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Cozaar is a specific angiotensin II receptor antagonist (type AT1). Does not suppress kininazu II - an enzyme that destroys bradykinin. Reduces the OPSD, reduces afterload, reduces systemic blood pressure. Reduces pressure in the pulmonary circulation.
- arterial hypertension;
- chronic ischemic heart disease, accompanied by symptoms of heart failure (as part of combination therapy with diuretics and cardiac glycosides).
1 tab. contains losartan potassium 50 mg.
Losartan is marketed under different brands and generic names, and comes in different dosage forms:
|Brand name||Manufacturer||Country||Dosage form|
|Cozaar||Merck Sharp & Dohme||USA||pills|
|Lorista||Krka dd Novo mesto AO||Slovenia||pills|
|Lorista||Krka dd Novo mesto AO||Russia||pills|
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Dosage and Administration
With hypertension, the average daily dose is 50 mg. The multiplicity of reception - 1 time / day. The maximum hypotensive effect develops 3-6 weeks after the start of the drug. If necessary, the daily dose of the drug can be increased to 100 mg.
Cardiovascular: during controlled clinical trials, dizziness was observed more often than with placebo; orthostatic reactions were also observed, depending on the dose of the drug.
From the laboratory indicators: when conducting controlled clinical trials, significant changes in standard laboratory parameters were rarely associated with Cozaar. Hyperkalemia was noted (serum potassium more than 5.5 meq / l) in 1.5% of patients, increased ALT levels.
Allergic reactions: angioedema (including swelling of the face, lips, throat and / or tongue), urticaria.
On the part of the digestive system: diarrhea.
From the side of the central nervous system: migraine.
Dermatological reactions: itching.
Other: renal dysfunction, myalgia.
In most cases, Cozaar is well tolerated, side effects are mild and transient, and do not require discontinuation of the drug. The cumulative incidence of cozar side effects is comparable to placebo.
- hypersensitivity to the drug.
No clinically significant interaction of Cozaar with other drugs was noted. Hydrochlorothiazide, digoxin, warfarin, cimetidine, phenobarbital, and ketoconazole have been used in pharmacokinetic clinical studies.
Pregnancy and Lactation
Data on the use of Cozaar during pregnancy is not. However, it is known that drugs acting directly on the renin-angiotensin system, when applied in the second and third trimesters of pregnancy, can cause a defect of development or even death of a developing fetus. Therefore, in the event of pregnancy, the administration of Kozar should be stopped immediately.
Experimental studies have shown that the drug causes developmental defects and leads to death of the fetus or newborn. It is believed that the mechanism of such exposure is a pharmacologically mediated effect on the renin-angiotensin system. Renal perfusion of the human fetus, depending on the development of the renin-angiotensin system, begins in the second trimester; the risk to the fetus increases if Cozaar is taken in the II or III trimester of pregnancy.
It is not known whether losartan is excreted in breast milk. When applying Cozaar during lactation, a decision should be made either to discontinue breastfeeding or to discontinue treatment with the drug, taking into account its importance to the mother.
In patients with dehydration (for example, receiving treatment with diuretics in high doses), symptomatic hypotension may occur at the beginning of Kozaar treatment. It is necessary to carry out the correction of dehydration before the appointment of Cozaar, or to begin treatment with the use of the drug at a lower dose.
Pharmacological data indicate that the concentration of losartan in the plasma of patients with cirrhosis of the liver increases significantly, so patients with a history of liver disease should use the drug in a lower dose.
Some drugs that affect the renin-angiotensin system may increase blood urea and serum creatinine in patients with bilateral renal stenosis or arterial stenosis of a single kidney. Angiotensin II receptor antagonists can potentially have a similar effect, although such data are currently not available.
Clinical studies did not reveal any differences in the safety and efficacy of Cozaar in elderly patients.
Overdose information is limited.The most likely symptoms of overdose are: marked reduction in blood pressure and tachycardia; bradycardia may occur due to parasympathetic stimulation.
Treatment: symptomatic therapy. Losartan and its active metabolite are not removed from the bloodstream during hemodialysis.
- Brand name: Cozaar
- Active ingredient: Losartan
- Dosage form: pills, coated.
- Manufacturer: Merck Sharp & Dohme
- Country of Origin: USA
- Toxicokinetic analysis of losartan during gestation and lactation in the rat
- Losartan therapy for Raynaud's phenomenon and scleroderma: Clinical and biochemical findings in a fifteen-week, randomized, parallel-group, controlled trial
- Comparative pharmacokinetics of two tablet formulations of Losartan: bioequivalence assessment
- Influence of Losartan, an angiotensin receptor antagonist, on neointimal proliferation in cultured human saphenous vein
- ChemInform Abstract: Preparation of a Key Intermediate for the Angiotensin II Antagonist Losartan via Vilsmeier Chloroformylation
- ChemInform Abstract: Phosphodiesterase Inhibitory Properties of Losartan. Design and Synthesis of New Lead Compounds.
- Trityl Losartan
- ChemInform Abstract: Molecular Sieves-Supported Palladium(I) Catalyst: Suzuki Coupling of Chloroarenes and an Easy Access to Useful Intermediates for the Synthesis of Irbesartan, Losartan and Boscalid.
- Effects of intracerebroventricular losartan on angiotensin II-mediated pressor responses and c-fos expression in near-term ovine fetus
- The effect of single oral low-dose losartan on posture-related sodium handling in post-TIPS ascites-free cirrhosis
- Rosiglitazone versus rosiglitazone and metformin versus rosiglitazone and losartan in the treatment of nonalcoholic steatohepatitis in humans: A 12-month randomized, prospective, open- label trial
- Effect of losartan, an Angiotensin II receptor antagonist, on portal pressure in cirrhosis
- Different protective actions of losartan and tempol on the renal inflammatory response to acute sodium overload
- [11C]Methyl-losartan as a potential ligand for PET imaging angiotensin II AT1 receptors
- Losartan reduces the onset of type 2 diabetes in hypertensive Japanese patients with chronic hepatitis C
- Rapid determination of losartan and losartan acid in human plasma by multiplexed LC–MS/MS
- A case of parkinsonism worsened by losartan: A probable new adverse effect
- Simultaneous determination of a novel angiotensin II receptor blocking agent, losartan, and its metabolite in human plasma and urine by high-performance liquid chromatography
- Enzyme-assisted synthesis and structure characterization of glucuronic acid conjugates of losartan, candesartan, and zolarsartan
- Stability study of losartan/hydrochlorothiazide tablets
- Supramolecular interactions between losartan and hydroxypropyl-β-CD: ESI mass-spectrometry, NMR techniques, phase solubility, isothermal titration calorimetry and anti-hypertensive studies
- Comparison of liquid chromatography, capillary electrophoresis and super-critical fluid chromatography in the determination of Losartan Potassium drug substance in Cozaar® tablets
- The thermodynamic dissociation constants of losartan, paracetamol, phenylephrine and quinine by the regression analysis of spectrophotometric data