Title:Losartan: A Pharmacotherapy in Cardiovascular Disease
Volume: 5
Author(s): Zahra Tolou Ghamari*
Affiliation:
- Deputy of Research and Technology, Nosocomial Research Center, Isfahan Alzahra Research Center, Isfahan University of Medical Sciences,
Isfahan, Iran
Keywords:
Losartan, Cardiovascular disease, Pharmacotherapy, Side-effects, Interactions, Renin-angiotensin system.
Abstract:
Background:
A recently published article confirmed that in 2019, around 523 million people suffered from cardiovascular disease (including 18.6 million
deaths) worldwide. Losartan, a drug, was patented 35 years ago and approved for medical use in the United States in 1995 (28 years ago). As an
effective treatment for hypertension, losartan blocks the interaction of angiotensin II with its receptor by inhibiting the renin-angiotensin system.
Objective:
This article aims to review the available literature and recent studies demonstrating the efficacy, safety, mechanism of action and drug-drug
interactions of losartan in cardiovascular disease.
Methods:
This is a focused literature review with the keywords relevant to the terms performed in PubMed, Scopus and Web of Science through May 28,
2023, according to the PRISMA guidelines. Based on the PICO standard format, fifty-two relevant in-depth consequent guide approaches and
evidence-based choices were selected associated with a knowledgeable collection of current, high-quality manuscripts.
Results:
After oral administration, time to reach maximum concentration is about 1-2 hours. With a 78% binding to protein, it has a bioavailability of
25-35%. Losartan is not removed by hemodialysis. For the full effect to occur, it may take up to 6 weeks. The drug is mainly prescribed for
patients with high blood pressure, diabetic nephropathy, hypertension and left ventricular hypertrophy. The publication reported higher drug
exposures and adverse reactions in women than men with antihypertensive medications. Losartan could improve changes in gut microbiota that
might be associated with hypertension. In the high-risk group of renal transplant recipients with arterial hypertension, research reported wellcontrolled
blood pressure with losartan monotherapy.
Conclusion:
In addition to the major losartan interactions with captopril, enalapril, lisinopril, and lithium, there are moderate interactions with aspirin,
pregabalin, alprazolam, amitriptyline, baclofen, betamethasone, buspirone. Muscle cramps, respiratory infection, cough, hyperkalemia, anemia and
stuffy nose are the main reported side effects. As polypharmacy could hide pharmacokinetics interaction due to cytochrome P450, therefore, the
combination of losartan with drugs such as phenobarbital, rifampin or fluconazole needs vigilant attention regarding therapeutic drug monitoring.