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Losartan: Drug information

Losartan: Drug information
(For additional information see "Losartan: Patient drug information" and see "Losartan: Pediatric drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
ALERT: US Boxed Warning
Fetal toxicity:

When pregnancy is detected, discontinue losartan as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus.

Brand Names: US
  • Cozaar
Brand Names: Canada
  • AG-Losartan [DSC];
  • APO-Losartan [DSC];
  • Auro-Losartan;
  • BIO-Losartan [DSC];
  • Cozaar;
  • JAMP-Losartan;
  • MINT-Losartan [DSC];
  • PMS-Losartan;
  • Priva-Losartan [DSC];
  • SANDOZ Losartan;
  • Septa-Losartan [DSC];
  • TARO-Losartan [DSC];
  • TEVA-Losartan
Pharmacologic Category
  • Angiotensin II Receptor Blocker;
  • Antihypertensive
Dosing: Adult
Acute coronary syndrome

Acute coronary syndrome:

Note: Alternative therapy in patients who cannot tolerate an angiotensin-converting enzyme (ACE) inhibitor (eg, due to cough or angioedema) (Ref). Angiotensin II receptor blockers (ARBs) do not appear to elevate the risk of angioedema (Ref); however, patients must be educated that angioedema due to an ACE inhibitor can sometimes reoccur within months following discontinuation (Ref); referral to an allergist may be appropriate.

Non-ST-elevation acute coronary syndrome (alternative agent) (off-label use):

Note: Initiate in stable patients prior to hospital discharge as a component of an appropriate medical regimen, which may include antiplatelet agent(s), a beta-blocker, and a statin. Continue indefinitely for patients with concurrent diabetes, left ventricular ejection fraction ≤40%, hypertension, or stable chronic kidney disease (Ref). Dosing is based on general dosing range in the manufacturer's labeling.

Oral: Initial: 25 to 50 mg once daily depending on initial blood pressure; increase dose as tolerated up to 100 mg/day under close monitoring to avoid hypotension.

ST-elevation myocardial infarction (alternative agent) (off-label use):

Note: In hemodynamically stable patients with large anterior ST-elevation myocardial infarction, consider starting within 24 hours of presentation as a component of an appropriate medical regimen, which may include antiplatelet agent(s), a beta-blocker, and a statin. Continue therapy indefinitely (Ref).

Oral: Initial: 25 to 50 mg once daily depending on initial blood pressure; increase dose as tolerated up to 100 mg/day under close monitoring to avoid hypotension (Ref).

Heart failure with reduced ejection fraction

Heart failure with reduced ejection fraction (alternative agent) (off-label use):

Note: Alternative therapy in patients who cannot tolerate an angiotensin II receptor-neprilysin inhibitor (ARNI) or an ACE inhibitor (eg, due to cough or angioedema); consultation with a heart failure specialist and/or an allergist may be appropriate (Ref). ARBs do not appear to elevate the risk of angioedema (Ref); however, angioedema due to an ACE inhibitor can sometimes reoccur within months following discontinuation (Ref).

Oral: Initial: 25 to 50 mg once daily; increase dose (eg, double) every ≥1 to 2 weeks based on response and tolerability to a target dose of 150 mg once daily (Ref). In hospitalized patients, may titrate more rapidly as tolerated (Ref).

Hypertension, chronic

Hypertension, chronic:

Note: For patients who warrant combination therapy (BP >20/10 mm Hg above goal or suboptimal response to initial monotherapy), may use with another appropriate agent (eg, long-acting dihydropyridine calcium channel blocker or thiazide diuretic) (Ref).

Oral: Initial: 25 to 50 mg once daily; evaluate response after ~2 to 4 weeks and titrate dose (eg, increase the daily dose by doubling) as needed up to 100 mg/day in 1 to 2 divided doses; if additional blood pressure control is needed, consider combination therapy. Patients with severe asymptomatic hypertension and no signs of acute end organ damage should be evaluated for medication titration within 1 week (Ref).

Marfan syndrome with aortic aneurysm

Marfan syndrome with aortic aneurysm (off-label use):

Note: Losartan may be used in patients with an aortic aneurysm or with a risk factor for developing an aortic aneurysm; may be used as monotherapy or in combination with a beta-blocker. (Ref).

Oral: Initial: 50 mg once daily; after 2 weeks, may increase dose based on blood pressure response and tolerability up to 100 mg/day (Ref).

Posttransplant erythrocytosis

Posttransplant erythrocytosis (kidney transplant recipients) (off-label use):

Note: For patients with a hemoglobin concentration >17 g/dL (Ref).

Oral: Initial: 25 to 50 mg once daily; if inadequate response seen within 4 weeks, may increase to 100 mg once daily based on hemoglobin and blood pressure response; if hemoglobin remains >17 g/dL after an additional 4 weeks, consider alternative therapy (Ref).

Proteinuric chronic kidney disease, diabetic or nondiabetic

Proteinuric chronic kidney disease, diabetic (labeled use) or nondiabetic (off-label use):

Oral: Initial: 25 to 50 mg once daily depending on baseline BP; titrate gradually (eg, by doubling the dose every 2 to 4 weeks) up to the maximally tolerated dose, not to exceed 100 mg once daily. If proteinuria target is not met despite optimized dosage, consider additional therapies (eg, sodium-glucose cotransporter-2 inhibitor) (Ref).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

The renal dosing recommendations are based upon the best available evidence and clinical expertise. Senior Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.

Altered kidney function: Mild to severe impairment: No dosage adjustment necessary (Ref).

Hemodialysis, intermittent (thrice weekly): Poorly dialyzed (losartan and active metabolite): No supplemental dose or dosage adjustment necessary (Ref).

Peritoneal dialysis: Poorly dialyzed (losartan and active metabolite): No dosage adjustment necessary (Ref).

CRRT: No dosage adjustment necessary (Ref).

PIRRT (eg, sustained, low-efficiency diafiltration): No dosage adjustment necessary (Ref).

Dosing: Hepatic Impairment: Adult

US labeling:

Mild to moderate hepatic impairment: Initial: 25 mg once daily

Severe hepatic impairment: There are no specific dosage adjustments provided in the manufacturer’s labeling (has not been studied); initiate therapy at a reduced dosage and titrate as needed. Use with caution in patients with ascites due to cirrhosis (Ref).

Canadian labeling: Mild to severe hepatic impairment or a history of hepatic impairment: Initial: 25 mg once daily

Dosing: Older Adult

Refer to adult dosing.

Dosing: Pediatric

(For additional information see "Losartan: Pediatric drug information")

Hypertension

Hypertension:

Children ≥6 years and Adolescents: Oral: Initial: 0.7 mg/kg once daily; maximum initial dose: 50 mg/dose; titrate to desired effect; maximum daily dose: 1.4 mg/kg/day or 100 mg/day; may be administered once daily or divided twice daily (Ref); Note: Doses >1.4 mg/kg/day (or >100 mg/day) have not been studied (Ref).

Canadian labeling: Children ≥6 years and Adolescents ≤16 years: Oral: Cozaar prescribing information [Canada]:

≥20 kg to <50 kg: Initial: 25 mg once daily; titrate to desired effect; maximum dose: 50 mg/day.

≥50 kg: Initial: 50 mg once daily; titrate to desired effect; maximum dose: 100 mg/day.

Marfan syndrome, aortic-root dilation

Marfan syndrome, aortic-root dilation: Limited data available, optimal place in therapy not defined: Infants ≥6 months, Children, and Adolescents: Oral: Initial: 0.3 to 0.5 mg/kg/day for 21 days, then increase as tolerated to 0.7 to 0.9 mg/kg/day for 21 days, then increase up to 1 to 1.4 mg/kg/day; maximum daily dose: 1.4 mg/kg/day or 100 mg/day (whichever is lower). Note: Dose adjustments (decreased dose and/or frequency) were considered for certain adverse drug reactions (eg, fatigue, dizziness) and lab abnormalities within the study protocol. Dosing based on a large randomized study of patients with Marfan syndrome and a dilated aortic root who were randomized to receive losartan (n=305, ages: 11 ± 6.2 years) or atenolol (n=303, ages: 11.5 ± 6.5 years). Mean losartan dose required was 1.3 ± 0.2 mg/kg/day. Both losartan and atenolol showed a decrease in aortic root z score over a 3-year period (Ref). Similar results were shown in a small, retrospective cohort study (n=18, age: 14 months to 16 years) (Ref).

Proteinuria reduction, chronic kidney disease

Proteinuria reduction, chronic kidney disease: Limited data available: Children and Adolescents: Oral: Initial: 0.35 to 0.8 mg/kg/dose once daily; maximum initial dose: 50 mg/dose. May increase as tolerated to reduce proteinuria; maximum daily dose: 1.4 mg/kg/day up to 100 mg/day. Dosing based on multiple studies in pediatric patients with proteinuria due to kidney disease either as monotherapy or in combination with ACE inhibitor therapy (Ref).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Pediatric

Children ≥6 years and Adolescents: Oral:

Altered kidney function:

CrCl ≥30 mL/minute/1.73 m2: No dosage adjustment necessary unless also volume depleted. If volume depleted, consider initiating at a lower dose.

CrCl <30 mL/minute/1.73 m2: Not recommended for use.

Hemodialysis, intermittent: Not dialyzed (losartan and active metabolite): There are no dosing adjustments in the manufacturer's labeling; based on adult data, no dosage adjustment necessary (Ref).

Peritoneal dialysis: There are no dosing adjustments in the manufacturer's labeling; based on adult data, poorly dialyzed and no dosage adjustment necessary (Ref).

Dosing: Hepatic Impairment: Pediatric

Children ≥6 years and Adolescents: Oral:

Mild to moderate impairment: There are no pediatric-specific dosing recommendations provided by the manufacturer; however, based on adult recommendations, a lower initial dose is recommended.

Severe impairment: There are no dosing recommendations provided by the manufacturer (has not been studied).

Adverse Reactions (Significant): Considerations
Acute kidney injury

May be associated with increased serum creatinine and/or acute kidney injury. Increases in serum creatinine secondary to angiotensin II receptor blockers usually stabilize within 20% to 30% from baseline and are expected; additional increases may indicate renal artery stenosis or volume depletion (Ref).

Mechanism: Related to pharmacologic action; inhibits efferent kidney arteriolar vasoconstriction, lowering glomerular filtration pressure which can lead to a modest reduction in glomerular filtration rate (GFR) (Ref).

Onset: Expected to be similar to angiotensin-converting enzyme inhibitors: Intermediate; transient increases in serum creatinine generally occur within 2 weeks of initiation and stabilize within 2 to 4 weeks (Ref).

Risk factors:

• Sodium or volume depletion (Ref)

• Heart failure (Ref)

• Concurrent diuretic and/or nonsteroidal anti-inflammatory drug use (Ref)

• Older patients

• Hypotension (Ref)

• Preexisting kidney impairment (Ref)

• Patients with low renal blood flow (eg, renal artery stenosis) whose GFR is dependent on efferent arteriolar vasoconstriction by angiotensin II (Ref)

Hyperkalemia

Hyperkalemia may occur.

Mechanism: Related to pharmacologic action; blocks angiotensin II from binding to the adrenal receptor and interferes with generation of angiotensin II within the adrenal cortex, decreasing aldosterone release and impairing kidney potassium excretion (Ref).

Onset: Generally occurs within 1 week of treatment initiation (Ref).

Risk factors:

• High dietary intake of potassium (Ref)

• Baseline elevated potassium (≥5 mmol/L) (Ref)

• Older patients (Ref)

• Kidney dysfunction (Ref)

• Diabetes mellitus (Ref)

• Concurrent use of medications known to decrease renin and aldosterone (eg, direct renin inhibitors, nonsteroidal anti-inflammatory drugs, cyclosporine, tacrolimus, beta-blockers, sulfamethoxazole/trimethoprim, azole antifungals) (Ref)

• Concurrent use of potassium-sparing diuretics, potassium supplements, and/or potassium-containing salt substitutes (Ref)

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Incidences occurred with hypertensive patients unless otherwise specified.

1% to 10%:

Cardiovascular: Edema (<2%), hypotension (type 2 diabetic nephropathy: ≥4%), orthostatic hypotension (type 2 diabetic nephropathy: ≥4%), palpitations (<2%), syncope (<2%)

Dermatologic: Pruritus (<2%), skin photosensitivity (<2%), skin rash (<2%), urticaria (<2%)

Endocrine & metabolic: Hyperkalemia (type 2 diabetic nephropathy: ≥4%; incidence varies in literature and may be impacted by comorbidities) (Desai 2007; Weir 2010; Yusuf 2008), hypoglycemia (type 2 diabetic nephropathy: ≥4%)

Gastrointestinal: Abdominal pain (<2%), diarrhea (type 2 diabetic nephropathy: ≥4%), nausea (<2%), vomiting (<2%)

Genitourinary: Urinary tract infection (type 2 diabetic nephropathy: ≥4%)

Hematologic & oncologic: Anemia (type 2 diabetic nephropathy: ≥4%; hypertension: <2%)

Nervous system: Depression (<2%), dizziness (3%), drowsiness (<2%), fatigue (type 2 diabetic nephropathy: ≥4%), paresthesia (<2%), sleep disorder (<2%), vertigo (<2%)

Neuromuscular & skeletal: Arthralgia (<2%), asthenia (type 2 diabetic nephropathy: ≥4%), back pain (hypertension and type 2 diabetic neuropathy: 2% to ≥4%), myalgia (<2%)

Otic: Tinnitus (<2%)

Respiratory: Cough (ARBs: 3%) (Matchar 2008), dyspnea (<2%), nasal congestion (2%), upper respiratory tract infection (8%)

Postmarketing:

Cardiovascular: Facial edema (van Rijnsoever 1998), lip edema (Cha 1999; Kazim 2010), vasculitis (Shalavadi 2015)

Endocrine & metabolic: Hyponatremia (Das 2015)

Gastrointestinal: Dysgeusia (Heeringa 1998; Malnick 1999)

Hematologic & oncologic: Henoch-Schonlein purpura (Bosch 1998; Brouard 2001), thrombocytopenia (Ada 2002; Patel 2013)

Hepatic: Hepatitis (Al-Halawani 2014)

Hypersensitivity: Anaphylaxis (Kazim 2010), angioedema (Cha 1999; Rivera 1999)

Respiratory: Laryngeal edema (Rivera 1999)

Contraindications

Hypersensitivity to losartan or any component of the formulation; concomitant use with aliskiren in patients with diabetes mellitus.

Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Canadian labeling: Additional contraindications (not in US labeling): Concomitant use with aliskiren in patients with moderate to severe kidney impairment (GFR <60 mL/minute/1.73 m2).

Warnings/Precautions

Concerns related to adverse effects:

• Angioedema: Angiotensin II receptor antagonists (ARBs) do not appear to elevate the risk of angioedema (Rasmussen 2019; Toh 2012). Patients with a history of angioedema due to an angiotensin-converting enzyme inhibitor must be educated that sometimes there can be recurrence within months following discontinuation (Beltrami 2011). No matter the cause of angioedema, prolonged frequent monitoring is required, especially if tongue, glottis, or larynx are involved, as they are associated with airway obstruction. Discontinue therapy immediately if angioedema occurs. Aggressive early management is critical. IM administration of epinephrine may be necessary. Do not readminister the ARB to patients who experience angioedema from this medication.

• Hypotension: Symptomatic hypotension may occur upon initiation in patients who are salt or volume depleted (eg, those treated with high-dose diuretics); correct volume depletion prior to administration. This transient hypotensive response is not a contraindication to further treatment with losartan.

Disease-related concerns:

• Aortic/mitral stenosis: Use with caution in patients with significant aortic/mitral stenosis.

• Ascites: Generally, avoid use in patients with ascites due to cirrhosis or refractory ascites; if use cannot be avoided in patients with ascites due to cirrhosis, monitor BP and kidney function carefully to avoid rapid development of kidney failure (AASLD [Runyon 2013]).

• Hepatic impairment: Use with caution in patients with hepatic impairment or a history of hepatic impairment; dose adjustment needed.

• Kidney impairment: Use with caution with preexisting kidney insufficiency.

Special populations:

• Race/ethnicity: In Black patients, the BP-lowering effects of ARBs may be less pronounced. The exact mechanism is not known; differences in the renin-angiotensin-aldosterone system, low renin levels, and salt sensitivity more commonly found in Black patients may contribute (Brewster 2013; Helmer 2018; manufacturer’s labeling).

• Surgical patients: In patients on chronic ARB therapy, intraoperative hypotension may occur with induction and maintenance of general anesthesia; however, discontinuation of therapy prior to surgery is controversial. If continued preoperatively, avoidance of hypotensive agents during surgery is prudent (Hillis 2011). Based on current research and clinical guidelines in patients undergoing noncardiac surgery, continuing ARB is reasonable in the perioperative period. If ARBs are held before surgery, it is reasonable to restart postoperatively as soon as clinically feasible (ACC/AHA [Fleisher 2014]).

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Tablet, Oral, as potassium:

Cozaar: 25 mg

Cozaar: 50 mg [scored]

Cozaar: 100 mg

Generic: 25 mg, 50 mg, 100 mg

Generic Equivalent Available: US

Yes

Pricing: US

Tablets (Cozaar Oral)

25 mg (per each): $3.82

50 mg (per each): $5.12

100 mg (per each): $6.98

Tablets (Losartan Potassium Oral)

25 mg (per each): $0.16 - $3.08

50 mg (per each): $0.17 - $2.27

100 mg (per each): $0.19 - $3.10

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Tablet, Oral, as potassium:

Cozaar: 25 mg, 50 mg, 100 mg [contains corn starch]

Generic: 25 mg, 50 mg, 100 mg

Administration: Adult

Oral: Administer without regard to meals; however, administer consistently with respect to food intake at about the same time every day.

Administration: Pediatric

Oral: May be administered with or without food.

Use: Labeled Indications

Hypertension, chronic: Management of hypertension in adults and children ≥6 years of age.

Proteinuric chronic kidney disease, diabetic: Treatment of diabetic nephropathy with an elevated serum creatinine and proteinuria (urinary albumin to creatinine ratio ≥300 mg/g) in patients with type 2 diabetes and a history of hypertension.

Use: Off-Label: Adult

Heart failure with reduced ejection fraction; Marfan syndrome with aortic aneurysm; Non-ST-elevation acute coronary syndrome; Posttransplant erythrocytosis (kidney transplant recipients); Proteinuric chronic kidney disease, nondiabetic; ST-elevation myocardial infarction

Medication Safety Issues
Sound-alike/look-alike issues:

Cozaar may be confused with Colace, Coreg, Hyzaar, Zocor

Losartan may be confused with lorcaserin, valsartan

Metabolism/Transport Effects

Substrate of CYP2C9 (major), CYP3A4 (minor); Note: Assignment of Major/Minor substrate status based on clinically relevant drug interaction potential

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

Alfuzosin: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Aliskiren: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Aliskiren may enhance the hypotensive effect of Angiotensin II Receptor Blockers. Aliskiren may enhance the nephrotoxic effect of Angiotensin II Receptor Blockers. Management: Aliskiren use with ACEIs or ARBs in patients with diabetes is contraindicated. Combined use in other patients should be avoided, particularly when CrCl is less than 60 mL/min. If combined, monitor potassium, creatinine, and blood pressure closely. Risk D: Consider therapy modification

Amifostine: Blood Pressure Lowering Agents may enhance the hypotensive effect of Amifostine. Management: When used at chemotherapy doses, hold blood pressure lowering medications for 24 hours before amifostine administration. If blood pressure lowering therapy cannot be held, do not administer amifostine. Use caution with radiotherapy doses of amifostine. Risk D: Consider therapy modification

Amphetamines: May diminish the antihypertensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Angiotensin II: Receptor Blockers may diminish the therapeutic effect of Angiotensin II. Risk C: Monitor therapy

Angiotensin-Converting Enzyme Inhibitors: Angiotensin II Receptor Blockers may enhance the adverse/toxic effect of Angiotensin-Converting Enzyme Inhibitors. Angiotensin II Receptor Blockers may increase the serum concentration of Angiotensin-Converting Enzyme Inhibitors. Management: Use of telmisartan and ramipril is not recommended. It is not clear if any other combination of an ACE inhibitor and an ARB would be any safer. Consider alternatives when possible. Monitor blood pressure, renal function, and potassium if combined. Risk D: Consider therapy modification

Antihepaciviral Combination Products: May increase the serum concentration of Losartan. Management: Consider decreasing the losartan dose and monitoring for evidence of hypotension and worsening renal function if these agents are used in combination. Risk D: Consider therapy modification

Antipsychotic Agents (Second Generation [Atypical]): Blood Pressure Lowering Agents may enhance the hypotensive effect of Antipsychotic Agents (Second Generation [Atypical]). Risk C: Monitor therapy

Arginine: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Barbiturates: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Benperidol: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Berberine-Containing Products: May enhance the hypotensive effect of Losartan. Berberine-Containing Products may increase the serum concentration of Losartan. Risk C: Monitor therapy

Brigatinib: May diminish the antihypertensive effect of Antihypertensive Agents. Brigatinib may enhance the bradycardic effect of Antihypertensive Agents. Risk C: Monitor therapy

Brimonidine (Topical): May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Bromperidol: May diminish the hypotensive effect of Blood Pressure Lowering Agents. Blood Pressure Lowering Agents may enhance the hypotensive effect of Bromperidol. Risk X: Avoid combination

CYP2C9 Inhibitors (Moderate): May decrease serum concentrations of the active metabolite(s) of Losartan. CYP2C9 Inhibitors (Moderate) may increase the serum concentration of Losartan. Risk C: Monitor therapy

Dapoxetine: May enhance the orthostatic hypotensive effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Dexmethylphenidate: May diminish the therapeutic effect of Antihypertensive Agents. Risk C: Monitor therapy

Diazoxide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Drospirenone-Containing Products: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

DULoxetine: Blood Pressure Lowering Agents may enhance the hypotensive effect of DULoxetine. Risk C: Monitor therapy

Eplerenone: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Finerenone: Angiotensin II Receptor Blockers may enhance the hyperkalemic effect of Finerenone. Risk C: Monitor therapy

Flunarizine: May enhance the therapeutic effect of Antihypertensive Agents. Risk C: Monitor therapy

Heparin: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Heparins (Low Molecular Weight): May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Herbal Products with Blood Pressure Increasing Effects: May diminish the antihypertensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Herbal Products with Blood Pressure Lowering Effects: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Hypotension-Associated Agents: Blood Pressure Lowering Agents may enhance the hypotensive effect of Hypotension-Associated Agents. Risk C: Monitor therapy

Indoramin: May enhance the hypotensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Levodopa-Foslevodopa: Blood Pressure Lowering Agents may enhance the hypotensive effect of Levodopa-Foslevodopa. Risk C: Monitor therapy

Lithium: Angiotensin II Receptor Blockers may increase the serum concentration of Lithium. Management: Initiate lithium at lower doses in patients receiving an angiotensin II receptor blocker (ARB). Consider lithium dose reductions in patients stable on lithium therapy who are initiating an ARB. Monitor lithium concentrations closely when combined. Risk D: Consider therapy modification

Loop Diuretics: May enhance the hypotensive effect of Angiotensin II Receptor Blockers. Loop Diuretics may enhance the nephrotoxic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Lormetazepam: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Lumacaftor and Ivacaftor: May decrease the serum concentration of CYP2C9 Substrates (High Risk with Inhibitors or Inducers). Lumacaftor and Ivacaftor may increase the serum concentration of CYP2C9 Substrates (High Risk with Inhibitors or Inducers). Risk C: Monitor therapy

Methylphenidate: May diminish the antihypertensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Molsidomine: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Naftopidil: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Nicergoline: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Nicorandil: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Nicorandil: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Nitroprusside: Blood Pressure Lowering Agents may enhance the hypotensive effect of Nitroprusside. Risk C: Monitor therapy

Nonsteroidal Anti-Inflammatory Agents: Angiotensin II Receptor Blockers may enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents. Specifically, the combination may result in a significant decrease in renal function. Nonsteroidal Anti-Inflammatory Agents may diminish the therapeutic effect of Angiotensin II Receptor Blockers. The combination of these two agents may also significantly decrease glomerular filtration and renal function. Risk C: Monitor therapy

Nonsteroidal Anti-Inflammatory Agents (Topical): May diminish the therapeutic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Obinutuzumab: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Management: Consider temporarily withholding blood pressure lowering medications beginning 12 hours prior to obinutuzumab infusion and continuing until 1 hour after the end of the infusion. Risk D: Consider therapy modification

Pentoxifylline: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Pholcodine: Blood Pressure Lowering Agents may enhance the hypotensive effect of Pholcodine. Risk C: Monitor therapy

Phosphodiesterase 5 Inhibitors: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Polyethylene Glycol-Electrolyte Solution: Angiotensin II Receptor Blockers may enhance the nephrotoxic effect of Polyethylene Glycol-Electrolyte Solution. Risk C: Monitor therapy

Potassium Salts: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Potassium-Sparing Diuretics: Angiotensin II Receptor Blockers may enhance the hyperkalemic effect of Potassium-Sparing Diuretics. Risk C: Monitor therapy

Prazosin: Antihypertensive Agents may enhance the hypotensive effect of Prazosin. Risk C: Monitor therapy

Prostacyclin Analogues: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Quinagolide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Ranolazine: May enhance the adverse/toxic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Silodosin: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Sodium Phosphates: Angiotensin II Receptor Blockers may enhance the nephrotoxic effect of Sodium Phosphates. Specifically, the risk of acute phosphate nephropathy may be enhanced. Risk C: Monitor therapy

Sparsentan: May enhance the adverse/toxic effect of Angiotensin II Receptor Blockers. Risk X: Avoid combination

Tacrolimus (Systemic): Angiotensin II Receptor Blockers may enhance the hyperkalemic effect of Tacrolimus (Systemic). Risk C: Monitor therapy

Terazosin: Antihypertensive Agents may enhance the hypotensive effect of Terazosin. Risk C: Monitor therapy

Tolvaptan: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Trimethoprim: May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Urapidil: Antihypertensive Agents may enhance the hypotensive effect of Urapidil. Risk C: Monitor therapy

Reproductive Considerations

Avoid use of an angiotensin II receptor blocker (ARB) in patients who may become pregnant and who are not using effective contraception (ADA 2023).

Medications considered acceptable for the treatment of chronic hypertension during pregnancy may generally be used in patients trying to conceive. ARBs are fetotoxic. Transition patients prior to conception to an agent preferred for use during pregnancy unless treatment with an ARB is absolutely necessary (ACC/AHA [Whelton 2018]; ACOG 2019; NICE 2019).

When an ARB is used for the treatment of proteinuric chronic kidney disease in patients who could become pregnant, discontinue use at the first positive pregnancy test (ADA 2023; Fakhouri 2023)

Pregnancy Considerations

Drugs that act on the renin-angiotensin system can cause injury and death to the developing fetus. Exposure to an angiotensin II receptor blocker (ARB) during the first trimester of pregnancy may be associated with an increased risk of fetal malformations (ACOG 2019; ESC [Regitz-Zagrosek 2018]).Following exposure during the second or third trimesters, drugs that act on the renin-angiotensin system are associated with oligohydramnios. Oligohydramnios, due to decreased fetal kidney function, may lead to fetal lung hypoplasia and skeletal malformations. Oligohydramnios may not appear until after an irreversible fetal injury has occurred. ARB use during pregnancy is also associated with anuria, hypotension, kidney failure, skull hypoplasia, and death in the fetus/neonate. Monitor infants exposed to an ARB in utero for hyperkalemia, hypotension, and oliguria. Exchange transfusions or dialysis may be required to reverse hypotension or improve renal function.

Chronic maternal hypertension is also associated with adverse events in the fetus/infant. Chronic maternal hypertension may increase the risk of birth defects, low birth weight, premature delivery, stillbirth, and neonatal death. Actual fetal/neonatal risks may be related to the duration and severity of maternal hypertension. Untreated chronic hypertension may also increase the risks of adverse maternal outcomes, including gestational diabetes, preeclampsia, delivery complications, stroke, and myocardial infarction (ACOG 2019).

Discontinue ARBs as soon as possible once pregnancy is detected. Agents other than an ARB are recommended for the treatment of chronic hypertension during pregnancy (ACOG 2019; ESC [Cífková 2020]; ESC [Regitz-Zagrosek 2018]; SOGC [Magee 2022]). Closely monitor patients exposed to an ARB during pregnancy with serial ultrasounds.

ARBs are not recommended for the treatment of proteinuric chronic kidney disease during pregnancy (Fakhouri 2023).

Breastfeeding Considerations

It is not known if losartan is present in breast milk.

Due to the potential for serious adverse reactions in the breastfeeding infant, the manufacturer recommends a decision be made whether to discontinue breastfeeding or to discontinue the drug, considering the importance of treatment to the mother. When treatment for hypertension is needed in a breastfeeding patient, consider use of an agent other than an angiotensin II receptor blocker (ESC [Cífková 2020]; NICE 2019).

Dietary Considerations

Some products may contain potassium.

Monitoring Parameters

Blood pressure; serum electrolytes (eg, potassium [especially for patients taking concomitant potassium-sparing diuretics, potassium supplements, and/or potassium-containing salts]); serum creatinine; BUN.

Mechanism of Action

As a selective and competitive, nonpeptide angiotensin II receptor antagonist, losartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II; losartan interacts reversibly at the AT1 and AT2 receptors of many tissues and has slow dissociation kinetics; its affinity for the AT1 receptor is 1000 times greater than the AT2 receptor. Angiotensin II receptor antagonists may induce a more complete inhibition of the renin-angiotensin system than ACE inhibitors, they do not affect the response to bradykinin, and are less likely to be associated with nonrenin-angiotensin effects (eg, cough and angioedema). Losartan increases urinary flow rate and in addition to being natriuretic and kaliuretic, increases excretion of chloride, magnesium, uric acid, calcium, and phosphate.

Pharmacokinetics (Adult Data Unless Noted)

Note: No significant differences in pharmacokinetic parameters have been identified across studied pediatric age groups (6 to 16 years) and adult population.

Onset of action: ~6 hours

Absorption: Well absorbed; slowed with food

Distribution: Vd: Losartan: 34 L; E-3174 (active metabolite): 12 L

Protein binding, plasma: High, >98%; primarily to albumin

Metabolism: Hepatic (~14%) via CYP2C9 and 3A4 to active metabolite, E-3174 (10 to 40 times more potent than losartan); extensive first-pass effect

Bioavailability: ~33%; AUC of E-3174 (active metabolite) is 4 times greater than losartan; extemporaneously prepared suspension and tablet have similar bioavailability of losartan and E-3174

Half-life elimination:

Losartan: Children 6 to 16 years: 2.3 ± 0.8 hours; Adults: 2.1 ± 0.7 hours

E-3174 (active metabolite): Children 6 to 16 years: 5.6 ± 1.2 hours; Adults: 7.4 ± 2.4 hours

Time to peak, serum: Losartan: Children: 2 hours, Adults: 1 hour; E-3174 (active metabolite): Children: 4.1 hours, Adults: 3.5 hours

Excretion: Urine (35%; ~4% as unchanged drug, ~6% as E-3174 [active metabolite]); feces (~60% [oral])

Clearance: Adults:

Plasma: Losartan: 600 mL/minute; E-3174 (active metabolite): 50 mL/minute

Renal: Losartan: 75 L/minute; E-3174 (active metabolite): 25 mL/minute

Pharmacokinetics: Additional Considerations (Adult Data Unless Noted)

Altered kidney function: Plasma concentrations and AUC of losartan and its active metabolite are increased 50% to 90% and renal clearance reduced 55% to 85% in patients with mild (CrCl 50 to 74 mL/minute) and moderate (CrCl 30 to 49 mL/minute) kidney impairment.

Hepatic function impairment: Plasma concentrations of losartan are increased 5 times and active metabolite increased 1.7 times in patients with mild to moderate alcoholic cirrhosis. Total plasma clearance of losartan is reduced ~50% and oral bioavailability is about doubled.

Sex: Plasma losartan concentrations are about twice as high in hypertensive women as hypertensive men, but plasma concentrations of active metabolite are similar.

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AE) United Arab Emirates: Cozaar | Hetlosar | Locardia | Losargen | Losart | Lozap | Zargo;
  • (AR) Argentina: Antipresol | Besubial | Cartan | Casuar | Cozaarex | Enromic | Fabosic | Fada losartan | Fensartan | Fensartan cronos | Fiban | Fraban | Jesan | Klosartan | Loctenk | Loplac | Lorebil | Losacor | Losarlan | Losartan gen med | Losartan Hlb | Losartan labsa | Losartan nexo | Losartan northia | Losartan pfizer | Losartan potasico | Losartan puntanos | Losartan richet | Losartan vannier | Niten | Paxon | Paxon xr | Presimax | Presinor | Prisonil | Tacardia | Tarcane | Temisartan | Tenopres;
  • (AT) Austria: Cosaar | Losartan | Losartan +Pharma | Losartan Arcana | Losartan G.L. | Losartan krka | Losartan MSD | Losartan pfizer | Losartan stada | Losartan teva;
  • (AU) Australia: Cozaar | Cozavan;
  • (BD) Bangladesh: Acusan | Angilock | Anin | Anreb | Araten | Cardisan | Cardon | Cozaril | Etan | Larb | Lk | Lohyp | Lok | Lopo | Lopoten | Losa | Losacard | Losan | Losapot | Losar | Losarcar | Losardil | Losarpex | Losart | Losarva | Losatan | Losium | Lospil | Lospre | Lospri | Lotas | Nusartan | Osartan | Osartek | Osartil | Ostan | Parten | Pertilos | Precon | Preslo l | Prosan | Raklok | Renosart | Rosatan | Sarlo | Sb losak | Vasotan | Xelotan;
  • (BE) Belgium: Cozaar | Loortan | Losartan EG | Losartan krka | Losartan pfizer | Losartan potassium accord;
  • (BF) Burkina Faso: Angizaar | Emtan | Losagen | Losar | Losar denk | Medzar | Medzar fort | Prezar | Zyltan;
  • (BG) Bulgaria: Cozaar | Hypertonic | Lorista | Losartan | Losartan genericon | Lotar | Lozap | Rasoltan;
  • (BR) Brazil: Aradois | Arartan | Cardvita | Corus | Cozaar | Cytrana | Lanzacor | Lorsacor | Losacoron | Losaprin | Losartan potassico | Losartana potassica | Losartec | Losartion | Losatal | Lotanol | Redupress | Torlos | Valtrian | Zaarpress | Zart;
  • (CH) Switzerland: Cosaar | Cosaar forte | Cosaar submite | Losartan actavis | Losartan Axapharm | Losartan Helvepharm | Losartan mepha | Losartan sandoz | Losartan Spirig | Losartan spirig hc | Losartan Streuli | Losartan teva | Losartan zentiva | Losartax;
  • (CI) Côte d'Ivoire: Cozaar | Emtan | Losagen | Losar | Losar denk 100 | Losar denk 25 | Losar denk 50 | Medzarfort | Prezar | Zartan | Zartan fort | Zyltan;
  • (CL) Chile: Aratan | Corodin | Cozaar | Lopren | Losapres | Losarbon | Losartan | Sanipresin | Simperten | Valinor;
  • (CN) China: Bei yi | Cozaar;
  • (CO) Colombia: Ancor | Angiobloq | Aralox | Arapres | Arapres anzg | Artana | Convertal | Cotasar | Cozaar | Expopress | Karplan | L card | Lopren | Losakem | Losanorm | Losarbay | Losartan | Losartan denk | Losartan potasico | Lozarten | Medsart | Myotan | Sarmed | Satoren | Tensartan | Tensofar | Tensypres k;
  • (CZ) Czech Republic: Apo losartan | Arionex | Cozaar | Lakea | Lorista | Losartan | Losartan aurobindo | Losartan Bluefish | Losartan krka | Losartan Orion | Losartan stada | Losartan teva | Losartic | Lozap | Nopretens | Sangona | Sidok;
  • (DE) Germany: Cozaar | Lorzaar | Lorzaar protect | Losar Q | Losar Teva | Losargamma | Losartan 1A Pharma | Losartan aaa | Losartan AbZ | Losartan Acis | Losartan actavis | Losartan AL | Losartan Aristo | Losartan Atid | Losartan axiromed | Losartan Biomo | Losartan CT | Losartan Dura | Losartan Hennig | Losartan Heumann | Losartan Hexal | Losartan Hormosan | Losartan Kalium Axcount | Losartan kalium pfizer | Losartan kalium puren | Losartan kalium volkspharma | Losartan Ratiopharm | Losartan sandoz | Losartan stada | Losartan Steiner | Losartan Winthrop | Losartan-Kalium Axcount | Losartan-Kalium Basics | Losartan-Kalium Beta | Losartan-Kalium Bluefish | Losartan-Kalium Orifarm | Losartan-kalium TAD;
  • (DK) Denmark: Ancozan;
  • (DO) Dominican Republic: Accord | Angibloc | Avantar | Cardioram | Cardizaar | Covance | Cozaar | Doxalam | Eurolosart | Iberclofam | Klovat | Losacor | Losartan | Losartan Feltrex | Losartan Lam | Losartan MK | Losartan potasico | Losartan wemed | Losartas | Nefrotal | Paxon | Presidol | Presotan | Renotensyl | Rodicard | Satoren | Tamisen | Triatec | Valpresor;
  • (EC) Ecuador: Angiolow | Angioten | Arados | Cardiodan | Cardiostar 100 | Cardiostar 50 | Cardiovasc | Convertal | Corodin | Covance | Cozaar | Italsartan | Lodestar | Losarbon | Losartan | Losartan la sante | Losartan potasico | Lostab | Myocord | Nefrotal | Rasertan | Riocel | Satoren | Simperten | Soolan | Zart;
  • (EE) Estonia: Cozaar | Lorista | LOSARTAN ACCORD | Losartan actavis | Lozap;
  • (EG) Egypt: Amosar | Aratins | Cozaar | Kanzar | Losar | Losarmepha | Losartan | Lostapressin | Lozapress | Remtozar;
  • (ES) Spain: Cozaar | Cozaar inicio | Lavestra | Losartan | Losartan Acost | Losartan actavis | Losartan Almus | Losartan Alter | Losartan Asol | Losartan Bexal | Losartan Cinfa | Losartan Combix | Losartan Davur | Losartan Edigen | Losartan Kern Pharma | Losartan Korhispana | Losartan Lareq | Losartan mabo | Losartan Normon | Losartan Pensa | Losartan pharma combix | Losartan Pharmacia | Losartan Pharmagenus | Losartan ranbaxy | Losartan ratio | Losartan Ratiopharm | Losartan sandoz | Losartan Silanes | Losartan stada | Losartan Sumol | Losartan Tecnigen | Losartan teva | Losartan UR | Losartan Vir | Losartan Winthrop;
  • (ET) Ethiopia: Czartan | Losar denk 100 | Losar denk 25 | Losar denk 50 | Losarva | Losium | Zyltan;
  • (FI) Finland: Cozaar | Losafarm | Losarstad | Losartan actavis | Losartan agp | Losartan krka | Losartan orifarm | Losartan Orion | Losartan pfizer | Losartan ranbaxy | Losartan teva | Losatrix;
  • (FR) France: Cozaar | Losartan actavis | Losartan Almus | Losartan Alter | Losartan Arrow Generiques | Losartan Biogaran | Losartan Bouchara Recordati | Losartan Cristers | Losartan EG | Losartan Evolugen | Losartan intas | Losartan Isomed | Losartan krka | Losartan mylan | Losartan pfizer | Losartan phr lab | Losartan Qualimed | Losartan ranbaxy | Losartan Ratiopharm | Losartan sandoz | Losartan teva | Losartan Winthrop | Losartan Zydus;
  • (GB) United Kingdom: Cozaar | Losartan | Losartan potasssium | Zovencal;
  • (GH) Ghana: Lorpam;
  • (GR) Greece: Cozaar | Cozapert | Golasan | Hypozar | Loben | Lorfast | Lorotens | Losadrac | Losalet | Losarb | Lozanel | Lozatan | Lyosan | Mozartan | Ozarium | Press Down | Proelsartan | Rabolan | Rapifast;
  • (GT) Guatemala: Losarac;
  • (HK) Hong Kong: Apo losartan | Cozaar | Emlosar | Lopress | Lorista | Losacor | Losanorm | Losartan | Losartan stada | Losartan tiasar | Lostad T50 | Osartil | Vick Losartan | Zaart | Zyltan;
  • (HR) Croatia: Cozaar | Lakea | Lorista | Losartan genera | Losartic | Lotan | Lotar;
  • (HU) Hungary: Arbartan | Artager | Cozaar | Lavestra | Losartan 1 A Pharma | Losartan krka | Losartan Ratiopharm | Lozarep | Portiron | Prelow | Stadazar | Tervalon;
  • (ID) Indonesia: Acetensa | Angioten | Cozaar | Insaar | Koinsar | Lifezar | Losartan | Santesar | Sartaxal;
  • (IE) Ireland: Cosartal | Cozaar | Cozatan | Losartan | Losartan KRKA | Losartan rowa | Losartan teva | Lotanos | Lozitar | Myzaar | Solvatan;
  • (IL) Israel: Losardex | Losarta | Lotan | Ocsaar;
  • (IN) India: Alsar | Alsartan | Angilo | Angireb | Angizaar | Asart | Atzaar | Biosartan | Biozaar | Bp cure | Cardikare | Cosart | Covance | Cozar | Czar | Czartan | Giftan | Ht Norm | Icosar | Lanxes | Lara | Lartan | Lo | Loar | Lolek | Lopassium | Lopt | Lorsave | Losacar | Losagard | Losain | Losakind | Losalife | Losamax | Losan | Losanorm | Losar | Losaral | Losarmed | Losartas | Losasun | Losatec | Losatrust | Losavas | Loscom | Losfirst | Losgard | Losium | Lospot | Lostat | Lot | Lotace | Lotak | Lotas | Lotop | Lozitan | Ltk | Miotin | Myotan | Nusar | Nuzar | Omnitan | Pozaar | Presartan | Relate | Repace | Resilo | Revas | Rigard | Sarpot | Tozaar | Vazortan | Zaart | Zargo | Zarlo | Zilos | Zyltan;
  • (IQ) Iraq: L sartan | Losart;
  • (IS) Iceland: Lopress | Presmin;
  • (IT) Italy: Dalosar | Lastan | Lorista | Lortaan | Losahyp | Losaprex | Losartan Acv | Losartan AHCL | Losartan Almus | Losartan Ate | Losartan aurobindo | Losartan Doc | Losartan dr reddy's | Losartan EG | Losartan Ger | Losartan Myl | Losartan pfizer | Losartan Pns | Losartan Ran | Losartan Tecnigen | Losartan Tev | Losartan Wpi | Neo lotan | Precten;
  • (JO) Jordan: Azarten | Cozaar | Lacine | Losart;
  • (JP) Japan: Losartan k | Losartan K Nissin | Losartan potasium ffp | Losartan potassium jg | Losartan potassium teva | Nu lotan;
  • (KE) Kenya: Alsartan | Angilock | Angisartan | Angitan | Angizaar | Bepsar | Carditan | Cozaar | Dinlaar | Lorsa | Lortan | Losacar | Losagen | Losakind | Losangio | Losapress | Losar | Losar denk | Losartan | Losartas | Losatec | Lozart | Normopress | Nusar | Presartan | Prosan | Repace | Reten | Sartilos | Tozaar | Xartan | Zaart | Zyltan;
  • (KR) Korea, Republic of: Arb | Arbitan | Aukostan | Azertan | Bearotan | Br sartan | Caroza | Casatan | Celsartan | Ceroz | Cezar | Cmg Losartan | Colosa | Coroza | Cortan da | Cosal | Cosaltan | Cosarotan | Cosartan | Cosca | Cozaar | Cozahu | Cozaril | Cozarotan | Cozarsaltan | Cozartan | Cozasartan | Cozatan | Elsartan | Elzatan | Frosatan | Hanlim losartan | Huniz losartan potassium | Hysaltan | Ilyangbio losartan potassium | Inno.n losartan | Jw lozaltan | Kosartan | Kozanew | Ksaltan | Kuhnil losartan potassium | Kukje losartan | L sartan | Local | Locatan | Loders | Loiza | Losa K | Losacatan | Losaco | Losain | Losal | Losamax | Losapa | Losar | Losar v | Losargen | Losaridon | Losarmax | Losarpin | Losartal | Losartam | Losartan | Losartan cj | Losartan Han All | Losartin | Losastar | Losat | Losata | Losatal | Losatam | Losatan | Losatan i | Losatin | Losato | Lositan | Lositen | Lotan | Lotazin | Lotein | Lozacal | Lozarsin | Lozasartan | Lozata | Lozatal | Lozet | Loziten | Luzatan | Medilosa | Mothers Rosa | New losar | Newcosar | Newrosar | Newrosatan | Nurotan | Osartan | Rocatan | Rocotan | Rosa | Rosabel | Rosain | Rosarin | Rosarzen | Rosat | Rosawin | Roza | Rozentan | Rp losa | Salotan | Salotin | Sarlotan | Sezar | Simsatan | Taiguk losartan | Vicoza | Wonsartan | Zaratan | Zarotan | Zartan | Zerosaltan | Zerosartan;
  • (KW) Kuwait: Cozaar | Losart | Sartan | Sortiva;
  • (LB) Lebanon: Cozaar | Lacine | Losanet | Losart | Losartan | Losartan Biogaran;
  • (LT) Lithuania: Covance | Cozaar | Lorista | Losacor | Losartan Ingen Pharma | Losartan krka | Lozap | Sartens | Tarnasol;
  • (LU) Luxembourg: Cozaar | Loortan | Losartan EG | Losartan Ratiopharm;
  • (LV) Latvia: Covance | Cozaar | Lorista | LOSARTAN ACCORD | Lozap | Sartens;
  • (MA) Morocco: Acard | Ancine | Anginib | Aratens | Avazar | Cozaar | Lacine | Losartan Gt | Medzar | Prezar | Rosar | Tanzaar | Vizartan;
  • (MX) Mexico: Accolok | Alderan | Ara 2 | Athakare | Bicardren | Bimidal | Cimaher | Colibs | Conciluk | Corperia | Cozaar | Frensodol | Jomasar | Leny | Leverstat | Lodestar | Lopred | Losartan | Losartan genplus | Losartan landsteiner | Lospotar | Lozydel | Miniter | Plavisin | Punab | Ratnat | Saravanta | Sartadem | Staars | Takilpam | Targancil | Tasico | Viopexa;
  • (MY) Malaysia: Covance | Cozaar | Lorista | Losacar | Losagen | Losartan | Losartan stada | Losartas | Presartan | Rasoltan | Rosal | Rosart | Saranto | Tanzaril | Tosan | Tozaar | Zosaar | Zylovaa | Zyltan;
  • (NG) Nigeria: Arbitense | Bloctran | Hetlosar | Loryza | Losakind | Losarmax 50 | Losartan | Losartan makinga | Losrtec | Lotan | Meem losartan | Multichris losartan potassium | Myotan | Nusar | Ocepress | Rosart | Skg losartan | Xavor;
  • (NL) Netherlands: Cozaar | Entrizen | Kaliumlosartan | Kaliumlosartan Actavis | Kaliumlosartan ratiopharm | Kaliumlosartan Sandoz | Losanox | Losartan | Losartan Kalium Cf | Losartan Kalium Ranbaxy | Losartankalium | Losartankalium accord | Losartankalium Apotex | Losartankalium Aurobindo | Losartankalium Mylan | Losartankalium PCH | Losartankalium xiromed;
  • (NO) Norway: Cozaar | Cozaar start | Losartan krka | Losartan medic valley | Losartan orifarm | Losartan teva;
  • (NZ) New Zealand: Cozaar | Losartan actavis | Lostaar;
  • (PE) Peru: Angizaar | Aratan | Artan | Artanbix | Camir | Cardiovital | Cormac | Corodin | Covance | Cozaar | Czartan | Hyperan | Locarmec | Lortan | Losacor | Losadel | Losapresan | Losarbon | Losaren | Losarquilab | Losartan | Losartan potasico | Nusar | Pressaliv | Resilo | Rifex | Simperten;
  • (PH) Philippines: A.R.A | Actizar | Angel 50 | Angioten | Angisartan | Anin | Anzar | Arbloc | Artal | Baczartan | Bepsar | Besartan | Cardizar | Congezar | Cotenace | Cozaar | Doxar | Dylaran | Ecozar | Ekosart | Eseflah | Ezartan | Getzar | Gosartan | Hartzar | Hextan | Hylos | Hypertan | Hyperthree | Jensar | Kardiostan | Kenzar | Ksart | Lanzaar | Lifezar | Lipewin | Lobip | Lortan | Losaar | Losacar | Losagan | Losakind | Losangio | Losar | Losarcure | Losargard | Losark | Losarniel | Losart | Losartan | Losartan Winthrop | Losavas | Losium | Lostar | Lozaar | Lozart | Medzart | Moxifast | Myotan | Mysartan | Myzar | Natrasol | Natrazol | Neosartan | Nipartan | Normoten | Parten | Pharex Losartan | Presartan | Prestan | Prolostan | Provizar | Prozar | Q pid | Quezar | Ritemed Losartan | Saranto | Sartan | Scilosar | Sydentan | Torlos | Vamzar | Vivasartan | Xartan | Zaran | Zarnat | Zarphil | Zarpose | Zartan s | Zarten | Zeftan | Zilzart;
  • (PK) Pakistan: A2a | Aceartin | Acozar | Actilop | Actitar | Bepsar | Blaze | Co actitar | Corik | Corus | Coryton | Cozaar | Eziday | Giozar | Kosart | Kulb | Larsen | Lastron | Locor | Lopec | Losaan | Losafast | Losar-k | Losartan | Losartec | Losartin | Losascot | Losaten | Losium | Lostress | Lot | Lotansin | Lotar | Lotense | Lozarta | Lozatin | Loze | Megasar | Normopress | Osran | Sar-k | Sarcol | Sartan | Stumpan | Tansin | Teslo | Traslo | Vezaar | Welsar k | Xavor | Xeta | Zonate | Zosartan-k | Zostat;
  • (PL) Poland: Apo Lozart | Cozaar | Lakea | Loreblok | Lorista | Losacor | Losagen | Losargamma | Losartan arrow | Losartan Bluefish | Losartan genoptim | Losartan krka | Losartan pfizer | Losartan Ratiopharm | Losartanum 123ratio | Losartic | Lozap | Presartan | Rasoltan | Sortabax | Stadazar | Xartan | Zeprez;
  • (PR) Puerto Rico: Cozaar;
  • (PT) Portugal: Aratis Farbio | Cozaar | Decara | Lortaan | Losartan | Losartan Almus | Losartan aurobindo | Losartan aurovitas | Losartan Azevedos | Losartan bluepharma | Losartan daquimed | Losartan mepha | Losartan mylan | Losartan tecnimede | Losartan Wynn;
  • (PY) Paraguay: Accord | Convertal | Coronovo | Disgrenol | Fabosic | Gadotensil | Hecordil | Hiperaltam | Hipercor | Latral | Losartan bioethic pharma | Losartan millet | Losartan nl pharma | Lozax | Rhytmus | Simperten | Temlosal | Tensofar;
  • (QA) Qatar: Cozaar | Lacine | Losanet | Losart | Sartan | Sortiva | Sortiva Forte;
  • (RO) Romania: Cozaar | Lorista | Lozap | Talosan;
  • (RU) Russian Federation: Bloctran | Bloktran | Brozaar | Cardomin sanovel | Cozaar | Karsartan | Lakea | Lorista | Losacor | Losap | Losarel | Losartan | Losartan akrikhin | Losartan canon | Losartan macleods | Losartan richter | Losartan teva | Lotor | Lozap | Presartan | Renicard | Vasotens | Vazotenz | Vero losartanum | Zysacar;
  • (SA) Saudi Arabia: Apo losartan | Azar | Cozaar | Lacine | Pms losartan | Sartan | Sortiva | Stravis;
  • (SE) Sweden: Cozaar | Klomentan | Losarstad | Losartan actavis | Losartan agp | Losartan aurobindo | Losartan Bluefish | Losartan jubilant | Losartan krka | Losartan mylan | Losartan orifarm | Losartan pfizer | Losartan sandoz | Losartan teva | Losatrix | Lostankal;
  • (SG) Singapore: Angizaar | Cozaar | Losagen | Losartan | Losartan Hexal | Losartas | Lozarsin fc | Rosart | Sartocad;
  • (SI) Slovenia: Cozaar | Lorista | Losartan Alkaloid | Losartan mylan | Losartic | Lotar | Rasoltan;
  • (SK) Slovakia: Asortek | Cozaar | Lakea | Lorista | Losartan Bluefish | Losartan krka | Losartan Orion | Losartan stada | Losartan teva | Losartan zentiva | Lozap;
  • (TH) Thailand: Cozaar | Lanzaar | Loranta | Losacar | Losartan | Tanzaril | Tosan;
  • (TN) Tunisia: Cozaar | Losar | Losartan Winthrop | Medzar | Zartan;
  • (TR) Turkey: Cozaar | Eklips | Felow | Hilos | Losartil | Loxibin | Pensartan | Sarilen | Sarvas;
  • (TW) Taiwan: Cosar fc | Coxco | Cozaar | Depressor | Hetlosar | Kinzaar | Losacar | Losapin | Losart | Losartan | Losartan cyh | Losartan teva | Losater | Losenta | Lostan | Lowtan | Lowten | Sluxdin | Zosaa | Zosatan;
  • (UA) Ukraine: Angizaar | Brozaar | Cardomin | Cozaar | Erinorm | Hyperzar | Klosart | Lorista | Losakar | Losar | Losartan | Losartan sandoz | Losartan teva | Losartin | Lotar | Lozap | Lozar | Presartan | Sentor;
  • (UG) Uganda: Angizaar | Losaberg | Losacar | Losagen | Losar denk 100 | Losar denk 50 | Losartas | Losium | Presartan | Sartan | Tozaar | Vazortan;
  • (UY) Uruguay: Angiopal | Cartan | Convertal | Losartan potasico | Losartan potasico opko | Loxar | Ras | Regulapres | Tensilar;
  • (VE) Venezuela, Bolivarian Republic of: Alvotinox | Angilock | Biortan | Biosartan | Cormac | Cozaar | Leny | Losarlab p | Losartan | Losartan potasico | Losartana potassica | Losartol | Losawell | Nefrotal | Ofapres | Presartan | Redyscar | Sortal | Sutralar | Tenserpil;
  • (VN) Viet Nam: Fatedia | Lostad t100 | Nerazzu | Nonanti | Sartanpo | Savi losartan;
  • (ZA) South Africa: Auro losartan | Austell Losartan | Cipla Losartan | Ciplazar | Cozaar | Hytenza | Los-arb | LOSARTAN ACCORD | Losartan biotech | Losartan macleods | Losartan unicorn | Lozaan | Normoten | Renicard | Spec Losartan | Zaario | Zartan;
  • (ZM) Zambia: Losa | Losakind | Losar | Losar denk 100 | Losar denk 25 | Losar denk 50 | Nusar | Presartan | Tozaar | Vazortan | Zyltan;
  • (ZW) Zimbabwe: Losagen | Losar | Losartas | Presartan | Tozaar 50
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