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- Product ID: Losartan Potassium
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Acuten 30mg Tablet — Losartan Potassium
Generic Name: Losartan Potassium 30mg
Manufacturer: Beximco Pharmaceuticals Ltd.
Drug Class: Angiotensin II Receptor Blocker (ARB) — Antihypertensive / Renoprotective
Dosage Form: Tablet
Prescription Status: Prescription Only (Rx)
Mechanism of Action
Losartan is the first orally active angiotensin II receptor blocker (ARB). It selectively blocks the angiotensin II type 1 (AT1) receptor, preventing angiotensin II from causing vasoconstriction, aldosterone secretion, and sodium retention. This reduces peripheral vascular resistance and blood pressure without affecting heart rate. Losartan is converted in the liver to its active metabolite EXP3174, which is approximately 10–40 times more potent and has a longer duration of action.
Relevance to diabetes: The RENAAL trial (2001) demonstrated that losartan 50–100mg reduces the risk of doubling serum creatinine, end-stage renal disease (ESRD), and death in patients with Type 2 Diabetes and nephropathy, independent of its blood pressure-lowering effect — establishing ARBs as first-line reno-protective therapy in diabetic nephropathy.
Indications
- Hypertension — monotherapy or combination with other antihypertensives
- Diabetic nephropathy with hypertension in Type 2 DM — reduces progression to ESRD (RENAAL trial)
- Reduction of cardiovascular morbidity and mortality in hypertensive patients with left ventricular hypertrophy (LIFE trial)
- Heart failure — when ACE inhibitors are not tolerated
Dosage and Administration
| Indication | Dose | Notes |
|---|---|---|
| Hypertension (starting) | 25–50mg once daily | 30mg suited for patients needing intermediate starting dose |
| Hypertension (maintenance) | 50–100mg once daily | Titrate after 3–4 weeks based on BP response |
| Diabetic nephropathy | 50mg once daily → increase to 100mg | Based on blood pressure tolerance |
| Volume depletion / Liver disease | 25mg once daily to start | Monitor closely for hypotension |
Take at the same time each day. May be taken with or without food. Maximum effect at 3–6 weeks of therapy.
Blood Pressure Targets in Diabetes
| Patient Group | Target BP | Notes |
|---|---|---|
| T2DM + Hypertension | <130/80 mmHg | ARB first-line; add CCB or diuretic if needed |
| Diabetic nephropathy | <130/80 mmHg | Losartan 50–100mg proven renoprotective (RENAAL) |
| Elderly (>65 years) | <140/90 mmHg | Individualise — avoid symptomatic hypotension |
Black Box Warning — Foetal Toxicity
Contraindicated in pregnancy. Losartan, like all ARBs acting on the renin-angiotensin system, can cause foetal injury or death when used in the 2nd or 3rd trimester (foetal renal dysfunction, oligohydramnios, neonatal renal failure, skull hypoplasia). Discontinue immediately when pregnancy is detected. Women of childbearing potential should use effective contraception.
Contraindications
- Pregnancy (all trimesters)
- Hypersensitivity to losartan or any ARB
- Concurrent use with ACE inhibitors or aliskiren (dual RAAS blockade)
- Aliskiren in patients with diabetes or eGFR <60 ml/min/1.73m²
Drug Interactions
| Drug / Class | Effect |
|---|---|
| ACE inhibitors / Aliskiren | Avoid — hypotension, hyperkalaemia, acute kidney injury |
| Potassium-sparing diuretics / K+ supplements | Hyperkalaemia — monitor potassium |
| NSAIDs (including COX-2 inhibitors) | Reduced antihypertensive effect; acute renal failure risk |
| Fluconazole (CYP2C9 inhibitor) | Reduces conversion to active EXP3174 — possible reduced efficacy |
| Rifampicin (CYP inducer) | Reduces losartan levels — reduced BP control |
| Lithium | ARBs increase lithium levels — toxicity risk |
Side Effects
| System | Side Effects |
|---|---|
| Cardiovascular | Dizziness, hypotension (especially first dose) |
| Renal | Serum creatinine rise (mild, acceptable), hyperkalaemia |
| Respiratory | Cough (much rarer than ACE inhibitors) |
| GI | Nausea, diarrhoea, abdominal pain (uncommon) |
| Metabolic | Mild uricosuric effect — slight uric acid reduction (unique among ARBs) |
Monitoring
- Blood pressure — at each clinic visit; home BP monitoring encouraged
- Serum potassium and creatinine — baseline, 2 weeks post-initiation, then annually
- Urine ACR — annually to monitor diabetic nephropathy progression
- Liver function — baseline in patients with hepatic impairment
Storage
Store below 30°C. Protect from moisture and direct sunlight. Keep out of reach of children.
Medical Disclaimer
The information provided here is for educational and informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Acuten (Losartan Potassium) must only be used under the supervision of a qualified physician. Strictly contraindicated in pregnancy. Regular monitoring of blood pressure, renal function, and serum potassium is essential. DiabetesStore.com.bd does not endorse self-medication.
