Losar (losartan) is an angiotensin receptor blocker (ARB) which relaxes and widens blood vessels, lowers blood pressure, improves blood flow, improves oxygen delivery to the heart, and reduces the heart's workload. While this all sounds very beneficial, Losar---like all ARBs---is rarely a preferred treatment, and is typically given only when ACE inhibitors are unsuitable.

For individuals unable to take ACE inhibitors, Losar is typically prescribed to help lower high blood pressure. It is also beneficial in helping delay progress of diabetic nephropathy in patients who also have hypertension, as well as help patients who have an enlarged heart avoid stroke. Less commonly Losar may be used, off-label, in a variety of other conditions.

With modified dosing Losar can be used in patients as young as 6 years old. Parents should not give this medication to children without explicit doctor approval.

Hypertension & Type II Diabetes

Losar treatment is similar in treating both hypertension and slowing progression of nephropathy in type 2 diabetes when hypertension is also present. The medication is administered once-per-day, with or without food as desired.

In adults:

• Start with 50 mg once per day.
• After two or three weeks, dosage may be increased to 100 mg per day.
• Do not exceed 100 mg per day. Adding another medication will provide more benefit.

In children age 6 and up dosage is based on weight:

• Administer 0.7 mg per kg of weight, taken once per day.
• Do not exceed 50 mg per day.

In both cases treatment may continue for as long as it provides benefit, which may be for the remainder of life.

Some patients are able to make and maintain lifestyle changes that control hypertension and type 2 diabetes. Recommended changes usually include:

• Reaching/maintaining a healthy weight
• Managing blood glucose
• Managing cholesterol levels
• Regular exercise
• Reducing sodium intake

Though at least some of the above often contribute significantly to hypertension or type 2 diabetes, this is not always the case. Some patients experience little difference after making significant lifestyle changes. These individuals will likely need to stay on the medication. Most, however, if lifestyle changes are made and maintained, will eventually be able to stop taking Losar.

Preventing Stroke

Preventing stroke in patients with an enlarged heart usually also involves a diuretic, such as HCTZ. It's possible to buy Losar in combination with HCTZ in the product Hyzaar for those who prefer to take just one tablet, or the two can be taken individually.

To prevent stroke:

• Start with 50 mg Losar once per day.
• After several days, add 12.5 mg of HCTZ.
• The end goal is 100 mg Losar and 25 mg HCTZ per day, but depending on blood pressure this may not be attainable.

Black patients with left ventricular hypertrophy should note that this medication may be only marginally effective, or not effective at all. Beta-blockers like atenolol (brand name Tenormin) produced much better result for black patients in studies.

Adverse Reactions

Serious side effects from Losar are rare, but they do unfortunately happen. Be alert for and seek medical attention if experiencing:

• Painful urination
• Difficulty breathing
• Chest pain
• Rapid, slow, or irregular heartbeat
• Loss of movement
• Severe weakness
• Confusion

Most side effects are much milder, and they typically stop occurring as the body adjusts to treatment:

• Dizziness
• Dry cough
• Stuffy nose
• Sore throat
• Mild back pain

Losar can cause harm to unborn babies, especially if taken in the second or third trimester. Pregnant women should avoid this product. Effects on nursing infants are unclear.

This medication may interact with a variety of other, unrelated medications, including some over-the-counter variety. Double-check with a doctor or pharmacist before taking other products with Losar.