Losartan Potassium (5 brand names, 2 dosage forms, 1 route)
Available dosage forms: TABLET, SUSPENSION.
Routes of administration: ORAL.
Brand Names
- ARBLI
- COZAAR
- HYZAAR
- LOSARTAN POTASSIUM
- LOSARTAN POTASSIUM AND HYDROCHLOROTHIAZIDE
Related Health Topics
Boxed Warning
When pregnancy is detected, discontinue losartan Potassium tablets as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus [see Warnings and Precautions (5.1)].
Contraindications
Losartan potassium tablets are contraindicated: • In patients who are hypersensitive to any component of this product. • For coadministration with aliskiren in patients with diabetes.
Mechanism of Action
Angiotensin II [formed from angiotensin I in a reaction catalyzed by angiotensin converting enzyme (ACE, kininase II)] is a potent vasoconstrictor, the primary vasoactive hormone of the renin-angiotensin system, and an important component in the pathophysiology of hypertension. It also stimulates aldosterone secretion by the adrenal cortex. Losartan and its principal active metabolite block the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT 1receptor found in many tissues, (e.g., vascular smooth muscle, adrenal gland). There is also an AT 2receptor found in many tissues but it is not known to be associated with cardiovascular homeostasis. Neither losartan nor its principal active metabolite exhibits any partial agonist activity at the AT 1receptor, and both have much greater affinity (about 1000-fold) for the AT 1receptor than for the AT 2receptor. In vitrobinding studies indicate that losartan is a reversible, competitive inhibitor of the AT 1receptor. The active metabolite is 10 to 40 times more potent by weight than losartan and appears to be a reversible, non-competitive inhibitor of the AT 1receptor. Neither losartan nor its active metabolite inhibits ACE (kininase II, the enzyme that converts angiotensin I to angiotensin II and degrades bradykinin), nor do they bind to or block other hormone receptors or ion channels known to be important in cardiovascular regulation.
Overdosage
Significant lethality was observed in mice and rats after oral administration of 1000 mg/kg and 2000 mg/kg, respectively, about 44 and 170 times the maximum recommended human dose on a mg/m 2basis. Limited data are available in regard to overdosage in humans. The most likely manifestation of overdosage would be hypotension and tachycardia; bradycardia could occur from parasympathetic (vagal) stimulation. If symptomatic hypotension should occur, supportive treatment should be instituted. Neither losartan nor its active metabolite can be removed by hemodialysis.