Repace (losartan) is an angiotensin receptor blocker (ARB) used to help treat hypertension (high blood pressure) in individuals who can't take ACE inhibitors. The medication is also beneficial in slowing the progression of diabetic nephropathy in individuals who have both diabetes and hypertension, as well as helping to prevent stroke in patients who have an enlarged heart. It may also be used, though less commonly, in other similar conditions.

The medication works by relaxing and widening blood vessels, which lowers blood pressure, improves blood flow, improves oxygen delivery to the heart, and reduces the heart's workload. However, the medication is not without risk of side effects and is usually not the preferred treatment when ACE inhibitors can be used instead.

Repace is suitable for patients as young as 6 years old, though modified dosing is required for young patients.

Treatment Overview

Repace comes in tablets, which should be swallowed whole and not split or crushed. Tablets are typically taken just once per day. Food is optional according to personal preference.

Treatment is very similar when treating hypertension and slowing progression of nephropathy in diabetes when hypertension is also present:

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 Repace treatment may continue for as long as it provides benefit, which may be for the remainder of life if lifestyle changes are not made or prove to be inadequate.

Preventing stroke in patients with an enlarged heart usually also involves a diuretic, such as HCTZ. It's possible to buy Repace 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 Repace once per day.
• After several days, add 12.5 mg of HCTZ.
• The end goal is 100 mg Repace and 25 mg HCTZ per day, but depending on blood pressure this may not be attainable.

Note that black patients with left ventricular hypertrophy may find this medication is only marginally effective, or not effective at all. Beta-blockers like atenolol produced much better results for black patients in studies.

Potential Complications

Serious side effects from Repace 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

Repace 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 varieties. Double-check with a doctor or pharmacist before taking other products with Repace.