Cozaar Effectively Lowers Blood Pressure and Protects Kidneys
Cozaar
| Product dosage: 25mg | |||
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Cozaar (losartan potassium) is an angiotensin II receptor blocker (ARB) prescribed for the management of hypertension and for the treatment of diabetic nephropathy in patients with type 2 diabetes and a history of hypertension. It works by blocking the action of angiotensin II, a substance in the body that causes blood vessels to tighten, resulting in their relaxation and lowering of blood pressure. This mechanism not only aids in cardiovascular risk reduction but also provides specific organ-protective benefits, particularly for the kidneys.
Features
- Active ingredient: Losartan potassium
- Available in tablet strengths: 25 mg, 50 mg, 100 mg
- Administration: Oral
- Onset of action: Within 1 hour; peak effect in 6 hours
- Duration: 24-hour blood pressure control with once-daily dosing
- Bioavailability: Approximately 33%
- Protein binding: High (>98%)
- Metabolism: Hepatic, primarily via CYP2C9 and CYP3A4
- Excretion: Urine (35%) and feces (58%) as metabolites
Benefits
- Provides consistent 24-hour blood pressure control with a single daily dose, supporting adherence and reducing cardiovascular risk.
- Demonstrates nephroprotective effects by reducing proteinuria and slowing the progression of kidney disease in type 2 diabetic patients with hypertension.
- Exhibits a favorable side effect profile, with a lower incidence of cough compared to ACE inhibitors.
- May offer cardiovascular benefits beyond blood pressure lowering, including potential reduction in stroke risk.
- Does not require dosage adjustment in elderly patients based on age alone.
- Can be used as part of a combination therapy regimen for enhanced antihypertensive efficacy.
Common use
Cozaar is primarily indicated for the treatment of hypertension, either as monotherapy or in combination with other antihypertensive agents. It is also used for the treatment of diabetic nephropathy—an kidney disease associated with type 2 diabetes—manifested by elevated serum creatinine and proteinuria (>300 mg/day). In this population, Cozaar has been shown to slow the progression of renal disease. Off-label uses may include heart failure management (when ACE inhibitors are not tolerated) and left ventricular hypertrophy reduction.
Dosage and direction
The recommended initial dose for hypertension is 50 mg once daily. The dosage can be increased to 100 mg once daily based on blood pressure response. For volume-depleted patients (e.g., those treated with diuretics), a starting dose of 25 mg once daily is recommended. For diabetic nephropathy, the usual starting dose is 50 mg once daily, which may be increased to 100 mg once daily based on blood pressure response. Cozaar may be administered with or without food. Tablets should be swallowed whole with a glass of water.
Precautions
- Monitor renal function and potassium levels periodically, especially in patients with renal impairment, diabetes, or those taking potassium supplements or potassium-sparing diuretics.
- Use with caution in patients with hepatic impairment; consider a lower starting dose.
- Symptomatic hypotension may occur in volume-depleted or salt-depleted patients; correct these conditions prior to administration.
- Not recommended during pregnancy due to potential risk of fetal injury; discontinue if pregnancy is detected.
- Avoid use in patients with bilateral renal artery stenosis or unilateral stenosis in a solitary kidney, due to risk of increased serum creatinine and blood urea nitrogen (BUN).
- Angioedema has been reported; discontinue immediately if it occurs.
Contraindications
- Hypersensitivity to losartan or any component of the formulation.
- Concomitant use with aliskiren in patients with diabetes.
- Pregnancy (second and third trimesters).
Possible side effect
Common adverse reactions (≥1% and greater than placebo) include:
- Dizziness
- Upper respiratory infection
- Nasal congestion
- Back pain
- Fatigue
Less common but serious side effects may include:
- Hypotension (especially in volume-depleted patients)
- Hyperkalemia
- Impaired renal function
- Angioedema (rare)
- Increases in liver enzymes
Drug interaction
- Potassium supplements/potassium-sparing diuretics: Increased risk of hyperkalemia.
- NSAIDs: May reduce antihypertensive effect and increase risk of renal impairment.
- Lithium: Increased lithium concentrations; monitor lithium levels.
- Other antihypertensive agents: Additive hypotensive effects.
- Rifampin: May decrease losartan concentrations.
- Fluconazole: May increase losartan concentrations.
Missed dose
If a dose is missed, it should be taken as soon as possible on the same day. If it is near the time of the next dose, skip the missed dose and resume the usual dosing schedule. Do not double the dose to catch up.
Overdose
Symptoms of overdose may include hypotension and tachycardia. Bradycardia could occur from parasympathetic (vagal) stimulation. Treatment should be supportive and directed at stabilizing blood pressure and heart rate. Losartan and its active metabolite are not removed by hemodialysis.
Storage
Store at 25°C (77°F); excursions permitted to 15–30°C (59–86°F). Keep in the original container, tightly closed, and protect from light and moisture. Keep out of reach of children and pets.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional for diagnosis and individualized treatment recommendations. Do not initiate or discontinue medication without medical supervision.
Reviews
Clinical studies and post-marketing surveillance demonstrate that Cozaar is generally well-tolerated and effective for blood pressure control and renal protection. In the RENAAL trial, losartan significantly reduced the risk of doubling of serum creatinine, end-stage renal disease, or death in patients with type 2 diabetes and nephropathy. Many patients report satisfactory 24-hour blood pressure control with minimal side effects, though individual responses may vary. Adherence to once-daily dosing is frequently cited as a significant advantage in long-term management.