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Losartan should not be prescribed simultaneously with potassium supplements, potassium-sparing diuretics (e.g. spironolactone, triamterene, amiloride) or salt substitutes containing potassium, in view of the risk of hyperkalemia.
No interactions are reported when losartan are co-administered with erythromycin, ketoconazole, phenobarbital, cimetidine, warfarin, digoxin, hydrochlorothiazide these interactions have not been found to be of any clinical significance.
Rifampin and fluconazole may inhibit the formation of the active metabolite of losartan. However, the clinical consequences of these interactions have not been evaluated.
Non-steroidal anti-inflammatory drugs (NSAIDs) including selective cyclooxygenase-2 inhibitors (cox-2 inhibitors) may blunt the hypotensive effects of losartan and it is better to avoid the concomitant use of both.
In some patients with compromised renal function who are being treated with non-steroidal anti-inflammatory drugs, including selective cyclooxygenase-2 inhibitors, the co-administration of angiotensin II receptor antagonists may result in a further deterioration of renal function. These effects are usually reversible.
As with other drugs which affect the excretion of sodium, lithium excretion may be reduced. Therefore, serum lithium levels should be monitored carefully if lithium salts are to be co-administered with angiotensin II receptor antagonists.
