Avoid use or use a much smaller dose in patients who are volume-depleted; correct depletion first.
Use with caution in patients with pre-existing renal insufficiency or significant aortic/mitral stenosis.
Use caution in patients with unilateral or bilateral renal artery stenosis to avoid a decrease in renal function.
AUCs of losartan (not the active metabolite) are about 50% greater in patients with Clcr <30 ml/minute and are doubled in hemodialysis patients.
When used to reduce the risk of stroke in patients with HTN and LVH, may not be effective in African-American population.
Use caution with hepatic dysfunction, dose adjustment may be needed.