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Home > Drug Category > Blood Pressure Medication (Angiotensin Receptor Blocker) > Cozaar and Equivalent

Cozaar (Losartan Potassium) Information

Cozaar, which contains the active ingredient losartan potassium, is an Angiotensin II Receptor Blocker (ARB). It is primarily indicated for the treatment of hypertension (high blood pressure), used either alone or in combination with other antihypertensive agents. Cozaar is also shown to reduce the risk of stroke in patients with hypertension and Left Ventricular Hypertrophy (LVH), and for the treatment of diabetic nephropathy (kidney disease) in patients with type 2 diabetes and hypertension, as it helps slow the progression of renal disease in this population. Losartan is administered orally, typically once or twice daily.

The mechanism of action for losartan involves blocking the potent vasoconstrictor hormone Angiotensin II. Angiotensin II causes narrowing of blood vessels (vasoconstriction) and stimulates the release of aldosterone, which causes the body to retain sodium and water. Losartan works by selectively blocking the binding of Angiotensin II to the AT1 receptor found in vascular smooth muscle, the kidney, and the adrenal glands. It is important to note that losartan is an active ARB, and its major active metabolite, a carboxylic acid derivative, contributes significantly to its blood pressure-lowering effect. By blocking the AT1 receptor, losartan promotes vasodilation (widening of blood vessels). It inhibits aldosterone secretion, resulting in sustained reductions in blood pressure and organ protection. Unlike ACE inhibitors, losartan has a very low incidence of cough.

Cozaar Side Effects

Cozaar is generally well tolerated, but side effects related to its impact on blood pressure and the renin-angiotensin system may occur. Common side effects often reported include dizziness, particularly when standing up quickly (postural dizziness), upper respiratory tract infection, nasal congestion, back pain, and fatigue.

However, more serious side effects can occur, leading to significant monitoring protocols. If any of the following symptoms are experienced, the patient should stop taking the medication and seek immediate medical attention:
• Angioedema: A rare but severe and potentially life-threatening swelling of the face, lips, tongue, or throat, which can impair breathing. This requires immediate emergency medical attention.
• Fetal Toxicity (Boxed Warning): Use during pregnancy is associated with significant harm to the developing fetus, including fetal death, hypotension, renal failure, and skull hypoplasia. The drug must be discontinued immediately upon confirmed pregnancy.
• Hyperkalemia (High Potassium): A significant elevation in serum potassium levels, especially in patients with heart failure, renal impairment, or those taking potassium-sparing diuretics, requires immediate management.
• Renal Impairment/Failure: In patients whose kidney function is dependent on the renin-angiotensin system (e.g., those with bilateral renal artery stenosis), losartan may cause acute kidney failure or worsening renal function.
• Symptomatic Hypotension: Excessive lowering of blood pressure, especially in patients who are volume-depleted (e.g., on high-dose diuretics), which may lead to fainting (syncope).

Cozaar Precautions

Due to the risk of fetal harm, Cozaar carries a Boxed Warning regarding use during pregnancy and must be discontinued as soon as pregnancy is detected. Women of childbearing age should be advised about the risks of use during pregnancy and discuss appropriate contraceptive use or alternative therapies if they are planning to become pregnant. It is contraindicated in patients with a known history of hypersensitivity to losartan or a history of angioedema related to previous ARB or ACE inhibitor therapy. Caution is advised when initiating therapy in volume-depleted patients (e.g., those on high-dose diuretics) or salt-depleted patients, as they are at a greater risk for symptomatic hypotension, which may require correction before starting the drug. The concurrent use of Cozaar with the drug aliskiren is contraindicated in patients with diabetes or moderate to severe renal impairment (GFR less than 60 millilitres per minute). Patients with heart failure, renal impairment, or bilateral renal artery stenosis require careful and frequent monitoring of serum creatinine and potassium levels while on ARBs.

Do I need a prescription to order Cozaar?

Yes, a prescription is required from your physician to order Cozaar.