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Losartan selectively blocks the AT 1 receptorIn vitro and in vivo losartan and its pharmacologically active carboxylic acid metabolite E-3174 block all physiologically relevant actions of angiotensin IIregardless of the source or route of its synthesis.
Epidemiological evidence regarding the risk of teratogenicity following exposure to ACE inhibitors during the first trimester of pregnancy has not been conclusivehowever a small increase in risk cannot be excludedWhilst there is no controlled epidemiological data on the risk with Angiotensin II Receptor InhibitorsAIIRAssimilar risks may exist for this class of medicinal productsUnless continued AIIRA therapy is considered essentialpatients planning pregnancy should be changed to alternative anti-hypertensive treatments which have an established safety profile for use in pregnancyWhen pregnancy is diagnosedtreatment with losartan should be stopped immediately andif appropriatealternative therapy should be started.
In patients with mild to moderate alcohol-induced hepatic cirrhosisthe plasma levels of losartan and its active metabolite after oral administration were respectively 5 and 1.7 times higher than in young male volunteerssee section 4.2 and 4.4
Pharmacotherapeutic groupAngiotensin II antagonistsplainATC codeC09CA01.
Control of high blood pressure should be part of comprehensive cardiovascular risk managementincludingas appropriatelipid controldiabetes managementantithrombotic therapysmoking cessationexerciseand limited sodium intakeMany patients will require more than 1 drug to achieve blood pressure goalsFor specific advice on goals and managementsee published guidelinessuch as those of the National High Blood Pressure Education Program’s Joint National Committee on PreventionDetectionEvaluationand Treatment of High Blood PressureJNC
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