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:
- Blood vessels
- Adrenal cortex
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
- 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.
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.
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
- Renal failure
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.
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.
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.
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.
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.
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.
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
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.
Cozaar is contraindicated for the following patients:
- Patients with hypersensitivity to any element of Cozaar.
- Diabetic patients coadministering with aliskiren.
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