Losartan is a angiotensin II receptor blocker (ARB) primarily used to treat hypertension, heart failure, and kidney damage caused by diabetes. This medication works by blocking the effects of angiotensin II, causing blood vessels to dilate, lowering blood pressure, and reducing the workload on the heart, thereby improving heart and kidney function. It is also used to slow the progression of kidney disease in diabetic patients, especially when there is an increase in albumin in the urine.
The mechanism of action of losartan differs from that of other similar medications, as it does not affect angiotensin-converting enzyme (ACE), thus avoiding specific side effects such as cough. This characteristic makes it an alternative choice for patients who cannot use ACE inhibitors. Clinical trials have shown that long-term use can reduce the risk of heart attacks and improve survival rates in patients with chronic heart failure.
The generic name for losartan is losartan, and common brand names include:
This medication is available in various forms, including tablets and oral suspensions, with a dosage range typically from 25 mg to 100 mg. Combination formulations may be used with diuretics, but this requires a physician's assessment before prescribing.
Losartan is classified as an angiotensin II receptor blocker (ARB) and is considered a second-line medication for the treatment of hypertension. Drugs in this category primarily act on the renin-angiotensin-aldosterone system (RAAS), differing in mechanism from ACE inhibitors but having similar effects on blood pressure control.
In the field of heart disease treatment, ARB medications are categorized as key drug classes for heart failure management. The selection of this category of medication should be based on the patient's individual medical history; for example, patients with a history of chronic cough may prefer ARBs over ACE inhibitors.
The main indications include:
This medication can also be used for primary prevention in high-risk patients, such as hypertensive patients with concomitant heart disease. Physicians may adjust the medication strategy based on indicators such as left ventricular hypertrophy or metabolic syndrome.
Mild side effects include:
Serious but less common side effects include:
Contraindications: Pregnant women in the second or third trimester may experience fetal harm or death from using losartan, thus it is strictly prohibited for use in pregnant women. Patients with severe renal impairment require dosage adjustments, as it may exacerbate hyperkalemia.
Special precautions:
Co-administration with non-steroidal anti-inflammatory drugs (NSAIDs) may reduce the antihypertensive effect and increase the risk of kidney damage. When used in combination with potassium-sparing diuretics (such as spironolactone), the risk of hyperkalemia may increase more than threefold.
Co-administration with lithium may lead to lithium toxicity, requiring monitoring of blood levels. Certain antibiotics (such as tetracyclines) may affect metabolism due to changes in kidney function, necessitating dosage adjustments by the physician. All prescription medications, over-the-counter drugs, or herbal medicines being used should be disclosed to the physician.
The initial dose for adults with hypertension is typically 50 mg once daily, which can be adjusted to 100 mg daily based on blood pressure response. For heart failure patients, the starting dose is 25 mg twice daily, gradually increasing based on tolerance. It should be taken at the same time each day, with or without food.
Patients with renal impairment (creatinine clearance less than 30 mL/min) should reduce the dose to 25-50 mg daily. During treatment, avoid sudden discontinuation; tapering is recommended to prevent rebound hypertension.
If a dose is missed, it should be taken as soon as remembered. However, if the time until the next dose is less than 6 hours, the missed dose should be skipped, and the regular dosing schedule should be resumed. Never take a double dose to make up for a missed dose, as this may increase the risk of hypotension.
If missed doses occur frequently, the patient should contact their physician immediately to adjust the medication plan. Pharmacists may provide pill organizers or reminder devices to help patients establish a regular medication routine.
Acute overdose may lead to severe hypotension, dizziness, or fainting. If overdose is suspected, seek immediate medical attention, which may require intravenous fluids or vasopressor support. Symptoms of toxicity may appear within hours, and blood pressure and urine output should be closely monitored.
Chronic overdose may lead to persistent hyperkalemia, requiring immediate blood tests and medication adjustments. If patients experience muscle weakness, palpitations, or abnormal ECG findings, they should be treated as an emergency.
Yes. Losartan may affect potassium ion metabolism in the body, so regular monitoring of blood potassium levels is recommended. Avoid excessive intake of high-potassium foods (such as bananas and spinach) or potassium supplements, especially when used in combination with potassium-sparing diuretics. Patients with poor kidney function should adjust their diet according to medical advice.
What should I do if I experience dizziness or headaches after taking the medication?Dizziness is a common initial side effect that usually resolves within a few weeks as the body adapts. It is advisable to rise slowly when getting up or changing positions to avoid sudden standing. If symptoms are severe or persistent, contact a physician immediately, as dosage adjustments or increased fluid intake may be necessary to improve blood pressure regulation.
What drug interactions should I be aware of when using losartan with other antihypertensive medications?Co-administration with diuretics (such as thiazides) can enhance the antihypertensive effect but may increase the risk of elevated potassium levels. Avoid using with angiotensin-converting enzyme inhibitors (such as enalapril) to prevent increased risks of renal dysfunction or hyperkalemia. Physicians will adjust dosages and monitor relevant indicators based on the patient's condition.
Can pregnant women or those planning to become pregnant use losartan?Losartan is contraindicated during the second and third trimesters of pregnancy, as it may cause fetal harm or death. Women planning to become pregnant should inform their physician in advance and switch to other safe medications. Women of childbearing age should use effective contraception while on this medication and regularly monitor their pregnancy status.
Do I need to have regular liver and kidney function tests if I use losartan long-term?Regular blood tests, including serum creatinine and potassium levels, are recommended, especially for patients with renal impairment who need close monitoring. If symptoms such as muscle pain, decreased urine output, or unexplained fatigue occur, the medication should be stopped immediately, and medical attention should be sought to rule out the risk of rhabdomyolysis or acute kidney injury.
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