Losartan is indicated in the treatment of all grades of hypertension.
Dosage: The usual starting and maintenance dose is 50 mg once daily for most patients. The maximal antihypertensive effect is attained 3-6 weeks after initiation of therapy. Some patients may receive an additional benefit by increasing the dose to 100 mg once daily. In patients who are salt depleted corrective measures should be used before starting Losartan and the initial dose should be reduced to 25 mg. Losartan may be administered with other antihypertensive agents. Losartan may be administered with or without food.
No initial dosage adjustment is necessary in patients with mild renal impairment (CrCl 20-50 ml/min). For patients with moderate to severe renal impairment (CrCl < 20 ml/min) or patients on dialysis, a lower starting dose of 25 mg is recommended.
Use in elderly:
Patients up to 75 years: No initial dosage adjustment is necessary for this group of patients.
Patients over 75 years: A lower starting dose of 25 mg once daily is recommended.
Side effects: In controlled clinical trials in patients with essential hypertension, dizziness was the only side effect reported that occurred with an incidence greater than placebo in 1% or more of patients treated with Losartan. Rarely, rash was reported although the incidence in controlled clinical trials was less than placebo. Angioedema, involving swelling of the face, lips and/or tongue has been reported rarely in patients treated with Losartan. Serious hypotension (particularly on initiating treatment in salt-depleted patients) or renal failure (mainly in patients with renal artery stenosis) may be encountered during Losartan treatment.