COZAAR (losartan potassium) is indicated for the treatment of essential hypertension.
COZAAR may be used alone or concomitantly with thiazide diuretics.
A great majority of patients with severe hypertension in controlled clinical trials required combination therapy. COZAAR has been used concomitantly with beta-blockers and calcium channel blockers, but the data on such use are limited.
The safety and efficacy of concurrent use with angiotensin converting enzyme inhibitors have not been established.
COZAAR is also indicated to delay the progression of renal disease as measured by the occurrence of doubling of serum creatinine, and end stage renal disease, and to reduce proteinuria.
Hypotension
Occasionally, symptomatic hypotension has occurred after administration of losartan, in some cases after the first dose. It is more likely to occur in patients who are volume-depleted by diuretic therapy, dietary salt restriction, dialysis, diarrhea, or vomiting. In these patients, because of the potential fall in blood pressure, therapy should be started under close medical supervision. Similar considerations apply to patients with ischemic heart or cerebrovascular disease, in whom an excessive fall in blood pressure could result in myocardial infarction or cerebrovascular accident.
Valvular Stenosis
There is concern on theoretical grounds that patients with aortic stenosis might be at particular risk of decreased coronary perfusion when treated with vasodilators because they do not develop as much afterload reduction
