Losartan: Price, Dosage & Where to Buy

Losartan is an angiotensin II receptor blocker prescribed to treat high blood pressure in adults and children over six years of age. It is also used to reduce the risk of stroke in patients with hypertension and left ventricular hypertrophy, and to treat diabetic kidney disease in patients with type 2 diabetes and a history of hypertension. Generic losartan has been available since October 2010.

Losartan is indicated for the treatment of hypertension to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and heart attacks. It is approved for use in adults and children six years of age and older.

Losartan is also indicated to reduce the risk of stroke in patients with hypertension and left ventricular hypertrophy, though evidence suggests this benefit does not apply to Black patients. Additionally, losartan is used for the treatment of diabetic nephropathy with elevated serum creatinine and proteinuria in patients with type 2 diabetes and a history of hypertension. In this population, losartan reduces the rate of progression of kidney disease as measured by doubling of serum creatinine or end-stage renal disease requiring dialysis or transplantation.

The label lists 25 mg, 50 mg, and 100 mg tablets, as well as a 10 mg/mL oral suspension. For adult hypertension, the usual starting dose is 50 mg once daily, and the dosage can be increased to a maximum of 100 mg once daily as needed. A starting dose of 25 mg is recommended for patients with possible intravascular depletion, such as those on diuretic therapy.

For paediatric hypertension in children six years and older, the usual recommended starting dose is 0.7 mg per kg once daily, up to 50 mg total. Dosage should be adjusted according to blood pressure response. Doses above 1.4 mg per kg or in excess of 100 mg daily have not been studied in paediatric patients.

For patients with left ventricular hypertrophy, the usual starting dose is 50 mg once daily, with hydrochlorothiazide added or the dose increased to 100 mg based on response. For diabetic nephropathy, the usual starting dose is 50 mg once daily, increased to 100 mg once daily based on blood pressure response. In patients with mild-to-moderate hepatic impairment, the recommended starting dose is 25 mg once daily.

Losartan belongs to a class of medicines called angiotensin II receptor blockers. The renin-angiotensin system is a hormone system that regulates blood pressure and fluid balance. Angiotensin II is a powerful chemical that causes blood vessels to narrow, which increases blood pressure.

Losartan works by blocking angiotensin II from binding to its receptors on blood vessel walls. When these receptors are blocked, blood vessels remain relaxed and widened, which allows blood to flow more easily and reduces blood pressure.

This mechanism also reduces the strain on the heart and kidneys. By acting on the renin-angiotensin system, losartan helps protect the kidneys in patients with diabetes and slows the progression of kidney damage.

Losartan carries a boxed warning for foetal toxicity. When pregnancy is detected, losartan must be discontinued as soon as possible. Use of drugs that act on the renin-angiotensin system during the second and third trimesters of pregnancy reduces foetal renal function and increases foetal and neonatal morbidity and death.

Resulting oligohydramnios can be associated with foetal lung hypoplasia and skeletal deformations. Potential neonatal adverse effects include skull hypoplasia, anuria, hypotension, renal failure, and death. Pregnant women taking losartan should undergo serial ultrasound examinations to assess the intra-amniotic environment.

Neonates with histories of in utero exposure to losartan should be closely observed for hypotension, oliguria, and hyperkalemia. It is not known whether losartan is excreted in human milk, but significant levels were found in rat milk. A decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.

If a dose of losartan is missed, general guidance is to continue with the next scheduled dose at the usual time. Patients should not double the dose to make up for the missed one. Because losartan is usually dosed once daily, maintaining a consistent schedule helps keep blood pressure controlled throughout the day.

Missing a single dose is unlikely to cause immediate harm, but regularly missing doses can reduce the effectiveness of the medicine in controlling blood pressure and protecting the kidneys. Patients who frequently forget doses should discuss strategies with their pharmacist or doctor to improve adherence.

The label directs storage at 20°C to 25°C, which corresponds to 68°F to 77°F, and advises protecting the tablets from light. The product should not be used if the blister is torn or broken, as this is part of the protection system. For the compounded oral suspension, the label specifies refrigeration at 2°C to 8°C (36°F to 46°F) for up to four weeks.

The suspension should be shaken prior to each use and returned promptly to the refrigerator to maintain quality. Store all formulations out of reach of children.