Lifezar Special Precautions

Hypotension and Electrolyte/Fluid Imbalance: Symptomatic hypotension may be observed in patients who are intravascularly volume-depleted (e.g., those treated with high-dose diuretics). These conditions should be corrected before starting losartan therapy, or a lower starting dose should be used.
Monitor serum potassium levels in type 2 diabetic patients with nephropathy treated with an angiotensin II antagonist.
Electrolyte imbalances are common in patients with renal impairment, with or without diabetes, and should be addressed.
Renal Disease: Due to inhibition of the renin-angiotensin-aldosterone system, changes in renal function including renal failure have been seen in susceptible patients (e.g., patients whose renal function is dependent on the renin-angiotensin-aldosterone system such as those with severe cardiac insufficiency, pre-existing renal dysfunction) treated with losartan; these changes in renal function may be reversible upon discontinuation of therapy in some patients.
Treatment with ACE inhibitors has been associated with oliguria and/or progressive azotemia, and (rarely) with acute renal failure and/or death in patients whose renal function may depend on the activity of the renin-angiotensin-aldosterone system (e.g., patients with severe congestive heart failure). Similar outcomes have been observed with losartan.
In studies, ACE inhibitors may increase blood urea nitrogen (BUN) and serum creatinine in patients with unilateral or bilateral renal artery stenosis. Renal effects have been observed with losartan; these effects may be reversible upon discontinuation of therapy in some patients.
Liver disease: In patients with a history of liver impairment, a lower dose of losartan should be given since significantly increased plasma concentrations of the drug in cirrhotic patients have been observed in pharmacokinetic studies.
Potassium-sparing Diuretics/Supplements/Salt Substitute: Patients taking losartan should be advised not to use potassium-sparing diuretics, potassium supplements, or salt substitutes containing potassium without consulting a physician. (See Interactions.)
General: Treatment with drugs that affect the renin-angiotensin-aldosterone system has been associated with acute hypotension, azotemia, oliguria or, rarely, acute renal failure in patients whose vascular tone and renal function depend predominantly on the activity of this system (e.g., patients with severe congestive heart failure or underlying renal disease, including renal artery stenosis). As with any antihypertensive agent, excessive hypotension in patients with ischemic cardiopathy or ischemic cerebrovascular disease could result in a myocardial infarction or stroke.
Use in Pregnancy & Lactation: See Use in Pregnancy & Lactation section for further information.
Use in Children: Losartan is not recommended in neonates and in children with glomerular filtration rate <30 mL/min/1.73 m², as no data are available. Losartan is also not recommended in children with hepatic impairment.
Use in the Elderly: There were no age-related differences in efficacy or safety profile of losartan.