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" What is it used for?  High blood pressure with no known cause (essential hypertension) in adults and in children and adolescents aged 6 to 18 years. Reducing risk of stroke in adults with high blood pressure and an enlarged heart (left ventricular hypertrophy). Treating kidney disease in adults with high blood pressure and type 2 diabetes with kidney complications (diabetic nephropathy). Treating chronic heart failure in adults who can&amp;#039;t take medicines called ACE inhibitors.   How does it work? Cozaar tablets and oral suspension both contain the active ingredient losartan potassium, which is a type of medicine called an angiotensin II antagonist. Losartan is also available without a brand name, ie as the generic medicine. Losartan works by blocking receptors in the body known as angiotensin II receptors. This prevents the action of a hormone called angiotensin II. Angiotensin II is involved in regulating blood pressure and fluid balance. It has two main actions. It causes the blood vessels to narrow and the kidneys to retain salt and water.  Losartan blocks the receptors that angiotensin II acts on, and so prevents its actions. The main result of this is that the peripheral blood vessels are allowed to widen, which means that there is more space and less resistance in these blood vessels. This is the main mechanism by which the pressure in the blood vessels is lowered.  Blocking the actions of angiotensin II also increases the amount of fluid removed from the blood by the kidneys. This decreases the amount of fluid in the blood vessels, which also lessens the resistance and pressure in the blood vessels. The combined overall effect of these changes is to lower the blood pressure, hence losartan is used to treat high blood pressure.  Losartan has been shown to reduce the risk of stroke in people who have high blood pressure together with an enlargement in the left side of their heart (left ventricular hypertrophy). People with both these conditions may therefore be prescribed losartan to reduce their chances of experiencing a stroke. However, this medicine is not effective for this particular use in black people.  Losartan has also been shown to delay the progression of kidney disease in people with type 2 diabetes who have related kidney complications. If you have diabetic kidney disease you may be prescribed losartan for this reason, regardless of whether or not you also have high blood pressure. The reduced pressure within the blood vessels also means that the heart doesn&amp;#039;t have to work as hard to pump the blood around the body. For this reason, losartan may sometimes be prescribed to people with heart failure.   How do I take it?  The dose of losartan prescribed depends on the condition being treated and how well it is controlled. Follow the instructions given by your doctor or pharmacist. These will be printed on the dispensing label your pharmacist has put on the packet of medicine.  Losartan is usually taken once a day. It can be taken either with or without food. The tablets should be swallowed with a drink of water. You should try to always take your losartan at the same time of day to help you remember it. If you forget to take a dose at your usual time take it as soon as you remember. However if you forget a dose for the whole day, just leave out the missed dose and take your next dose as usual the following day. Do not take a double dose to make up for a missed dose. You will usually need to keep taking this medicine long-term to help control your condition. Don&amp;#039;t stop taking this medicine unless your doctor tells you to.   Warning!  Dizziness and weariness may occasionally occur during treatment with blood pressure lowering medicines. This may be made worse by drinking alcohol. If you are affected you should take extra care when driving or operating machinery.  You should have regular blood tests to monitor the amount of potassium in your blood while you are taking this medicine, particularly if you are elderly or have heart failure or any problems with your kidneys.   Use with caution in  Elderly people over 75 years of age. People with a decreased volume of fluid in the body, eg due to high-dose diuretic therapy, low salt diet, diarrhoea, vomiting or dehydration. Your doctor may want you to start treatment with a lower dose. People with a history of decreased liver function. People with decreased kidney function. People with narrowing of one or both of the arteries that supply blood to the kidneys (renal artery stenosis). People who have had a kidney transplant. Severe heart failure. Heart disease characterised by thickening of the internal heart muscle and a blockage inside the heart (hypertrophic obstructive cardiomyopathy). Heart valve disease (mitral valve stenosis).  People with narrowing of the main artery that leaves the heart to supply blood to the body (aortic stenosis). People who have previously experienced an allergic reaction to a medicine that involved swelling of the lips, face, throat or tongue (angioedema).   Not to be used in  People with severely decreased liver function. Pregnancy. Breastfeeding. This medicine is not recommended for children under six years of age, or for children who have problems with their liver or kidney function. Cozaar tablets and suspension contain lactose and should not be taken by people with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption. Cozaar suspension also contains sucrose and should not be taken by people with rare hereditary problems of fructose intolerance.  This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.   Pregnancy and breastfeeding Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.   This medicine may be harmful to a developing baby. It is not recommended for use during the first trimester of pregnancy and should not be used during the second and third trimesters. If you think you could be pregnant or want to plan a pregnancy while taking this medicine you should get medical advice from your doctor straight away. It is not known if this medicine passes into breast milk. It is not recommended for mothers who are breastfeeding. Seek further medical advice from your doctor.   Side effects Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.  Common (affect between 1 in 10 and 1 in 100 people)  Dizziness, including dizziness when moving from sitting to standing. Spinning sensation (vertigo). Feeling weak or tired. Decreased kidney function. High blood potassium level (hyperkalaemia).   Uncommon (affect between 1 in 100 and 1 in 1000 people)  Sleepiness. Headache. Chest pain. Awareness of your heartbeat (palpitations). Shortness of breath. Cough. Disturbances of the gut, such as nausea, vomiting, diarrhoea, abdominal pain. Skin rashes or itching.   Rare (affect between 1 in 1000 and 1 in 10,000 people)  Inflammation of the liver (hepatitis). Allergic reactions such as severe swelling of lips, face or tongue (angioedema). Fainting.   Unknown frequency  Pain in the muscles and joints. Low red blood cell count (anaemia) or platelet count (thrombocytopenia). Depression. Migraine. Change in sensation of taste. Ringing in the ears (tinnitus). Abnormal liver function. Inflammation of the pancreas (pancreatitis). Erectile dysfunction (impotence).  The side effects listed above may not include all of the side effects reported by the medicine&amp;#039;s manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.   How can this medicine affect other medicines? It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to make sure that the combination is safe.  If losartan is used in combination with other medicines that lower blood pressure, either to treat high blood pressure (antihypertensives), or as a side effect, the combination might lower your blood pressure too much. This could make you feel dizzy or faint, particularly when moving from a lying or sitting position to sitting or standing. If this happens to you, you should sit or lie down until the symptoms pass. This is more likely to happen when you first start taking losartan with one of these medicines, particularly if you have been taking a high dose of a diuretic. Tell your doctor if any dizziness persists, as your medicine doses may need adjusting. Other medicines that decrease blood pressure include the following:   ACE inhibitors, eg enalapril aldesleukin alpha-blockers such as prazosin  alprostadil other angiotensin II receptor antagonists such as valsartan antipsychotics such as chlorpromazine benzodiazepines, eg temazepam, diazepam baclofen beta-blockers such as propranolol calcium-channel blockers such as verapamil, nifedipine clonidine diazoxide diuretics, eg furosemide, bendroflumethiazide dopamine agonists, eg bromocriptine, apomorphine hydralazine levodopa MAOI antidepressants, eg phenelzine methyldopa minoxidil moxonidine moxisylyte nicorandil nitrates, eg glyceryl trinitrate sildenafil  tizanidine.  Losartan may increase the amount of potassium in your blood. If it is taken with other medicines that can increase blood potassium, this effect may be enhanced. Such medicines include the following and these should generally be avoided while you are taking losartan. If they are used in combination with losartan, the amount of potassium in your blood should be monitored:   ACE inhibitors, eg captopril, enalapril ciclosporin drospirenone heparin non-steroidal anti-inflammatory drugs, eg indometacin, diclofenac, ibuprofen, naproxen potassium-sparing diuretics eg spironolactone, triamterene, amiloride potassium supplements potassium salts, eg potassium citrate for cystitis potassium-containing salt substitutes such as Lo-Salt tacrolimus trimethoprim.   Non-steroidal anti-inflammatory drugs (NSAIDs such as indometacin, diclofenac, ibuprofen or naproxen) may also oppose the blood pressure lowering effect of losartan and may increase the risk of side effects on the kidneys. You should not take these types of painkiller while you are taking losartan without getting advice from your doctor or pharmacist first. Losartan may increase blood levels of the medicine lithium. If you are taking lithium and start treatment with losartan, you should let your doctor know if you experience any signs that your lithium level is increasing, for example: loss of appetite, diarrhoea, vomiting, blurred vision, muscle weakness, lack of co-ordination, drowsiness, tremor, unsteadiness, muscle twitching, ringing in the ears or confusion. Your doctor will need to check your lithium level. Rifampicin and fluconazole may reduce the blood level and effect of losartan.  The following medicines may oppose the blood pressure lowering effect of this medicine:  corticosteroids, such as dexamethasone or prednisolone oestrogens, such as those in the contraceptive pill.   Other medicines containing the same active ingredient Losartan tablets are also available without a brand name, ie as the generic medicine. Cozaar-comp contains losartan in combination with a diuretic medicine called hydrochlorothiazide.  Last updated 20.08.2013 "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.netdoctor.co.uk/medicines/heart-and-blood/a6477/cozaar-losartan/>