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Overview of Losartan
Losartan is a medication that belongs to a class of drugs known as angiotensin receptor blockers (ARBs). It is commonly used to treat high blood pressure (hypertension) and to protect the kidneys in patients with diabetes. Losartan works by blocking the action of angiotensin II, a hormone that constricts blood vessels and increases blood pressure. By blocking the effects of angiotensin II, losartan helps to relax and widen blood vessels, thus lowering blood pressure and improving blood flow.
Losartan is also effective in reducing the risk of stroke in patients with high blood pressure and left ventricular hypertrophy, a condition where the heart muscle thickens and strains the heart. It may also be prescribed to patients with heart failure to improve heart function and reduce symptoms.
Overall, losartan is a well-tolerated medication with few side effects. It is typically taken once daily and can be used alone or in combination with other blood pressure medications. As with any medication, it is important to follow your doctor’s instructions and report any side effects or concerns while taking losartan.
Mechanism of Action
Losartan is an angiotensin II receptor blocker (ARB) that works by blocking the action of angiotensin II, a hormone that causes blood vessels to constrict. By blocking the angiotensin II receptor, losartan helps relax and widen blood vessels, lowering blood pressure and improving blood flow.
Losartan also inhibits the release of aldosterone, a hormone that can increase blood pressure by causing the kidneys to retain sodium and water. By blocking aldosterone, losartan helps reduce sodium and water retention, further lowering blood pressure.
Overall, the mechanism of action of losartan helps to decrease blood pressure, improve blood flow, and reduce the strain on the heart, making it an effective treatment for hypertension and other cardiovascular conditions.
Pharmacokinetics
Losartan is rapidly absorbed after oral administration and undergoes extensive first-pass metabolism by the liver to form its active metabolite, E-3174. The bioavailability of losartan is about 33%, and the peak plasma concentration of the active metabolite is reached in about 1 hour.
Losartan is highly bound to plasma proteins (99%) and has a volume of distribution of about 34 liters. It is metabolized in the liver by CYP2C9 and CYP3A4 enzymes to produce the active metabolite, which has a longer half-life than the parent compound.
The elimination half-life of losartan is about 2 hours, while the half-life of its active metabolite is around 6-9 hours. Losartan and its metabolites are mainly excreted in the feces and urine, with about 35% of the dose eliminated in the urine and 60% in the feces.
Drug Interactions
Losartan interacts with a number of drugs and substances, including:
- Potassium-Sparing Diuretics: Concurrent use of losartan with potassium-sparing diuretics (e.g. spironolactone) may increase the risk of hyperkalemia.
- NSAIDs: Nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce the antihypertensive effects of losartan.
- Lithium: Losartan may increase lithium levels, leading to toxicity.
- Antidiabetic Drugs: Losartan may enhance the hypoglycemic effects of antidiabetic drugs.
- Cyclosporine: Combining losartan with cyclosporine may increase the risk of kidney problems.
It is important to inform your healthcare provider about all the medications, supplements, and herbal products you are taking before starting losartan to prevent any potential drug interactions.
Drug Interactions
Losartan, being an angiotensin II receptor antagonist, may interact with other drugs and substances, affecting its pharmacokinetics and pharmacodynamics. It is essential to consider these interactions to ensure the safe and effective use of Losartan.
1. Potassium-Sparing Diuretics:
Concomitant use of Losartan with potassium-sparing diuretics or potassium supplements may increase serum potassium levels, leading to hyperkalemia. Monitoring of potassium levels is recommended when using these agents together.
2. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs):
NSAIDs, such as ibuprofen or naproxen, may reduce the antihypertensive effects of Losartan. Additionally, NSAIDs can impair renal function and increase the risk of acute kidney injury when used with Losartan. Caution is advised when combining these medications.
Adverse Effects and Precautions
Losartan is generally well-tolerated, but like any medication, it may cause some adverse effects. Common side effects include dizziness, fatigue, and hyperkalemia. It is important to monitor potassium levels regularly, especially in patients with renal impairment.
Some rare but serious side effects of losartan may include angioedema, a severe allergic reaction that can cause swelling of the face, lips, throat, or tongue. Patients should seek immediate medical attention if they experience any signs of angioedema.
Losartan may also rarely cause liver problems, indicated by jaundice or dark urine. Patients should be advised to report any symptoms of liver dysfunction to their healthcare provider immediately.
It is important to note that losartan may interact with other medications, such as certain diuretics, leading to increased risk of adverse effects. Patients should inform their healthcare provider of all medications they are taking to avoid potential drug interactions.