Losacar 50 Special Precautions

Hypersensitivity: Angioedema (see Adverse Reactions).
Hypotension and Electrolyte/Fluid Imbalance: In patients who are intravascularly volume depleted (e.g. patients treated with high dose diuretics), symptomatic hypotension may occur. These conditions should be corrected prior to administration of losartan or a lower starting dose should be used.
Liver Function Impairment: Based on pharmacokinetic data which demonstrate significantly increased plasma concentrations of losartan in cirrhotic patients, a lower dose should be considered for patients with a history of hepatic impairment.
Renal Function Impairment: Other drugs that affect the renin-angiotensin system may increase blood urea and serum creatinine in patients with bilateral renal artery stenosis or stenosis of the artery to a solitary kidney. While not confirmed this potentially may occur with angiotensin II receptor antagonists.
Use in Children: For patients ≥ 20 to < 50 kg, the recommended dose is 25 mg once daily. The dose can be increased to a maximum of 50 mg once daily. In patients > 50 kg, the starting dose is 50 mg once daily. The dose can be increased to a maximum of 100 mg once daily.
In pediatric patients who are intravascularly volume depleted, these conditions should be corrected prior to administration of losartan.
Losartan is not recommended in pediatric patients with glomerular filtration rate < 30 mL/min/1.73 m², in pediatric patients with hepatic impairment, or in neonates as no data are available.
The adverse experience profile for pediatric patients appears to be similar to that seen in adult patients.
Use in the Elderly: In clinical studies there was no age-related difference in the efficacy or safety profile of losartan.