Cozaar (Losartan Potassium)
Cozaar
Losartan Potassium
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Losartan (Generic)
Losartan Potassium
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Cozaar (Losartan Potassium)

What is Cozaar (Losartan Potassium)?

Cozaar is a medication that belongs to the angiotensin II antagonist receptor blockers group (ARBs). It is suitable for both adults and children over six years of age to help bring down mild-to-moderate high blood pressure. It is not yet known whether it is suitable for children under six years of age.

To help protect the kidneys against diabetes, Cozaar is also prescribed for adults with type-2 diabetes as well as high blood pressure and protein in their urine (proteinuria). A doctor may also prescribe this medication for other conditions. It can help lower the risk of diabetic nerve pain (neuropathy). For certain people with heart disease, it can help to reduce the risk of stroke.

How does Cozaar work?

To bring about the constriction of blood vessels, the body releases Angiotensin II, a natural chemical. The narrowing blood vessels results in higher blood pressure. Cozaar works on the renin-angiotensin system (RAS), a hormonal system that controls blood pressure. Angiotensin II Cozaar works by restricting angiotensin II and helping the blood vessels to relax, thereby causing a drop in blood pressure. It does this by preventing angiotensin II from binding to type 1 angiotensin 2 receptors (AT1). These are located in the:

  • Heart
  • Blood vessels
  • Kidney
  • Adrenal cortex
  • Lung
  • Brain

Available dosage, appearance and ingredients

Cozaar comes in the form of 25, 50 and 100mg pills, your doctor will advise you on the correct dosage. They are all film-coated and white in appearance and oval-shaped, except for the 100mg pill which is teardrop-shaped.

The non-medicinal ingredients include:

  • Carnauba wax
  • Corn starch
  • Hydroxypropyl cellulose
  • Hydroxypropyl methylcellulose
  • Lactose
  • Magnesium stearate
  • Microcrystalline cellulose
  • Titanium dioxide

Cozaar is also available in liquid form.

How should you take Cozaar?

Cozaar is usually taken once a day and can be taken with or without food.

To take this medication in its liquid form, shake the bottle vigorously before measuring out each dose. Do not use a typical household spoon, use a special measuring spoon for an accurate dose.

How to store Cozaar

  • Store Cozaar at 77°F (25°C); excursions permitted to 59-86°F (15-30°C).
  • Keep it in a tightly closed container and protect it from light.

Side Effects

The most common side effects of Cozaar include:

  • Feeling dizzy
  • Back pain
  • Flu symptoms (blocked nose, sore throat, sneezing)

Tell your doctor if you experience any side effects that cause discomfort or do not subside.

Warnings & Precautions

Cozaar should not be given to anyone else if it has not been directly prescribed to them by their doctor as it can be harmful.

Pregnancy

Anyone who learns they are pregnant should cease taking Cozaar as soon as possible. A developing fetus can be harmed by medication that impacts the renin-angiotensin system during the second and third trimesters. Specifically, it can reduce fetal renal function and increase fetal and neonatal death. Oligohydramnios has been linked to fetal lung hypoplasia, as well as skeletal deformity.

Possible neonatal effects include:

  • Skull hypoplasia
  • Anuria
  • Hypotension
  • Renal failure
  • Death

It is unknown whether Cozaar is excreted in human milk, but the potential for negative effects on nursing infants means the mother’s doctor should be consulted to decide whether to discontinue nursing or discontinue the drug based on how important taking the drug is to the mother.

Cough

A dry, persistent cough has been found to be associated with ACE-inhibitor use and may necessitate ending the use of ACE-inhibitor treatment.

Hypotension in volume- or salt-depleted patients

Symptomatic hypotension may occur in volume- or salt-depleted patients with an activated renin-angiotensin system.

Deterioration of renal functions

Diuretics and medication inhibiting the renin-angiotensin system can result in changes to renal functions and even acute renal failure. Patients with renal artery stenosis, chronic kidney disease, severe congestive heart failure, or volume depletion should beware. If their renal function partly depends on the renin-angiotensin system, they may be vulnerable to renal failure. Such patients should have their renal function regularly monitored. The use of Cozaar should end if a clinically significant change in renal function in a patient is detected.

Hyperkalemia

The use of other medication at the same time as Cozaar can result in increased serum potassium levels, leading to hyperkalemia. Serum potassium levels should be monitored regularly and treated. A reduction in Cozaar dosage or total discontinuation of its use may be necessary. Patients using Cozaar should not take potassium supplements or salt substitutes with potassium, at least not without asking their doctor.

Use in Specific Populations

For pediatric care of neonates with previous in utero exposure to Cozaar

If oliguria or hypotension is detected, pay attention to blood pressure and renal perfusion. To reverse hypotension, or restore renal function, medical carers should consider exchange transfusion or dialysis.

In patients aged between 6 and 16, Cozaar has been known to result in antihypertensive effects. So far, Cozaar has not been established as safe and effective in patients under 6 years of age or in pediatric patients with glomerular filtration rate <30 mL/min/1.73 m2

For geriatric care

There have been no general differences detected in effectiveness or safety between patients aged 75 or over and younger patients. However, it is a possibility that some older patients may be more sensitive to Cozaar.

Race

In a study, compared to black patients treated with Cozaar, black patients with hypertension as well as left ventricular hypertrophy receiving atenolol were not as likely to experience the primary composite endpoint. The first experience of stroke, myocardial infarction or cardiovascular death was the primary endpoint, studied with an intention-to-treat (ITT) angle.

Renal Issues

Relatively increased plasma concentrations of losartan and active metabolite are a symptom of renal inefficiency. An adjustment to the dose of Cozaar is unnecessary for patients with renal issues unless the patient in question is also volume-depleted.

Hepatic Issues

For patients experiencing mild-to-moderate hepatic issues, 25mg of Cozaar is the suggested starting dose. As for patients with severe hepatic issues, the effects of Cozaar have not yet been observed.

Interactions Between Cozaar & Other Medications

Medication that increases serum potassium

Using Cozaar with other medications that increase levels of serum potassium can cause hyperkalemia, so serum potassium levels should be monitored in such patients.

Lithium

This will raise the concentration of serum lithium and lithium toxicity has been detected during simultaneous use of lithium and angiotensin II receptor antagonists. Lithium levels should be monitored during use with other agents.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) Including Selective Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors)

Among elderly, volume-depleted patients, including those on diuretic medication, or with renal impairments, simultaneous use of Cozaar with NSAIDs, including selective COX-2 inhibitors, may result in worsening renal function, extending to possible acute renal failure. This is normally reversible, but renal function should be monitored periodically in patients receiving Cozaar and NSAID therapy.

NSAIDs, including selective COX-2 inhibitors, can reduce the antihypertensive result of angiotensin II receptor antagonists, including Cozaar.

Overdose & Contraindications

Overdose

There isn’t a lot of information available on overdosing on Cozaar. However, hypotension and tachycardia are the most likely outcomes.

Parasympathetic (vagal) stimulation could cause bradycardia. Treatment should be initiated if symptomatic hypotension is detected. It should be noted that hemodialysis will not be able to remove Cozaar or its active metabolite.

Contraindications

Cozaar is contraindicated for the following patients:

  • Patients with hypersensitivity to any element of Cozaar.
  • Diabetic patients coadministering with aliskiren.

FREQUENTLY ASKED QUESTIONS

  • aldesleukin
  • aliskiren
  • alpha-agonists (e.g., clonidine, methyldopa)
  • alpha-blockers (e.g., alfuzosin, doxazosin, tamsulosin)
  • amifostine
  • amiodarone
  • amphetamines (e.g., dextroamphetamine)
  • angiotensin-converting enzyme inhibitors (ACEIs; e.g., captopril, lisinopril, ramipril)
  • other angiotensin receptor blockers (ARBs; e.g., candesartan, irbesartan)
  • antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
  • apalutamide
  • “azole” antifungals (e.g., itraconazole, ketoconazole, voriconazole)
  • barbiturates (e.g., pentobarbital, phenobarbital)
  • beta-adrenergic blockers (e.g., atenolol, propranolol, sotalol)
  • bosentan
  • brimonidine
  • calcium channel blockers (e.g., amlodipine, diltiazem, nifedipine, verapamil)
  • carbamazepine
  • ceritinib
  • conivaptan
  • cyclosporine
  • dabrafenib
  • deferasirox
  • digoxin
  • diabetes medications (e.g., chlorpropamide, glyburide, pioglitazone, repaglinide)
  • diuretics (water pills; e.g., furosemide, hydrochlorothiazide, indapamide)
  • drospirenone
  • duloxetine
  • enzalutamide
  • eplerenone
  • ginger
  • ginseng (American)
  • guanfacine
  • heparin and low-molecular-weight heparins (e.g., dalteparin, tinzaparin)
  • HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delavirdine, efavirenz, etravirine, nevirapine)
  • levodopa
  • lithium
  • lumacaftor
  • methylphenidate
  • monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, phenelzine, rasagiline, selegiline, tranylcypromine)
  • medications that increase the level of potassium in the blood (e.g., spironolactone, amiloride, triamterene, or salt substitutes that contain potassium)
  • mifepristone
  • minoxidil
  • mitotane
  • modafinil
  • nitrates (e.g., nitroglycerin, isosorbide dinitrate, isosorbide mononitrate)
  • non-steroidal anti-inflammatory medications (NSAIDs; e.g., diclofenac, ibuprofen, naproxen)
  • obinutuzumab
  • pentoxifylline
  • phenytoin
  • phosphodiesterase 5 inhibitors (e.g., sildenafil, tadalafil, vardenafil)
  • quinine
  • rifabutin
  • rifampin
  • riociguat
  • ropinirole
  • sacubitril
  • John’s wort
  • sarilumab
  • sodium phosphates
  • tizanidine
  • tocilizumab
  • tolvaptan
  • trimethoprim
  • warfarin
  • yohimbine

Some of the more serious side effects Cozaar can cause include:

  • Lightheadedness
  • Pain or burning when urinating
  • Feeling nauseated
  • Weakness
  • Tingly feeling
  • Chest pain
  • Irregular heartbeats
  • Loss of movements
  • Little or no urination
  • Rapid weight gain
  • Swelling in hands, feet, ankles

If you experience any of these side effects, you should seek medical help as soon as possible.

These include:

  • Anaemia
  • Depression
  • Somnolence, headache, sleep disorders, paresthesia, migraine
  • Tinnitus
  • Palpitations, syncope, atrial fibrillation, CVA
  • Dyspnea
  • Abdominal pain, constipation, nausea, vomiting
  • Urticaria, pruritus, rash, photosensitivity
  • Myalgia, arthralgia
  • Impotence
  • Edema

Make sure your doctor is aware of it if you are pregnant, or if you have ever:

  • Had kidney disease
  • Had liver disease
  • Had congestive heart failure
  • Had an electrolyte imbalance

You should also let them know if you are on a low-salt diet or if you are dehydrated.

If you believe you are pregnant, do not take Cozaar. Instead, let your doctor know right away if you are pregnant. Cozaar can injury the unborn baby and possibly result in the fetus’ death if you take it during your second or third trimester.

Also, you should not breast-feed your baby while using this medicine.

Alcoholic drinks can lower your blood pressure and increase the side effects of Cozaar. You can take it with or without food, but stop using potassium supplements or salt substitutes, unless you have been advised to continue by your doctor.

You should avoid rising too swiftly from a sitting or lying position. Getting up too quickly may leave you feeling dizzy.

If you think you, or someone else, has taken an overdose of Cozaar, you should seek medical care immediately. If someone has taken Cozaar and has collapsed and isn’t breathing, you should contact the emergency medical services.

Take your normal dose as soon as possible. If it is almost time for you to take your next dose, you should skip the one you missed. You should not take two doses at the same time.

Does Cozaar block the Coronavirus receptor?

  • Cozaar is not a receptor. It blocks angiotensin II from binding to receptor type 1 angiotensin 2 (AT1), which lowers blood pressure.
  • Cozaar does not block the virus SARS-CoV-2 which causes COVID-19. People with high blood pressure have overactive renin-angiotensin systems whose activity can be reduced by Cozaar. In turn this may increase the risk of lung complications from COVID-19.
  • Animal studies found Cozaar to be good for reducing severe simulated lung injury in mice with other viruses, such as SARS. There haven’t been many human studies.
  • At the moment, beneficial effects of Cozaar are hypothetical. It is not advised to base medical therapy on untested hypothesese as unforeseen harm may outweigh any benefits.
  • For those on Cozaar, or any other ARB, the medical community advice is to continue with it unless your doctor tells you otherwise.

One normally needs to take Cozaar for around 3 to 6 weeks before seeing full results. Cozaar can be taken on its own, or with a water pill (diuretic). To see the best results, you should take it regularly, even if you are feeling fine. Remember, most people with hypertension do not feel unwell.

  • Cozaar doesn’t last as long in lower doses. If you take a dose of 25mg in the morning, your blood pressure could rise again by night. The effects of Diovan are felt in all doses for 24 hours.
  • Cozaar is approved by the FDA for high blood pressure. Diovan is approved for high blood pressure and heart failure.
  • The side effects are similar, but more frequently reported after taking Cozaar.
  • Diovan is available with sacubitril, a neprilysin inhibitor. Together the medication is called Entresto. Cozaar is not available with sacubitril.
  • Both are ARBs (angiotensin receptor blockers) to treat high blood pressure by blocking angiotensin II to lower blood pressure.
  • Side effects common to both include diarrhea, dizziness, and fatigue.
  • Cheap generics can be used, so the cost should be similar.
  • Both can increase potassium in the bloodstream, which means regular blood tests are advised.
  • Both are available in combination with the diuretic hydrochlorothiazide.
  • Both may interact with:
    • Lithium
    • Other blood pressure medications
    • potassium-sparing diuretics
    • Potassium supplements
    • Salt substitutes containing potassium
    • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Neither should be taken during pregnancy, neither are recommended during breastfeeding.

Arrhythmia (irregular heartbeat) has been detected with Cozaar, but it is rare. Dizziness is normally felt early in treatment or when the dosage is increased, but it usually dissipates as treatment continues.

Losartan and Losartan Potassium are one and the same. Losartan Potassium is the name and the salt (potassium). Both will deliver the stated amount of Losartan.