General Toxicity Notes
Blood pressure is the best guide to dose and interval. Hypotensive effects magnified by natriuretic agents or sodium depletion. Can cause hyperkalemia, metabolic acidosis. Acute renal dysfunction with bilateral or transplant renal artery stenosis, low renal perfusion pressure.
Excreted Unchanged %
4-10
Half-Life (Normalesrd) Hours
2.5-5.4/4-6
Plasma Protein Binding %
98
Volume Of Distribution L/Kg
0.45
Dose For Normal Renal Function
25-100 mg q24h
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
100% [A]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
100% [A]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
100% [A]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: None, [A]
Supplement For Dialysis [Recommendation Level]: Pd
PD: None, [A]
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: Dose for GFR 10-50, titrate, [D]
References
Goa KL, Wagstaff AJ. Losartan potassium: a review of its pharmacology, clinical efficacy and tolerability in the management of hypertension. Drugs. 1996; 51: 820-45. [PMID: 8861549] / Pedro AA, Gehr TW, Brophy DF, Sica DA. The pharmacokinetics and pharmacodynamics of losartan in continuous ambulatory peritoneal dialysis. J Clin Pharmacol. 2000; 40: 389-95. [PMID: 10761166] / Sica DA, Lo MW, Shaw WC, et al. The pharmacokinetics of losartan in renal insufficiency. J Hypertens. 1995; 13: S49-S52. [PMID unavailable] / Toto R, Shultz P, Raij L, Mitchell H, Shaw W, Ramjit D, et al. Efficacy and tolerability of losartan in hypertensive patients with renal impairment. Collaborative Group. Hypertension. 1998; 31: 684-91. [PMID: 9461241]