Losartan
Sources
Losartan (Cozaar)
Clinical Summary
Losartan is an angiotensin II receptor blocker (ARB). Documented on handwritten prescription as "Lo" — likely abbreviation for losartan (brand name: Cozaar).
Newly documented from handwritten prescription dated 2026-05-04. Dose: 50 mg once daily (afternoon, 0-1-0 dosing).
Dosing History
| Date | Dose | Frequency | Route | Context |
|---|---|---|---|---|
| 2026-05-04 | 50 mg | Once daily (afternoon, 0-1-0) | Oral | Documented from handwritten Rx ("Lo") |
This medication was NOT previously documented in any ingested raw source. No blood pressure readings have been ingested. Indication is PRESUMED to be hypertension and/or diabetic nephropathy protection (renoprotection in diabetes).
Indication
Presumed indications:
1. Hypertension (no BP readings documented yet)
2. Diabetic nephropathy protection — ARBs are first-line agents in diabetic patients for renoprotection, even in normotensive patients with microalbuminuria
Given Ishamma's Diabetes Mellitus diagnosis, losartan may be prescribed primarily for renoprotection rather than BP control.
Pharmacology
- Drug class: Angiotensin II receptor blocker (ARB)
- Mechanism: Blocks AT1 receptors, preventing angiotensin II-mediated vasoconstriction and aldosterone secretion. Results: reduced BP, reduced proteinuria, renoprotection.
- Half-life: ~2 hours (parent drug), ~6–9 hours (active metabolite E-3174)
- Standard dose: 25–100 mg once daily (current: 50 mg, mid-range)
Advantages in Diabetes + AML Setting
- Renoprotection: Slows progression of diabetic nephropathy
- Reduces proteinuria: Even in normotensive diabetic patients
- Cardioprotection: Reduces cardiovascular events in diabetes
- Well-tolerated: Lower cough risk compared to ACE inhibitors
Monitoring — CRITICAL
| Parameter | Frequency | Rationale | Ishamma Status |
|---|---|---|---|
| Blood pressure | Weekly initially, then monthly | Primary efficacy endpoint | NOT YET DOCUMENTED — gap |
| Serum potassium | Baseline, 1 week, then periodic | ARBs reduce aldosterone → hyperkalemia risk | K+ consistently normal (4.0 mmol/L May 4) |
| Renal function (creatinine, eGFR) | Baseline, 1 week, then periodic | ARBs can cause transient Cr rise (acceptable if <30%); contraindicated if bilateral RAS | Creatinine stable 0.7–0.9 mg/dL (normal) |
| Microalbuminuria / UACR | Baseline, then every 3–6 months | Monitor renoprotection efficacy | NOT YET DOCUMENTED — gap |
ARBs reduce aldosterone secretion, causing potassium retention. Risk factors for hyperkalemia:
- Renal impairment (Ishamma's renal function currently normal)
- Concurrent K+-sparing diuretics, NSAIDs, K+ supplements
- AML treatment effects on renal functionCurrent status: K+ 4.0 mmol/L (May 4) — normal. Continue monitoring.
[!info] Blood Pressure Monitoring Gap
No BP readings have been documented in any ingested lab/clinic note. Home BP monitoring or clinic BP records should be obtained to confirm hypertension diagnosis and treatment efficacy.
Drug Interactions
- NSAIDs: Reduce antihypertensive effect, increase renal impairment risk
- Potassium supplements / K+-sparing diuretics: Increased hyperkalemia risk
- Lithium: Increased lithium levels (not applicable here)
- No CYP3A4 interaction with posaconazole/venetoclax
Adverse Effects
- Hyperkalemia (most important in renal impairment)
- Dizziness, orthostatic hypotension (especially first dose)
- Acute renal failure (rare, usually in bilateral renal artery stenosis)
- Angioedema (rare, lower risk than ACE inhibitors)
- Does NOT cause cough (unlike ACE inhibitors)
Contraindications
- Pregnancy (teratogenic — ARBs are contraindicated in pregnancy)
- Bilateral renal artery stenosis
- History of angioedema with ARBs
Related
- Diabetes Mellitus — Renoprotection indication
- Nifedipine — Co-administered antihypertensive (calcium channel blocker)
- Potassium — Monitor for hyperkalemia
- Creatinine — Monitor renal function
- Microalbuminuria — Should be monitored (not yet documented)
Medication page created during ingest of 2026-05-04 handwritten prescription.