Alone or in combination w/ other antihypertensives eg, diuretics for HTN. Reduces risk of CV death, stroke & MI in patients w/ HTN & left ventricular hypertrophy. Diabetic nephropathy w/ elevated serum creatinine & proteinuria in patients w/ type 2 DM & history of HTN.
Adult HTN Initially 50 mg once daily. Patient w/ intravascular vol depletion or hepatic impairment 25 mg. Usual maintenance dose: 25-100 mg once or in 2 divided doses daily. Max antihypertensive effect: 3-6 wk after initiation of therapy. Hypertensive patient w/ left ventricular hypertrophy Initially 50 mg once daily + 12.5 mg hydrochlorothiazide daily. May be increased to 100 mg losartan once daily followed by 25 mg hydrochlorothiazide once daily based on BP response. Nephropathy in type 2 diabetic patient w/ proteinuria Initially 50 mg once daily. May be increased to 100 mg once daily. Ped weighing ≥20 to <50 kg Recommended dose: 25 mg once daily, may be increased to max of 50 mg once daily, >50 kg Initially 50 mg once daily, may be increased to max of 100 mg once daily.
Hypersensitivity (angioedema). Symptomatic hypotension in patients who are intravascularly vol depleted. Black patients. History of hepatic impairment. Bilateral renal artery stenosis or stenosis of artery to a solitary kidney. Correct intravascular vol depletion prior to treatment. 2nd & 3rd trimester of pregnancy. Lactation. Neonates. Not recommended in ped patient w/ GFR <30 mL/min/1.73 m2.
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