Indications: hypertension, including patients with left ventricular hypertrophy; diabetic nephropathy in type 2 diabetes mellitus, chronic heart failure (in patients ≥ 60 years) Due to its inhibition of urate transporter 1 it is the sartan of choice in gout.
Oral: usually 50 mg once daily (elderly over 75 years, moderate to severe renal impairment, intra-vascular volume depletion, initially 25 mg once daily); if necessary increased after several weeks to 100 mg once daily. However, there is some debate as to the benefit of increasing the dose from 50 mg to 100 mg. See the NLH Q&A Service answer Is there any evidence that increasing dose losartan from 50mg to 100mg reduces BP further? There is however some evidence that 150mg daily improves clinical outcomes in patients with heart failure compared to 50mg daily, in patients with heart failure and intolerance to ACE inhibitors. This is also consistent with work that suggests doses of losartan greater than 50mg daily has equivalent outcomes to candesartan in heart failure.
Diarrhoea, taste disturbance, cough, myalgia, asthenia, fatigue, migraine, vertigo, urticaria, pruritus, rash; rarely hepatitis, anaemia (in severe renal disease or following renal transplant), vasculitis (including Henoch-Schönlein purpura)
- ↑ Hamada T, Ichida K, Hosoyamada M, Mizuta E, Yanagihara K, Sonoyama K, Sugihara S, Igawa O, Hosoya T, Ohtahara A, Shigamasa C, Yamamoto Y, Ninomiya H, Hisatome I. Uricosuric action of losartan via the inhibition of urate transporter 1 (URAT 1) in hypertensive patients. American journal of hypertension. 2008 Oct; 21(10):1157-62.(Link to article – subscription may be required.)
- ↑ Svanström H, Pasternak B, Hviid A. Association of treatment with losartan vs candesartan and mortality among patients with heart failure. JAMA : the journal of the American Medical Association. 2012 Apr 11; 307(14):1506-12.(Link to article – subscription may be required.)