYP2C9. Approximately 14% of a dose of losartan administered intravenously or orally is converted to its active metabolite (EXP3174) with a carboxyl group. Biologically inactive metabolites are also formed: two main ones (as a result of hydroxylation of the butyl side chain) and a less significant one - N-2-tetrazole glucuronide.

Removal

Plasma clearance of losartan and its active metabolite is 600 ml/min and 50 ml/min, respectively. The renal clearance of losartan and its active metabolite is approximately 74 ml/min and 26 ml/min, respectively. When losartan is taken orally, about 4% of the dose is excreted unchanged by the kidneys and within 6% of the dose is excreted by the kidneys in the form of an active metabolite. Losartan and its active metabolite have linear pharmacokinetics when losartan is administered orally in doses up to 200 mg. After oral administration, plasma concentrations of losartan and its active metabolite decrease polyexponentially with a final half-life of approximately 2 and 6-9 hours, respectively.

Excretion of losartan and its metabolites occurs in the bile and kidneys. After oral administration of losartan labeled with 14 C, about 35% of the radioactive label is found in the urine and 58% in the feces.

Pharmacokinetics in special groups of patients

Plasma concentrations of losartan and its active metabolite in elderly male patients with arterial hypertension do not differ significantly from those in younger male patients with arterial hypertension.

Plasma concentrations of losartan were 2 times higher in women with hypertension compared with men with hypertension. Concentrations of the active metabolite did not differ between men and women. This apparent pharmacokinetic difference is not clinically significant.

When losartan was taken orally in patients with mild to moderate alcoholic liver cirrhosis, the concentrations of losartan and its active metabolite in the blood plasma were 5 and 1.7 times (respectively) higher than in young healthy male volunteers.

Plasma concentrations of losartan in patients with creatinine clearance above 10 ml/min did not differ from those in patients with normal renal function. In patients requiring hemodialysis, the area under the concentration-time curve (AUC) is approximately 2 times greater than in patients with normal renal function. Plasma concentrations of the active metabolite do not change in patients with impaired renal function or in patients on hemodialysis. Losartan and its active metabolite are not removed from the bloodstream by hemodialysis.

Indications

- arterial hypertension;

— reduction in the risk of associated cardiovascular morbidity and mortality in patients with arterial hypertension and left ventricular hypertrophy, manifested by a decrease in the cumulative incidence of cardiovascular mortality, the incidence of stroke and myocardial infarction;

- protection of the kidneys in patients with type 2 diabetes mellitus with proteinuria - slowing the progression of renal failure, manifested by a decrease in the incidence of hypercreatininemia, the incidence of end-stage chronic renal failure (ESRD), requiring hemodialysis or kidney transplantation, mortality rates, as well as a decrease in proteinuria;

- chronic failure when treatment with ACE inhibitors is ineffective.

Contraindications

- hypersensitivity to any of the components of the drug;

- pregnancy and breastfeeding;

— age up to 18 years;

- refractory hyperkalemia;

- lactose intolerance, lactase deficiency and glucose-galactose malabsorption syndrome;

- dehydration;

- severe liver failure (no experience with use);

- simultaneous use with aliskiren in patients with diabetes mellitus and/or impaired renal function (glomerular filtration rate less than 60 ml/min).

Carefully: liver failure (less than 9 Child-Pugh points), arterial hypotension, reduced circulating blood volume (BCV), water and electrolyte imbalance, hyperkalemia, bilateral renal artery stenosis or stenosis of the artery of a single kidney, renal failure, conditions after kidney transplantation, aortic and mitral stenosis, obstructive hypertrophic cardiomyopathy, history of angioedema, severe heart failure (IV functional class according to the NYHA classification), coronary heart disease, heart failure with life-threatening arrhythmias, cerebrovascular diseases, primary aldosteronism, heart failure with concomitant severe renal failure.

Dosage

Inside, regardless of food intake.

The drug can be taken either as monotherapy or in combination with other antihypertensive drugs.

Arterial hypertension

The standard initial and maintenance dose for most patients is 50 mg once daily. The maximum antihypertensive effect is achieved 3-6 weeks from the start of therapy.

In some patients, to achieve greater effect, the dose may be increased to a maximum daily dose of 100 mg once a day.

In patients with a reduced circulating blood volume (for example, when taking diuretics in large doses), the initial dose of the drug should be reduced to 25 mg 1 time per day (see section "Special Instructions").

There is no need to select the initial dose in elderly patients and in patients with renal failure, including patients on dialysis.

Patients with liver failure (less than 9 points on the Child-Pugh scale) during the hemodialysis procedure, as well as patients over 75 years old It is recommended to prescribe the drug at a lower initial dose of 25 mg once a day.

Reducing the risk of associated cardiovascular morbidity and mortality in patients with arterial hypertension and left ventricular hypertrophy

The standard initial dose of the drug is 50 mg 1 time per day. In the future, it is recommended to add hydrochlorothiazide or increase the dose of Losartan to 100 mg (taking into account the degree of reduction in blood pressure (BP)) in one or two doses.

Kidney protection in patients with type 2 diabetes mellitus and proteinuria.

The standard initial dose of the drug is 50 mg 1 time per day. In the future, it is recommended to increase the dose of Losartan to 100 mg 1 time per day, taking into account the degree of blood pressure reduction. Losartan can be prescribed together with other antihypertensive drugs (diuretics, slow calcium channel blockers, alpha and beta blockers, centrally acting antihypertensive drugs), insulin and other hypoglycemic drugs (sulfonylurea derivatives, glitazones and glucosidase inhibitors).

Chronic heart failure

The initial dose of the drug is 12.5 mg 1 time per day. Typically, the dose is titrated at weekly intervals (i.e., 12.5 mg once daily, 25 mg once daily, 50 mg once daily) to the usual maintenance dose of 50 mg once daily based on individual tolerance.

Side effects

In most cases, losartan is well tolerated, side effects are mild and transient and do not require discontinuation of the drug.

Side effects observed when taking the drug are classified into categories depending on the frequency of their occurrence: very common > 1/10 (10%); often > 1/100 (1%)< 1/10 (10 %); иногда > 1/1000 (0,1 %), < 1/100 (1 %): редко >1/10000 (0,01 %), < 1/1000 (0,1 %); очень редко < 1/10000 (0.01 %), включая отдельные события.

Side effects occurring with a frequency greater than 1%

General violations: asthenia, weakness, fatigue, chest pain, peripheral edema.

palpitations, tachycardia.

abdominal pain, diarrhea, dyspepsia, nausea.

pain in the back, legs, muscle cramps.

From the central nervous system (CNS): dizziness, headache, insomnia.

From the respiratory system: cough, bronchitis, swelling of the nasal mucosa, pharyngitis, sinusitis, upper respiratory tract infections.

Side effects occurring with an incidence of less than 1%

From the cardiovascular system: angina pectoris, symptomatic arterial hypotension (especially in patients with intravascular dehydration, for example, patients with severe heart failure or when taking diuretics in high doses), dose-dependent orthostatic hypotension, bradycardia, arrhythmias, myocardial infarction, vasculitis.

From the digestive system: anorexia, dry oral mucosa, toothache, flatulence, gastritis, constipation, hepatitis, liver dysfunction, vomiting.

From the skin: dry skin, ecchymosis, erythema, photosensitivity, increased sweating, alopecia.

Allergic reactions: urticaria, itching, skin rash, angioedema (including swelling of the larynx, vocal folds causing airway obstruction, and/or swelling of the face, lips, pharynx and/or tongue).

From the hematopoietic system: anemia, thrombocytopenia, eosinophilia, Henoch-Schönlein purpura.

From the nervous system and sensory organs: anxiety, sleep disturbance, drowsiness, memory impairment, peripheral neuropathy, paresthesia, hypoesthesia, tremor, ataxia, depression, fainting, tinnitus, taste disturbance, visual impairment, conjunctivitis, migraine.

From the musculoskeletal system: arthralgia, arthritis, shoulder and knee pain, fibromyalgia.

From the urinary system: Urinary urgency, urinary tract infections, renal dysfunction.

From the reproductive system: decreased libido, impotence.

Others: exacerbation of gout, nosebleeds.

From the laboratory parameters:

often - hyperkalemia (potassium content more than 5.5 mmol/l);

infrequently - increased concentrations of urea, residual nitrogen, creatinine in the blood serum;

very rarely - moderate increase in transaminase activity (aspartate aminotransferase, alanine aminotransferase), hyperbilirubinemia.

Attention! If any of the side effects listed in the instructions get worse or you notice any other side effects not listed in the instructions, tell your doctor.

Overdose

Information on drug overdose is limited.

Most likely symptoms

Marked decrease in blood pressure and tachycardia: bradycardia can occur due to parasympathetic (vagal) stimulation.

Treatment

Forced diuresis, symptomatic therapy. Neither losartan nor its active metabolite is removed from the body by hemodialysis.

Drug interactions

May be prescribed with other antihypertensive drugs.

There were no clinically significant interactions between losartan and drugs such as hydrochlorothiazide, digoxin, warfarin, cimetidine and phenobarbital, ketoconazole and erythromycin.

Rifampicin and fluconazole reduce the level of the active metabolite. The clinical significance of these interactions has not been established.

As with other agents that block the formation of angiotensin II and its effects, concomitant use of potassium-sparing diuretics (eg, spironolactone, triamterene, amiloride, eplerenone) or potassium-enhancing agents (eg, heparin), potassium supplements, and potassium-containing salts may may lead to an increase in serum potassium levels.

As with the use of other drugs that affect sodium excretion, treatment with losartan may be accompanied by a decrease in sodium excretion and an increase in the serum concentration of lithium, therefore, during simultaneous treatment with lithium preparations, its serum concentration should be monitored.

Nonsteroidal anti-inflammatory drugs (NSAIDs), including selective cyclooxygenase-2 (COX-2) inhibitors, may reduce the effect of diuretics and other antihypertensive agents. Therefore, the antihypertensive effect of angiotensin II receptor antagonists or ACE inhibitors may be weakened when used simultaneously with NSAIDs, incl. with selective COX-2 inhibitors.

In some patients with impaired renal function who have been treated with NSAIDs, co-administration of angiotensin II antagonists may cause a further deterioration of renal function. Usually this effect is reversible.

Other antihypertensive drugs may increase the severity of the antihypertensive effect of losartan. Concomitant use of drugs (for example, tricyclic antidepressants, antipsychotics, baclofen, amifostine) that lower blood pressure as a primary or side effect may increase the risk of developing arterial hypotension.

Dual blockade of the RAAS using angiotensin II receptor antagonists, ACE inhibitors or aliskiren is associated with an increased risk of hypotension, syncope, hyperkalemia and renal dysfunction (including acute renal failure) compared with monotherapy. It is necessary to carefully monitor blood pressure, renal function and water and electrolyte balance in patients taking losartan and other drugs that affect the RAAS. Losartan is not recommended for use simultaneously with aliskiren in patients with diabetes mellitus. The simultaneous use of Losartan and aliskiren should be avoided in patients with renal failure (glomerular filtration rate less than 60 ml/min).

When used concomitantly with fluvastatin (a weak inhibitor of the CYP2C9 isoenzyme), no difference in effect was detected.

If you are prescribed losartan and are taking other medications, consult your doctor about this.

special instructions

Allergic reactions. Anaphylactic reactions, angioedema involving the larynx and pharynx causing airway obstruction and/or swelling of the face, lips, pharynx and/or tongue have been reported rarely in patients taking losartan. Some of these patients had a history of angioedema while taking other medications, including ACE inhibitors. Therefore, when prescribing the drug to patients with a history of angioedema, special caution should be exercised.

Arterial hypotension and water-electrolyte imbalance or decreased blood volume. In patients with reduced blood volume (for example, those receiving treatment with diuretics in high doses), symptomatic arterial hypotension may occur. Correction of such conditions must be carried out before prescribing losartan or starting treatment with the drug at a lower dose (see section “Method of administration and dosage”). Violation of water and electrolyte balance is typical for patients with renal failure with type 2 diabetes mellitus or without diabetes mellitus, therefore, when prescribing the drug to this category of patients, special care should be taken due to the risk of developing hyperkalemia (see section Side effects, subsection Laboratory tests indicators).

During treatment, potassium levels in the blood should be regularly monitored, especially in elderly patients with impaired renal function. During treatment with losartan, patients should not take potassium supplements or salt substitutes containing potassium without first consulting their doctor.

Aortic or mitral stenosis, obstructive hypertrophic cardiomyopathy. As with all drugs that have a vasodilating effect, angiotensin II receptor antagonists should be administered with caution to patients with aortic or mitral stenosis or obstructive hypertrophic cardiomyopathy.

Coronary heart disease and cerebrovascular diseases. As with all drugs that have a vasodilating effect, angiotensin II receptor antagonists should be administered with caution to patients with coronary heart disease or cerebrovascular disease, since an excessive decrease in blood pressure in this group of patients can lead to the development of myocardial infarction or stroke.

Chronic heart failure (CHF). As with the use of other drugs that act on the RAAS, in patients with CHF and with or without impaired renal function, there is a risk of developing severe hypotension or acute renal failure.

There is insufficient experience with the use of losartan in patients with heart failure and concomitant severe renal failure, in patients with severe heart failure (NYHA functional class IV), as well as in patients with heart failure and symptomatic life-threatening arrhythmias. Therefore, losartan should be prescribed with caution to patients in these groups.

Primary hyperaldosteronism. Patients with primary hyleraldosteronism generally do not respond well to therapy with antihypertensive drugs that act by inhibiting the RAAS, so the use of losartan is not recommended in this group of patients.

Liver dysfunction. Data from pharmacokinetic studies indicate that the concentration of losartan in the blood plasma in patients with cirrhosis of the liver increases significantly, so patients with a history of liver disease should use the drug at a lower dose (see section "Dosage and Administration").

Renal dysfunction. Due to inhibition of the RAAS, changes in renal function, including the development of renal failure, have been observed in some susceptible patients. These changes may subside after treatment is stopped.

Some drugs that affect the RAAS may increase blood urea and serum creatinine concentrations in patients with bilateral renal artery stenosis or arterial stenosis of a solitary kidney. Changes in renal function may be reversible after therapy. During the treatment period, it is necessary to regularly monitor the concentration of creatinine in the blood serum at regular intervals.

Elderly patients. Clinical studies have not revealed any differences in the safety and effectiveness of losartan in elderly patients.

Impact on the ability to drive vehicles and machinery

During the treatment period, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions (dizziness is possible, especially in patients taking diuretic drugs and switching to drug therapy).

Pregnancy and lactation

The use of Losartan during pregnancy is contraindicated.

Drugs that directly affect the renin-angiotensin-aldosterone system (RAAS), when used in the second and third trimesters of pregnancy, can cause developmental defects or even death of the developing fetus. Therefore, if pregnancy is diagnosed, Losartan should be stopped immediately.

Experimental studies have shown that the drug causes developmental defects and leads to fetal or newborn death. It is believed that the mechanism of this effect is a pharmacologically mediated effect on the RAAS. Renal perfusion of the human fetus, depending on the development of the RAAS, begins in the second trimester. The risk to the fetus increases if Losartan is taken in the second or third trimester of pregnancy. The use of angiotensin II receptor antagonists in the second or third trimesters of pregnancy has a toxic effect on the fetus (decreased renal function, development of oligohydramnios, slower ossification of the skull) and the newborn (renal failure, arterial hypotension, hyperkalemia). If the drug Losartan was used in the second trimester of pregnancy and later, it is recommended to perform an ultrasound of the skull bones and evaluate kidney function.

It is not known whether Losartan is excreted in breast milk. When using Losartan during breastfeeding, a decision should be made either to stop breastfeeding or to stop treatment with the drug, taking into account its importance for the mother.

On prescription.

Storage conditions and periods

Store in a place protected from light at a temperature not exceeding 25°C. Keep out of the reach of children. Shelf life - 3 years.

Blood pressure tablets Losartan are a drug for lowering blood pressure; they belong to the group of non-peptide angiotensin 2 receptor blockers, selectively acting on these receptors.

The drug neutralizes the vasoconstrictor effect of angiotensin 2, normalizes the production of aldosterone by the adrenal glands and promotes a persistent decrease in blood pressure.

In this article we will look at why doctors prescribe Losartan, including instructions for use, analogues and prices for this drug in pharmacies. Real REVIEWS of people who have already used Losartan can be read in the comments.

Composition and release form

The dosage form of Losartan is tablets: biconvex, round, covered with a yellow film shell, on a cross section the core is white or almost white (15 or 30 tablets in a contour pack, in a cardboard pack, 2 or 1 pack, respectively).

• Active ingredient: losartan potassium – 100 mg.

Clinical and pharmacological group: angiotensin II receptor antagonist.

What does Losartan help with?

Direct indications for prescribing the drug are the following conditions:

• decreased circulating blood volume;
• rehabilitation after kidney transplant;
• arterial hypertension, especially at the initial stage of manifestation;
• chronic cardiac ischemia;
• protection of the kidneys and normalization of their activity in type II diabetes mellitus;
• chronic heart failure if there is no effect from therapy with other medications;
• reducing the risk of cardiovascular pathologies and the number of deaths in patients diagnosed with arterial hypertension and left ventricular hypertrophy.

Pharmacological properties

Lozap's instructions note that the drug is classified as a specific angiotensin II receptor antagonist. The drug Lozap plus, which has a hypotensive effect, reduces the total peripheral vascular resistance.

It is involved in lowering blood pressure, reducing the content of adrenaline and aldosterone in the blood, reducing the load on the heart muscle, and also providing a diuretic effect. Lozap helps increase exercise tolerance in patients with signs of heart failure, and also prevents the development of myocardial hypertrophy.

Instructions for use

According to the instructions for use, Losartan tablets for high blood pressure are taken once a day; the medication is not tied to meals. The tablets are not chewed, they are swallowed with water.

The average dosage of the drug is as follows:

• Chronic heart failure. The initial dose of the drug is 12.5 mg 1 time per day. Typically, the dose is titrated at weekly intervals (i.e., 12.5 mg once daily, 25 mg once daily, 50 mg once daily) to the usual maintenance dose of 50 mg once daily, depending on individual portability.
• Arterial hypertension. The standard initial and maintenance dose for most patients is 50 mg once daily. The maximum antihypertensive effect is achieved 3-6 weeks from the start of therapy.
• To prevent stroke, cardiovascular pathologies and reduce the risk of left ventricular hypertrophy and mortality in hypertension, take 50 mg of the drug once a day at the initial stage of treatment. If the drug does not lower blood pressure well, the dosage is increased to 100 mg per day or remains the same, but the diuretic drug hydrochlorothiazide is added to the Losartan tablets.
• Kidney protection in patients with type 2 diabetes mellitus and proteinuria. The standard initial dose of the drug is 50 mg 1 time per day. In the future, it is recommended to increase the dose of Losartan to 100 mg 1 time per day, taking into account the degree of blood pressure reduction. Losartan can be prescribed together with other antihypertensive drugs (diuretics, slow calcium channel blockers, alpha and beta blockers, centrally acting antihypertensive drugs), insulin and other hypoglycemic drugs (sulfonylurea derivatives, glitazones and glucosidase inhibitors).

Contraindications

The use of Losartan is contraindicated:

• During pregnancy and lactation;
• In case of hypersensitivity to the main or additional components;
• In children under 18 years of age;
• In case of severe renal failure (above 9 Child-Pugh points).
• With hereditary galactose intolerance, glucose-galactose malabsorption or lactase deficiency.

Losartan is prescribed with caution in case of decreased blood volume, arterial hypotension, bilateral stenosis of the arteries of a single kidney, heart failure with life-threatening arrhythmias, liver or kidney failure, and water-electrolyte imbalance.

Side effects

Losartan is usually well tolerated, side effects are transient and mild and do not require discontinuation of therapy. When using the drug, disorders of certain body systems may develop, manifesting themselves with varying frequencies:

• headache;
• increased feeling of hunger;
• irregular heartbeat;
• pain in various parts of the body;
• chills;
• cold sweat;
• coma;
• confusion of thoughts;
• difficulty breathing;
• painful urination;
• dizziness;
• nausea or vomiting;
• numbness or tingling in the arms, legs, lips;
• convulsions;
• slurred speech;
• cardiopalmus;
• frequent urge to urinate;
• unstable breathing during exercise;
• sudden and causeless hematomas;
• pain in the abdominal area or stomach;
• state of anxiety;
• bladder pain;
• bloody spots in the urine;
• blurred vision;
• pale skin;
• depression;
• feeling tired or weak;
• heaviness in the legs.

In case of an overdose of losartan, heart rhythm disturbances due to stimulation of the vagus nerve are especially dangerous. As treatment, diuretics and plenty of fluids are used to remove the drug from the body in combination with symptomatic therapy to improve the general well-being of the patient.

Losartan is a specific angiotensin II receptor antagonist (AT1 subtype), intended for internal administration.

The substance does not inhibit angiotensin-converting enzyme (kininase II), which catalyzes the reaction of producing angiotensin II from angiotensin I.

Losartan selectively interacts with AT1 receptors and does not bind to receptors of other hormones or ion channels, which play an important role in the regulation of the functions of the cardiovascular system. It does not suppress angiotensin-converting enzyme (kininase II) and does not prevent the destruction of bradykinin, so side effects indirectly caused by interaction with bradykinin occur quite rarely.

Main effects:

• an increase in the lumen of blood vessels, through blocking angiotensin II receptors (a hormone that causes vasospasm) is its main effect, causing a decrease in blood pressure.
• increased diuresis (also helps lower blood pressure).
• increased resistance to exercise in people who are “lucky enough” to acquire heart failure.
• slowing the progression of renal failure in patients with diabetes.

A single dose of Losartan tablet causes an antihypertensive effect (decrease in systolic and diastolic blood pressure), which reaches a maximum after 6 hours and then gradually decreases over 24 hours.

The maximum antihypertensive effect is observed after 3–6 weeks.

Indications for use

What does Losartan help with? The drug is prescribed in the following cases:

• arterial hypertension;
• reducing the risk of associated cardiovascular morbidity and mortality in patients with arterial hypertension and left ventricular hypertrophy;
• kidney protection in patients with type 2 diabetes mellitus with proteinuria;
• chronic heart failure with ineffective treatment with ACE inhibitors.

Instructions for use Losartan, dosage

The tablets are taken orally, regardless of food intake.

Arterial hypertension. According to the instructions, the standard initial and maintenance dose is 1 tablet of Losartan 50 mg 1 time per day. The antihypertensive effect is achieved after 3-6 weeks. In some cases, to achieve maximum effect, the dose can be increased to 100 mg 1 time per day.

In patients with reduced blood volume, the initial dose is reduced to 25 mg once a day.

Reducing the risk of associated cardiovascular morbidity and mortality in patients with left ventricular hypertrophy and arterial hypertension. The standard starting dose is 1 tablet of Losartan 50 mg once a day. In the future, the dose should be increased to 100 mg or hydrochlorothiazide should be added.

Kidney protection in patients with proteinuria and type 2 diabetes mellitus. The standard starting dose is 50 mg once a day. In the future, the dosage should be increased to 100 mg once a day.

Chronic heart failure. The initial dose is 12.5 mg 1 time per day. The dose is titrated at weekly intervals to a standard maintenance dose of 50 mg once daily.

For patients who have fluid and/or sodium deficiency, fluid and electrolyte disturbances should be corrected or a lower initial dose should be used before starting treatment.

Side effects

According to the instructions for use, the use of Losartan may be accompanied by the following side effects:

• From the cardiovascular system: dizziness, orthostatic hypotension.
• Metabolism: hyperkalemia.
• Allergic reactions: angioedema (including swelling of the face, lips, pharynx and/or tongue), urticaria.
• From the digestive system: diarrhea, increased ALT activity.
• From the side of the central nervous system: headache.
• Dermatological reactions: itching.
• Other: renal dysfunction, myalgia.

During treatment, potassium levels in the blood should be regularly monitored, especially in elderly patients with impaired renal function.

Contraindications

Losartan is contraindicated in the following cases:

• with increased individual sensitivity to various components of this drug.
• renal failure in severe form.
• period of bearing a baby. If the drug is taken in the second and third trimester, then the development of the fetus may occur with deviations, their consequences are irreversible. sometimes fetal death is diagnosed. but if pregnancy is discovered while taking this drug, then the course of therapy should be stopped immediately.
• lactation.
• The patient's age is under eighteen years.

Safety and effectiveness in children have not been established.

Overdose

Symptoms of overdose are tachycardia, a pronounced decrease in blood pressure, and the possible development of bradycardia.

Analogues of Losartan, price in pharmacies

If necessary, you can replace Losartan with an analogue of the active substance - these are the following drugs:

1. Angizar,
2. Hyperzar,
3. Cardomin,
4. Closart,
5. Kozaar,
6. Lorista,
7. Losacar,
8. Presartan,
9. Pulsar.

When choosing analogs, it is important to understand that the instructions for use of Losartan, price and reviews do not apply to drugs with similar effects. It is important to consult a doctor and not change the drug yourself.

Price in Russian pharmacies: Losartan tablets 50 mg 30 pcs. – from 67 to 94 rubles, 12.5 mg 30 pcs. – from 60 to 89 rubles.

Store in a place protected from light, out of reach of children at temperatures up to 25°C. Shelf life – 3 years. Dispensed in pharmacies with a doctor's prescription.

The results of treating any disease depend on the correct choice of medications. Sometimes their number is huge, but there is no effectiveness. Patients with problems in the cardiovascular system are also lost in the lists that appear in the doctor’s prescription.

Losartan is a medicine that can be found in the medicine cabinet of people suffering from arterial hypertension, renal or heart failure and other diseases that arise due to a malfunction in the circulatory system. The specifics of use, dosage rules, analogues and reviews of people who have taken losartan will be discussed in the article.

Description of the drug

Losartan is a selective (selective) drug that affects only the problem with the vascular system. It opposes angiotensin 2 receptors, blocking its manifestation. Losartan prevents vasoconstriction, which occurs precisely under the influence of the hormone angiotensin. The receptors of this hormone influence the process of formation of the substance aldosterone by the adrenal glands, which is also involved in the constriction of the smooth muscles of the vascular system.

When losartan enters the body, the total peripheral resistance and cardio-venous return, which occur with high blood pressure, decrease.

The medicine is available in the form of tablets with a dosage of 25, 50, 100 mg. Doctors usually prescribe a single dose of 50 mg if there is no reason to reduce or increase the daily dose. The appearance of the tablet is white, oval in shape, and there is a dose quantity marking on the surface, for example, the number 50.

The active substance of the drug is losartan potassium. This must be taken into account by people taking additional medications containing potassium to avoid an overdose of this substance. When prescribing losartan, the doctor takes this point into account and can adjust the therapy if a drug containing potassium has already been prescribed.

What auxiliary components are included in losartan can be studied in the instructions for use before purchasing.

Scope of application

The instructions for use of losartan provide for its administration to patients with problems in the cardiovascular system, but not only at the time of exacerbation of the pathology, but also for prevention:

• Reducing the risk of developing associated cardiovascular disease;
• Prevention of deaths due to pathologies of the heart, kidneys, liver due to problems in the blood vessels;
• Normalization of blood pressure with tonometer readings above 140 to 90 mmHg. st, persisting for a long time;
• Prevention of factors for the development of heart failure, renal failure, left ventricular hypertrophy of the heart muscle.

Losartan is prescribed only to patients who have been confirmed by a special research technique. If fluctuations in blood pressure suggest that the levels rise and fall, then taking the medicine may do more harm than good due to a stable decrease in levels. Even for long-term hypertensive patients, the doctor recommends constant monitoring of blood pressure so that losartan does not lead to the opposite result - a strong decrease. Arterial hypotension is no less dangerous for humans than hypertension. Insufficient blood flow to the organs will lead to a malfunction in the general system, for example, hypoxia of the brain occurs, insufficient blood supply to the lower and upper extremities, and weak functioning of the heart muscle.

The action of losartan begins immediately. 6 hours after the first dose, the patient can observe a stable decrease in systolic and diastolic pressure. But the effect of the drug on the vascular system gradually decreases and requires re-administration after 24 hours in order to maintain the result and prevent a new surge in the patient’s blood pressure. Even with the most advanced types of arterial hypertension, after 2.5 months of taking losartan, a stable decrease in blood pressure to normal values ​​remains.

Losartan tablets are also recommended for people with a history of type 2 diabetes mellitus. In these patients, the vessels suffer from an excess of glucose, which reduces the elasticity of the vessels, thinning their walls and creating a risk of blood clots or rupture of the vessels. A concomitant disease of diabetics is nephropathy, when the functionality of the kidneys is impaired and a situation may arise for organ transplantation or the appointment of a dialysis procedure. Losartan protects the kidneys of people with diabetes from developing kidney failure. Diabetics experience problems with frequent urination, as a result of which beneficial substances are washed out of the body. Losartan prevents this outcome.

The tablets reduce the number of strokes and myocardial infarctions in people with diagnosed diseases of the cardiovascular system, if the doctor made a timely prescription.

When should you not take Losartan?

As with any drug that contains a large number of ingredients, side effects occur, losartan tablets are not compatible with every organism. The drug underwent clinical trials, as a result of which the following discomfort was noted:

From the gastrointestinal tract

Based on the fact that the tablets first enter the gastrointestinal tract, where the process of metabolism, absorption into the blood and excretion through the liver and kidneys takes place, patients may experience discomfort in the abdomen (abdominal or stomach area).

Taste bud disturbances, nausea, vomiting, and diarrhea are side effects of losartan that have been observed in some people while taking the pills. Liver dysfunction may occur, and in rare cases hepatitis occurs.

From the central nervous system

The drug penetrates the blood and can affect the brain and nervous system. A number of patients reported complaints of headache, migraine, depression, memory impairment, drowsiness or insomnia.

At the same time, there was a decrease in vision, as if a veil appeared before the eyes, which interfered with vision. Some people have experienced conjunctivitis while taking losartan.

Disturbances in the hearing system were noted - ringing in the ears, decreased perception of sound

Losartan can provoke a reaction from the respiratory system - nasal congestion, sinusitis, sneezing, coughing, respiratory rhythm disturbances, throat spasms. These symptoms can be confused with the manifestation of a cold, the penetration of viruses into the body, although when the pills are discontinued, the signs of influenza and ARVI disappear.

A negative effect on the nervous system when taking losartan was noted in patient complaints of tremors and fainting.

From the heart and blood vessels

Despite the fact that losartan is intended to reduce the risk of complications from the cardiovascular system, a number of patients experienced negative consequences from using the pills:

• Heart rhythm disturbances, most often tachycardia. Patients claim that they feel and hear their heart beating.
• Symptomatic arterial hypotension (sharp decrease in pressure). The side effect was observed in individuals taking large quantities. Even without the use of pills that reduce high blood pressure, with constant use of diuretics, hypertension is reduced to normal levels. If you do not take this point into account, you can seriously harm your kidneys.
• Heart attack, stroke, bradycardia.

The listed side effects occur in rare cases if the nuances of the patient’s general well-being are not taken into account or the patient took medications, neglecting the instructions for using losartan and the doctor’s recommendations in combination with other medications.

From the reproductive function

The use of losartan tablets sometimes causes disturbances in the reproductive system in men. Decreased potency up to the complete disappearance of male libido. This may be explained by the fact that the tablets reduce blood pressure in all vessels. Very thin vessels go to the genital organs responsible for the reaction of the prostate gland, which nourish the cells and give them strength. If the pressure decreases, then in case of any pathologies in thin vessels, blood will not be able to reach the penis and prostate gland in the required volume.

From the musculoskeletal system

The active substance of losartan easily penetrates not only into the blood, but also into bone, cartilage, and joint tissue.

Therefore, in patients who already have disorders in the functioning of the musculoskeletal system, complaints of pain in the lower back, lower extremities, and cramps in the muscle tissue surrounding the human skeleton can be observed.

Arthritis, pain in the knees, shoulder girdle, fibromyalgia may appear a few days after starting to take losartan tablets.

Other adverse reactions

Allergic manifestations in the form of skin rashes, itching, swelling of the mucous membrane in the nasopharynx, attacks of suffocation may appear when taking the medicine if a person has an individual intolerance to the components of losartan.

In rare cases, partial or complete hair loss, nosebleeds, general malaise, weakness, and loss of interest in life are possible.

The listed symptoms of adverse reactions to taking losartan occur in rare cases, but you should not forget about them. If a doctor writes a prescription for a medicine to stabilize blood pressure or prevent cardiovascular complications, you need to clarify the possibility of side effects.

Admission rules

Losartan should be taken once a day, unless there are conditions for a more frequent schedule. These tablets should not be taken in a random order. Always only at one time, for example, in the morning at 9 o’clock.

At first, you can set an alarm to remind you to take your medication.

The drug has a time interval for the absorption and excretion of the active substance, which affects the maintenance of blood pressure.

The greatest effect occurs 1–2 hours after administration and over the next few hours there is a slow decrease in the effect of the substance on a special group of hormones responsible for increasing blood flow in the vessels. After 24 hours, the hypotensive effect of the drug ends. If you do not take a new dose of losartan, a new attack of arterial hypertension will occur.

If you miss the prescribed dosing time, you need to take the medicine as early as possible and adjust your further schedule, taking this into account.

There are no special instructions regarding the connection to the diet. The tablet can be taken before meals or after meals.

• The daily dosage is prescribed by the attending physician, taking into account the diagnostic results and the presence of additional pathologies in the patient. In the standard treatment of arterial hypertension, 50 mg of losartan per day is prescribed, which is drunk at a time. If the result is not achieved at this dosage, an increase to 100 mg per day is possible. The tablet can be divided into two doses to avoid a sharp drop in blood pressure.
• For adult patients, regardless of age, losartan is prescribed without individual calculation. Even older people do not require individual dosage selection. 50 mg is the standard prescription.
• The only exceptions are if there is a reduced volume of circulating blood, with liver failure and the age of patients over 75 years old, if an antihypertensive drug is prescribed for the first time. The initial dosage should not be more than 25 mg per day. Gradually this volume increases, but under the supervision of a doctor.
• Do not forget about the compatibility of medications if the patient is prescribed tablets for the treatment of other diseases, or is undergoing complex treatment of cardiovascular pathologies.
• For patients with diabetes mellitus, 50 mg per day is recommended to maintain kidney function. Losartan has no restrictions on compatibility with insulin, glucose-lowering drugs, or diuretics. If 50 mg is not enough to reduce hypertension, the dosage can be increased after consultation with your doctor.
• Chronic heart failure requires starting therapy with 12.5 mg of losartan and under medical supervision. If there are no adverse reactions, the dosage is gradually increased to the standard 50 mg per day.

The tablets are contraindicated for pregnant women, young mothers during lactation, and all children under 18 years of age.

Pay special attention

Based on the fact that the active ingredient of the drug in question is potassium losartan, systematic monitoring of the potassium content in the patient’s body is required. An overdose of a substance can lead to serious disturbances in various vital systems.

1. Particular attention to this point is due to the fact that the patient may be prescribed other drugs that contain the substance potassium, which is so necessary for the perfect functioning of the heart. Patients with type 2 diabetes mellitus are at risk if there are signs of kidney failure. There may be an imbalance in the water-electrolyte balance, which can cause hypokalemia (excess potassium).
2. All patients taking Losartan require daily monitoring of blood pressure readings and recording the results in a diary to eliminate the risk of an excessive decrease in systolic and diastolic pressure.
3. In case of serious pathologies in the liver, the dosage of the medicine should be adjusted by a doctor to avoid overdose. In such people, levels of the substance losartan potassium in the blood are higher than in patients without hepatic changes.
4. If the professional activity of a person with problems in the heart or blood vessels requires full concentration of attention and quick reaction to what is happening around, Losartan may be contraindicated for use. Adverse reactions include dizziness, decreased vision, and hearing, which can lead to serious problems.

Losartan analogues, cost

In the pharmaceutical industry, any drug has analogues or substitutes so that the patient has the opportunity to choose according to his budget and the absence of side effects. Losartan is no exception, and the following generics can be found on pharmacy shelves.

Before choosing one or another manufacturer, you need to take into account the doctor’s recommendations regarding possible side effects of a particular analogue or original drug. The price is often influenced by the composition of the tablets, the quantity in the package and the manufacturer. But medicine can be found for any budget due to the wide range of prices in pharmacies.

In addition to the listed analogues, you can pay attention to several more losartan substitutes:

• Blocktran is an excellent substitute for the original product. Produced in Russia. Available in tablet form with dosages ranging from 12.5 mg to 100 mg. Indicated for arterial hypertension, renal and heart failure, disorders of the heart muscle, and for protecting the kidneys in patients with diabetes. Contraindications are identical to losartan. The drug is a prescription drug.
• Lortenza is another substitute for Losartan. Prescribed for similar indications in patients who have not received a decent result from monotherapy. The active ingredient of the generic is losartan and.
• Losartan Nan is a Belarusian analogue containing losartan potassium as the active ingredient. It has a lower cost, but has the same effect as more expensive foreign-made substitutes.

Despite such a variety of drugs that have the same active ingredient, it is worth paying attention to the dosage of the tablets in a particular case. Some analogues take a longer time to be absorbed by the body and provide a therapeutic effect. Sometimes problems arise if the patient has not paid attention to the length of time losartan remains in the blood, the period of its complete elimination and compatibility with other drugs during complex therapy or the presence of pathologies that do not depend on pressure indicators, but progress independently.

When replacing the main drug prescribed by a doctor or previously purchased at a pharmacy, you should pay attention to the instructions and take into account all the circumstances. As a last resort, seek help in choosing a losartan analogue from a doctor.

In this article you can read the instructions for use of the drug Losartan. Reviews of site visitors - consumers of this medicine, as well as the opinions of specialist doctors on the use of Losartan in their practice are presented. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Analogues of Losartan in the presence of existing structural analogues. Use for the treatment of arterial hypertension and blood pressure reduction in adults, children, as well as during pregnancy and lactation.

Losartan- antihypertensive agent. It is a non-peptide blocker of angiotensin 2 receptors. It has high selectivity and affinity for AT1 type receptors (with the participation of which the main effects of angiotensin 2 are realized). By blocking these receptors, losartan prevents and eliminates the vasoconstrictor effect of angiotensin 2, its stimulating effect on the secretion of aldosterone by the adrenal glands and some other effects of angiotensin 2. It is characterized by a long-term effect (24 hours or more), which is due to the formation of its active metabolite.

Compound

Losartan potassium + excipients.

Pharmacokinetics

After oral administration, losartan is rapidly absorbed from the gastrointestinal tract. Bioavailability is about 33%. Metabolized during the “first pass” through the liver to form a carboxyl metabolite, which has more pronounced pharmacological activity than losartan, and a number of inactive metabolites. Plasma protein binding of losartan and the active metabolite is high - more than 98%. Losartan is excreted in the urine and feces (with bile) unchanged and in the form of metabolites. About 35% is excreted in urine and about 60% in feces.

Indications

• arterial hypertension;
• reducing the risk of associated cardiovascular morbidity and mortality in patients with arterial hypertension and left ventricular hypertrophy, manifested by a combined reduction in the incidence of cardiovascular mortality, the incidence of stroke and myocardial infarction;
• kidney protection in patients with type 2 diabetes mellitus with proteinuria - slowing the progression of renal failure, manifested by a decrease in the incidence of hypercreatininemia, the incidence of end-stage chronic renal failure requiring hemodialysis or kidney transplantation, mortality rates, as well as a decrease in proteinuria;
• chronic heart failure with ineffective treatment with ACE inhibitors.

Release forms

Film-coated tablets 12.5 mg, 25 mg, 50 mg and 100 mg (manufactured by Richter, Teva, N form with diuretic hydrochlorothiazide).

Instructions for use and dosage

The drug Losartan is taken orally, regardless of food intake. The tablets are swallowed without chewing, washed down with water. The frequency of administration is 1 time per day.

Arterial hypertension

For arterial hypertension, the average daily dose is 50 mg once a day. To achieve a greater therapeutic effect, the dose is increased to 100 mg per day.

Chronic heart failure

The initial dose for patients with chronic heart failure is 12.5 mg 1 time per day. Typically, the dose is increased at weekly intervals (i.e., 12.5 mg per day, 25 mg per day, and 50 mg per day) to a mean maintenance dose of 50 mg once daily, depending on the patient's tolerability.

Reducing the risk of development, cardiovascular diseases (including stroke) and mortality in patients with arterial hypertension and left ventricular hypertrophy

The initial dose of the drug is 50 mg 1 time per day. In the future, hydrochlorothiazide may be added in low doses or the dose of Losartan may be increased to 100 mg in 1 or 2 doses, taking into account the reduction in blood pressure.

Patients with concomitant type 2 diabetes mellitus with proteinuria

The drug is prescribed at an initial dose of 50 mg 1 time per day with a further increase in dose to 100 mg per day (taking into account the degree of blood pressure reduction) in one or two doses.

In patients with reduced blood volume (for example, when taking diuretics in high doses), the recommended initial dose of Losartan is 25 mg 1 time per day.

For patients with liver failure (less than 9 points on the Child-Pugh scale), during hemodialysis, as well as for patients over 75 years of age, a lower initial dose of the drug is recommended - 25 mg 1 time per day.

There is insufficient experience in using the drug in patients with severe liver failure, so the drug is not recommended in this category of patients.

The drug does not have any peculiarities of action when first taken or when discontinued, but blood pressure control is necessary as when taking any antihypertensive drug.

Antihypertensive drugs should be taken at the same prescribed time as recommended by a doctor to increase the therapeutic effect. If you miss one dose, you must take the next dose of the drug at the time closest to the time you usually take the drug or at the time when you remember that you missed a dose, moving the time of taking the next dose. You should not take a double dose of the drug.

Side effect

• dizziness;
• asthenia/fatigue;
• headache;
• insomnia;
• anxiety;
• sleep disturbance;
• drowsiness;
• memory disorders;
• peripheral neuropathies;
• paresthesia;
• migraine;
• tremor;
• depression;
• tinnitus;
• taste disturbance;
• changes in vision;
• conjunctivitis;
• nasal congestion;
• cough;
• upper respiratory tract infections (fever, sore throat);
• sinusitis;
• pharyngitis;
• rhinitis;
• nausea, vomiting;
• diarrhea;
• dyspeptic symptoms;
• abdominal pain;
• dryness of the oral mucosa;
• anorexia;
• convulsions;
• myalgia;
• pain in the back, chest, legs;
• arthralgia;
• tachy- or bradycardia;
• arrhythmias;
• angina pectoris;
• anemia;
• myocardial infarction;
• imperative urge to urinate;
• weakening libido;
• impotence;
• dry skin;
• rush of blood;
• photosensitivity;
• increased sweating;
• alopecia;
• hives;
• skin rash;
• angioedema, incl. face, lips, pharynx and/or tongue;
• fever;
• gout;
• vasculitis;
• eosinophilia;
• Henoch-Schönlein purpura.

Contraindications

• pregnancy;
• lactation period;
• age under 18 years;
• severe liver failure (more than 9 points on the Child-Pugh scale);
• hereditary galactose intolerance, lactase deficiency or glucose-galactose malabsorption syndrome;
• hypersensitivity to the components of the drug.

Use during pregnancy and breastfeeding

The use of Losartan during pregnancy is contraindicated. It is known that drugs that directly affect the renin-angiotensin-aldosterone system (RAAS), when used in the 2nd and 3rd trimesters of pregnancy, can cause developmental defects or even death of the developing fetus. Therefore, if pregnancy is diagnosed, Losartan should be stopped immediately.

It is not known whether losartan is excreted in breast milk. It is not recommended to take Losartan during lactation. If taking Losartan is necessary during lactation, then breastfeeding should be stopped.

Use in elderly patients

No dose adjustment is required in elderly patients.

Use in children

Contraindicated in children and adolescents under 18 years of age.

special instructions

For patients with chronic heart failure in whom a stable effect has been achieved as a result of the use of ACE inhibitors, it is not recommended to switch to taking angiotensin 2 receptor antagonists, incl. drug Losartan.

Patients with liver pathology (less than 9 points on the Chadd-Pugh scale, and especially with cirrhosis), incl. history, it is necessary to prescribe smaller doses.

In patients with dehydration (for example, receiving treatment with high doses of diuretics), symptomatic arterial hypotension may occur at the beginning of treatment with losartan (it is necessary to correct dehydration before prescribing losartan or start treatment with a lower dose).

Patients with impaired renal function, both with and without diabetes mellitus, often develop electrolyte abnormalities (hyperkalemia), which should be monitored. In the presence of acute or chronic renal failure, losartan may lead to deterioration of renal function with or without hyperkalemia.

During treatment with losartan, potassium levels in the blood should be regularly monitored, especially in elderly patients and with impaired renal function. The simultaneous use of losartan with potassium-sparing diuretics should be avoided.

In elderly patients using non-steroidal anti-inflammatory drugs, concomitantly taking diuretics, or with impaired renal function, the use of losartan may lead to deterioration of renal function, including the possibility of acute renal failure. These effects are usually reversible. Renal function should be periodically monitored in patients taking losartan and non-steroidal anti-inflammatory drugs.

Data on the safety and effectiveness of the drug in children are insufficient.

Impact on the ability to drive vehicles and operate machinery

The ability of the drug to influence the speed of psychomotor reactions and the ability to drive vehicles or other technical equipment has not been studied. Caution should be exercised when engaging in potentially hazardous activities that require increased attention and rapid psychomotor reactions.

Drug interactions

Losartan can be used concomitantly with other antihypertensive drugs.

Mutually enhances the effect of beta-blockers and sympatholytics.

The combined use of losartan with diuretics causes an additive effect.

There were no pharmacokinetic interactions of losartan with hydrochlorothiazide, digoxin, warfarin, cimetidine, phenobarbital, ketoconazole and erythromycin.

Rifampicin and fluconazole have been reported to reduce plasma concentrations of the active metabolite. The clinical significance of these interactions is currently unknown.

As with the use of other drugs that inhibit angiotensin or its action, the combined use of losartan with potassium-sparing diuretics (for example, spironolactone, triamterene, amiloride), potassium supplements, potassium-containing salts increases the risk of hyperkalemia.

Nonsteroidal anti-inflammatory drugs (NSAIDs), including selective cyclooxygenase-2 (COX-2) inhibitors, may reduce the effect of diuretics and other antihypertensive agents.

When used together, angiotensin 2 receptor antagonists and lithium may increase the concentration of lithium in the blood plasma. Taking this into account, it is necessary to weigh the benefits and risks of combined use of losartan with lithium salts. If it is necessary to use drugs together, the concentration of lithium in the blood plasma should be regularly monitored.

Analogues of the drug Losartan

Structural analogues of the active substance:

• Blocktran;
• Brozaar;
• Vasotens;
• Vero Losartan;
• Zisakar;
• Cardomin Sanovel;
• Carzartan;
• Kozaar;
• Lakea;
• Lozap;
• Losarel;
• Losartan McLeods;
• Losartan Richter;
• Losartan Teva;
• Lorista;
• Losakor;
• Lotor;
• Presartan;
• Renicard.

If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and look at the available analogues for the therapeutic effect.