Losartan#Contamination

Losartan potassium is chemically described as 2-butyl-4-chloro-1-[p-(o-1H-tetrazol-5-ylphenyl)benzyl]imidazole-5-methanol monopotassium salt. Its empirical formula is {{Format molecular formula|C22H23ClKN6O}}, and its molecular weight is 422.9.{{Cite web |title=Pharmaceutical formulation of losartan |url=https://patents.google.com/patent/US20090304755A1/en |url-status=live |archive-url=https://web.archive.org/web/20220105191955/https://patents.google.com/patent/US20090304755A1/en |archive-date=5 January 2022 |access-date=5 January 2022}}

Losartan is generally marketed as the (basic) potassium salt of the aromatized negatively charged tetrazole, called "losartan potassium".{{Cite web |title=See negatively charged tetrazole structure |url=https://www.rxlist.com/cozaar-drug.htm |url-status=live |archive-url=https://web.archive.org/web/20210122002247/https://www.rxlist.com/cozaar-drug.htm |archive-date=22 January 2021 |access-date=21 October 2017}} The molecule has an extended biphenyl group with a tetrazole which is being used in place of the carboxylic acid as a bioisostere.{{Cite web |title=DailyMed – Losartan Potassium 25 mg – losartan potassium tablet, film coated; Losartan Potassium 50 mg – losartan potassium tablet, film coated; Losartan Potassium 100 mg – losartan potassium tablet, film coated |url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a8817f22-8478-49b9-8354-ab27ca222c6b |url-status=live |archive-url=https://web.archive.org/web/20220427013220/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a8817f22-8478-49b9-8354-ab27ca222c6b |archive-date=27 April 2022 |access-date=27 April 2022}}

Losartan is used for hypertension, including in people with left ventricular hypertrophy (enlarged heart muscle), and kidney dysfunction among type II diabetics.{{Cite web |date=14 November 2019 |title=Cozaar – losartan potassium tablet, film coated |url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5ac32c20-169d-475a-fc8a-934f758d6ab0 |url-status=live |archive-url=https://web.archive.org/web/20210428160610/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5ac32c20-169d-475a-fc8a-934f758d6ab0 |archive-date=28 April 2021 |access-date=20 March 2020 |website=DailyMed}} It may also delay progression of diabetic nephropathy. It is a suitable pharmacological agent for the reduction of kidney (renal) disease progression in patients with type 2 diabetes, hypertension, and microalbuminuria (>30 mg/24 hours) or proteinuria (>900 mg/24 hours).{{Cite journal |vauthors=Boersma C, Atthobari J, Gansevoort RT, de Jong-Van den Berg LT, de Jong PE, de Zeeuw D, Annemans LJ, Postma MJ |year=2006 |title=Pharmacoeconomics of angiotensin II antagonists in type 2 diabetic patients with nephropathy: implications for decision making |journal=PharmacoEconomics |volume=24 |issue=6 |pages=523–35 |doi=10.2165/00019053-200624060-00001 |pmid=16761901 |s2cid=22960961}}

Although evidence shows calcium channel blockers and thiazide-type diuretics are preferred first-line treatments for most people (due to both efficacy and cost), an angiotensin II receptor antagonist such as losartan is recommended as first-line treatment in people under the age of 55 who cannot tolerate an ACE inhibitor.{{Cite web |date=24 August 2011 |title=Hypertension in adults: diagnosis and management |url=https://www.nice.org.uk/guidance/cg127/chapter/1-Guidance#choosing-antihypertensive-drug-treatment-2 |url-status=live |archive-url=https://web.archive.org/web/20170409111336/https://www.nice.org.uk/guidance/cg127/chapter/1-Guidance#choosing-antihypertensive-drug-treatment-2 |archive-date=9 April 2017 |access-date=8 April 2017 |website=National Institute for Health and Care Excellence (NICE)}} One study demonstrated losartan was superior to atenolol in the primary prevention of adverse cardiovascular events (myocardial infarction or stroke), with a reduction in cardiovascular morbidity and mortality for a comparable reduction in blood pressure. The maximal effects on blood pressure usually occur within 3–6 weeks of starting losartan.{{Cite book |last=Abrams A |url=https://archive.org/details/clinicaldrugther0008abra/page/846 |title='Clinical Drug Therapy Rationales for Nursing Practice |publisher=Lippincott Williams & Wilkins |year=2007 |isbn=978-0-7817-6263-2 |location=Philadelphia, Pa. |page=[https://archive.org/details/clinicaldrugther0008abra/page/846 846]}}

The most common adverse effects for losartan in adults are upper respiratory infections, dizziness, and back pain. People with type 2 diabetes and kidney disease may experience diarrhea, fatigue, low blood pressure, low blood glucose, elevated potassium, chest pain, or allergic reaction. Losartan should not be taken by people who are diabetic and taking aliskiren. Anemia may occur, due to inhibition of the renin–angiotensin system.{{Cite journal |vauthors=Cheungpasitporn W, Thongprayoon C, Chiasakul T, Korpaisarn S, Erickson SB |date=November 2015 |title=Renin-angiotensin system inhibitors linked to anemia: a systematic review and meta-analysis |journal=QJM |volume=108 |issue=11 |pages=879–884 |doi=10.1093/qjmed/hcv049 |pmid=25697787 |doi-access=free |title-link=doi}} As with other angiotensin receptor blockers, losartan may injure the liver, although this effect appears to be rare.{{Cite journal |vauthors=Patti R, Sinha A, Sharma S, Yoon TS, Kupfer Y |date=May 2019 |title=Losartan-induced Severe Hepatic Injury: A Case Report and Literature Review |journal=Cureus |volume=11 |issue=5 |pages=e4769 |doi=10.7759/cureus.4769 |pmc=6663042 |pmid=31363450 |doi-access=free}} Electrolyte imbalances may occur in people with kidney problems who take losartan. Adverse outcomes do not differ by sex, age, or race.

In October 2014, the U.S. Food and Drug Administration (FDA) issued a black box warning that losartan can cause fetal toxicity and should be discontinued as soon as pregnancy is detected.{{Cite web |date=16 October 2014 |title=Cozaar (losartan potassium) 25 mg, 50 mg, and 100 mg Tablets |url=https://www.fda.gov/Safety/MedWatch/SafetyInformation/ucm169666.htm |url-status=dead |archive-url=https://wayback.archive-it.org/7993/20170112172842/https://www.fda.gov/Safety/MedWatch/SafetyInformation/ucm169666.htm |archive-date=12 January 2017 |access-date=21 July 2015 |publisher=U.S. Food and Drug Administration (FDA)}} Using losartan while pregnant could result in fetal injury or death.

Overdosing would most likely result in decreased blood pressure, which could manifest as an increased heart rate, dizziness, feeling lightheaded, or loss of consciousness. Mice studies showed that lethality occurred at about 44 to 170 times the maximum recommended dose after the mice weights were taken into account.

Losartan may have adverse interactions with phenobarbital, rifampin, or fluconazole, possibly inhibiting its blood pressure-lowering effects.

{{See also|Valsartan#recalls|Angiotensin II receptor blocker#recalls}}

Between November 2018 and September 2019, the FDA announced multiple recalls of tablets containing losartan by Sandoz, Torrent Pharmaceuticals, Hetero Labs, Camber Pharmaceuticals, Legacy Pharmaceutical Packaging, Teva Pharmaceuticals, Vivimed Life Sciences, and Macleods Pharmaceutical Limited due to detection of one of the possible carcinogens N-nitrosodiethylamine, N-methylnitrosobutyric acid, or N-nitroso-N-methyl-4-aminobutyric acid in the active pharmaceutical ingredient (API).{{Cite press release |title=FDA provides update on its ongoing investigation into ARB drug products; reports on finding of a new nitrosamine impurity in certain lots of losartan and product recall |date=3 October 2019 |publisher=U.S. Food and Drug Administration (FDA) |url=https://www.fda.gov/news-events/press-announcements/fda-provides-update-its-ongoing-investigation-arb-drug-products-reports-finding-new-nitrosamine |access-date=3 October 2019 |url-status=live |archive-url=https://web.archive.org/web/20191003084728/https://www.fda.gov/news-events/press-announcements/fda-provides-update-its-ongoing-investigation-arb-drug-products-reports-finding-new-nitrosamine |archive-date=3 October 2019}}{{Cite web |date=8 November 2018 |title=Sandoz Inc. Issues Voluntary Nationwide Recall of One Lot of Losartan Potassium and Hydrochlorothiazide Due to the Detection of Trace Amounts of NDEA (N-Nitrosodiethylamine) Impurity Found in the Active Pharmaceutical Ingredient (API) |url=https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/sandoz-inc-issues-voluntary-nationwide-recall-one-lot-losartan-potassium-and-hydrochlorothiazide-due |url-status=live |archive-url=https://web.archive.org/web/20190907103710/https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/sandoz-inc-issues-voluntary-nationwide-recall-one-lot-losartan-potassium-and-hydrochlorothiazide-due |archive-date=7 September 2019 |access-date=5 October 2019 |publisher=U.S. Food and Drug Administration (FDA)}}{{Cite web |date=20 December 2018 |title=Torrent Pharmaceuticals Limited Issues Voluntary Nationwide Recall of Losartan Potassium Tablets, USP |url=https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/torrent-pharmaceuticals-limited-issues-voluntary-nationwide-recall-losartan-potassium-tablets-usp |url-status=dead |archive-url=https://web.archive.org/web/20190907100508/https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/torrent-pharmaceuticals-limited-issues-voluntary-nationwide-recall-losartan-potassium-tablets-usp |archive-date=7 September 2019 |access-date=5 October 2019 |publisher=U.S. Food and Drug Administration (FDA)}}{{Cite web |date=3 January 2019 |title=Torrent Pharmaceuticals Limited Expands Voluntary Nationwide Recall of Losartan Potassium Tablets, USP |url=https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/torrent-pharmaceuticals-limited-expands-voluntary-nationwide-recall-losartan-potassium-tablets-usp |url-status=live |archive-url=https://web.archive.org/web/20190907095806/https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/torrent-pharmaceuticals-limited-expands-voluntary-nationwide-recall-losartan-potassium-tablets-usp |archive-date=7 September 2019 |access-date=5 October 2019 |publisher=U.S. Food and Drug Administration (FDA)}}{{Cite web |date=23 September 2019 |title=Updated: Torrent Pharmaceuticals Limited Expands Voluntary Nationwide Recall of Losartan Potassium Tablets, USP and Losartan Potassium / Hydrochlorothiazide Tablets, USP |url=https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/updated-torrent-pharmaceuticals-limited-expands-voluntary-nationwide-recall-losartan-potassium-0 |url-status=dead |archive-url=https://web.archive.org/web/20191006034633/https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/updated-torrent-pharmaceuticals-limited-expands-voluntary-nationwide-recall-losartan-potassium-0 |archive-date=6 October 2019 |access-date=23 September 2019 |publisher=U.S. Food and Drug Administration (FDA)}}{{Cite web |date=15 July 2019 |title=Legacy Pharmaceutical Packaging, LLC Expands Voluntary Nationwide Recall of Losartan Potassium Tablets, USP, 50mg Due to the Detection of Trace Amounts of N-Nitroso N-Methyl 4-amino butyric acid (NMBA) Impurity Found in the Active Pharmaceutical Ingredient (API) |url=https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/legacy-pharmaceutical-packaging-llc-expands-voluntary-nationwide-recall-losartan-potassium-tablets |url-status=dead |archive-url=https://web.archive.org/web/20190913232047/https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/legacy-pharmaceutical-packaging-llc-expands-voluntary-nationwide-recall-losartan-potassium-tablets |archive-date=13 September 2019 |access-date=5 October 2019 |publisher=U.S. Food and Drug Administration (FDA)}}{{Cite web |date=26 June 2019 |title=Macleods Pharmaceutical Limited Issues Voluntary Nationwide Consumer Level Recall of Losartan Potassium 50mg and Losartan Potassium/Hydrochlorothiazide combination Tablets 50mg/12.5mg, 100mg/12.5mg and 100mg/25mg due to detection of NMBA (N-Nitroso-N-Methyl-4-aminobutyric acid) Impurity. |url=https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/macleods-pharmaceutical-limited-issues-voluntary-nationwide-consumer-level-recall-losartan-potassium |url-status=live |archive-url=https://web.archive.org/web/20191001203725/https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/macleods-pharmaceutical-limited-issues-voluntary-nationwide-consumer-level-recall-losartan-potassium |archive-date=1 October 2019 |access-date=5 October 2019 |publisher=U.S. Food and Drug Administration (FDA)}}{{Cite web |date=11 June 2019 |title=Teva Pharmaceuticals USA, Inc. Expands Voluntary Nationwide Recall of Losartan Potassium to 50 mg and 100 mg Tablets USP, Sold Exclusively to Golden State Medical Supply, Inc. |url=https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/teva-pharmaceuticals-usa-inc-expands-voluntary-nationwide-recall-losartan-potassium-50-mg-and-100-mg |url-status=live |archive-url=https://web.archive.org/web/20190913232046/https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/teva-pharmaceuticals-usa-inc-expands-voluntary-nationwide-recall-losartan-potassium-50-mg-and-100-mg |archive-date=13 September 2019 |access-date=5 October 2019 |publisher=U.S. Food and Drug Administration (FDA)}}{{Cite web |date=3 May 2019 |title=Vivimed Life Sciences Pvt Ltd Issues Voluntary Nationwide Recall of Losartan Potassium 25 mg, 50 mg and 100 mg Tablets, USP Due to the Detection of Trace Amounts of N-Nitroso-N-methyl-4-aminobutyric acid (NMBA) Impurity |url=https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/vivimed-life-sciences-pvt-ltd-issues-voluntary-nationwide-recall-losartan-potassium-25-mg-50-mg-and |url-status=live |archive-url=https://web.archive.org/web/20190913232045/https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/vivimed-life-sciences-pvt-ltd-issues-voluntary-nationwide-recall-losartan-potassium-25-mg-50-mg-and |archive-date=13 September 2019 |access-date=5 October 2019 |publisher=U.S. Food and Drug Administration (FDA)}}{{Cite web |date=26 April 2019 |title=Teva Pharmaceuticals USA, Inc. Issues Voluntary Nationwide Recall of Losartan Potassium 25 mg and 100 mg Tablets USP, Sold Exclusively to Golden State Medical Supply |url=https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/teva-pharmaceuticals-usa-inc-issues-voluntary-nationwide-recall-losartan-potassium-25-mg-and-100-mg |url-status=dead |archive-url=https://web.archive.org/web/20190913232043/https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/teva-pharmaceuticals-usa-inc-issues-voluntary-nationwide-recall-losartan-potassium-25-mg-and-100-mg |archive-date=13 September 2019 |access-date=5 October 2019 |publisher=U.S. Food and Drug Administration (FDA)}}{{Cite web |date=28 March 2019 |title=Legacy Pharmaceutical Packaging, LLC Issues Voluntary Nationwide Recall of Losartan Potassium Tablets, USP, 25mg, 50mg, and 100mg Due to the Detection of Trace Amounts of N-Nitroso N-Methyl 4-Amino Butyric Acid (NMBA) Impurity Found in the Active Pharmaceutical Ingredient (API) |url=https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/legacy-pharmaceutical-packaging-llc-issues-voluntary-nationwide-recall-losartan-potassium-tablets-0 |url-status=dead |archive-url=https://web.archive.org/web/20190907091211/https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/legacy-pharmaceutical-packaging-llc-issues-voluntary-nationwide-recall-losartan-potassium-tablets-0 |archive-date=7 September 2019 |access-date=5 October 2019 |publisher=U.S. Food and Drug Administration (FDA)}}{{Cite web |date=28 February 2019 |title=Camber Pharmaceuticals, Inc. Issues Voluntary Nationwide Recall of Losartan Potassium Tablets, USP, 25 mg, 50 mg and 100 mg Due to the Detection of Trace Amounts of N-Nitroso N-Methyl 4-amino butyric acid (NMBA) Impurity found in the Active Pharmaceutical Ingredient (API) |url=https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/camber-pharmaceuticals-inc-issues-voluntary-nationwide-recall-losartan-potassium-tablets-usp-25-mg |url-status=live |archive-url=https://web.archive.org/web/20190907092842/https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/camber-pharmaceuticals-inc-issues-voluntary-nationwide-recall-losartan-potassium-tablets-usp-25-mg |archive-date=7 September 2019 |access-date=5 October 2019 |publisher=U.S. Food and Drug Administration (FDA)}}{{Cite web |date=22 February 2019 |title=Macleods Pharmaceuticals Limited Issues Voluntary Nationwide Consumer Level Recall of One Lot (BLM 715A) of Losartan Potassium/Hydrochlorothiazide Combination Tablets 100mg/25mg Due to detection of NDEA (N-Nitrosodiethylamine) Impurity |url=https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/macleods-pharmaceuticals-limited-issues-voluntary-nationwide-consumer-level-recall-one-lot-blm-715a |url-status=dead |archive-url=https://web.archive.org/web/20190907093351/https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/macleods-pharmaceuticals-limited-issues-voluntary-nationwide-consumer-level-recall-one-lot-blm-715a |archive-date=7 September 2019 |access-date=5 October 2019 |publisher=U.S. Food and Drug Administration (FDA)}}

File:Renin-angiotensin-aldosterone system.svg

Losartan is a selective, competitive angiotensin II receptor type 1 (AT₁) antagonist, reducing the end organ responses to angiotensin II. Losartan administration results in a decrease in total peripheral resistance (afterload) and cardiac venous return (preload). All of the physiological effects of angiotensin II, including the release of aldosterone, are antagonized in the presence of losartan. Reduction in blood pressure occurs independently of the status of the renin–angiotensin system. As a result of losartan dosing, plasma renin activity increases due to the removal of the angiotensin II feedback. Renin is released from the kidneys when there is reduced renal arterial pressure, sympathetic activation, or increased sodium delivery to the distal renal tubule.{{Cite book |title=Basic & clinical pharmacology |date=30 November 2017 |publisher=McGraw-Hill Education |isbn=9781259641152 |editor-last=Katzung, Bertram G. |oclc=1048625746}} Renin then acts by converting angiotensinogen to angiotensin I; angiotensin-converting enzyme (ACE) converts angiotensin I to angiotensin II; angiotensin II causes vasoconstriction and aldosterone release. Aldosterone serves to retain sodium from the distal renal tubule. Sodium retention ultimately results in increased blood pressure.{{Cite journal |vauthors=Graudal NA, Hubeck-Graudal T, Jürgens G |date=January 2012 |title=Effects of low-sodium diet vs. high-sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride (Cochrane Review) |journal=American Journal of Hypertension |volume=25 |issue=1 |pages=1–15 |doi=10.1038/ajh.2011.210 |pmid=22068710 |doi-access=free}} Therefore, the use of angiotensin II receptor antagonists like losartan results in blocking the downstream effect of renin, and angiotensin II, and ultimately decreasing blood pressure.{{cn|date=February 2025}}

Angiotensin II receptor antagonists include losartan, valsartan, azilsartan, candesartan, eprosartan, irbesartan, olmesartan, and telmisartan. They all have the same mechanism of action and potentially inhibit the actions of angiotensin better than ACE inhibitors, such as lisinopril, because other enzymes than ACE have the capability of producing angiotensin II.

Losartan is a uricosuric. As a specific inhibitor of the urate transporter 1 (SLC22A12, URAT1), losartan blocks the uptake of uric acid into cells, thus leaving more available in the bloodstream to be filtered and excreted by the kidneys.{{Cite journal |vauthors=Hamada T, Ichida K, Hosoyamada M, Mizuta E, Yanagihara K, etal |date=1 October 2008 |title=Uricosuric action of losartan via the inhibition of urate transporter 1 (URAT 1) in hypertensive patients |journal=American Journal of Hypertension |volume=21 |issue=10 |pages=1157–1162 |doi=10.1038/ajh.2008.245 |pmid=18670416 |doi-access=free}} Because losartan can cause hyperkalemia, individuals should not use potassium supplements or salt substitutes containing potassium without appropriate monitoring by a physician.RxList. The Internet Drug Index. [http://www.rxlist.com/cozaar-drug/clinical-pharmacology.htm Clinical pharmacology of Cozaar] {{Webarchive|url=https://web.archive.org/web/20140106170728/http://www.rxlist.com/cozaar-drug/clinical-pharmacology.htm |date=6 January 2014 }}. Retrieved 6 January 2014.

Losartan is well absorbed following oral administration and undergoes significant first-pass metabolism to produce the 5-carboxylic acid metabolite, designated as EXP3174. About 14% of an oral dosage is converted to this metabolite, which is long-acting (6 to 8 hours) and a noncompetitive antagonist at the AT₁ receptor, contributing to the pharmacological effects of losartan. EXP3174 is 10–40 times more potent in blocking AT₁ receptors than losartan. In addition, the binding to the target enzyme is pH-sensitive, and the negatively charged tetrazole ring, which is similar in size to the negative carboxylic acid derivative, may contribute to the activity of the drug.{{Cite journal |vauthors=Noda K, Saad Y, Kinoshita A, Boyle TP, Graham RM, Husain A, Karnik SS |date=February 1995 |title=Tetrazole and carboxylate groups of angiotensin receptor antagonists bind to the same subsite by different mechanisms |url=http://www.jbc.org/content/270/5/2284.long |url-status=live |journal=The Journal of Biological Chemistry |volume=270 |issue=5 |pages=2284–2289 |doi=10.1074/jbc.270.5.2284 |pmid=7530721 |archive-url=https://web.archive.org/web/20220919071603/https://www.jbc.org/article/S0021-9258(19)47992-1/fulltext |archive-date=19 September 2022 |access-date=21 October 2017 |doi-access=free}}

Losartan's bioavailability is about 33%.

Metabolism is primarily by cytochrome P450 isoenzymes CYP2C9 and CYP3A4. Peak plasma concentrations of losartan and EXP3174 occur about one hour and three to four hours, respectively, after an oral dose. Both losartan and EXP3174 are more than 98% bound to plasma proteins. Losartan is excreted in the urine, and in the feces via bile, as unchanged drug and metabolites. About 4% of an oral dose is excreted unchanged in urine, and about 6% is excreted in urine as the active metabolite. The terminal elimination half-lives of losartan and EXP3174 are about 1.5 to 2.5 hours and 3 to 9 hours, respectively.

Losartan and other angiotensin-receptor antagonists exhibit fetal toxicity and should be avoided during pregnancy, particularly in the second and third trimesters.{{Cite journal |vauthors=Sica DA, Gehr TW, Ghosh S |year=2005 |title=Clinical pharmacokinetics of losartan |journal=Clin Pharmacokinet |volume=44 |issue=8 |pages=797–814 |doi=10.2165/00003088-200544080-00003 |pmid=16029066 |s2cid=41326620}}

{{main|Discovery and development of angiotensin receptor blockers}}

{{Reflist}}

• {{Cite journal |vauthors=Al-Majed AR, Assiri E, Khalil NY, Abdel-Aziz HA |date=2015 |title=Losartan: Comprehensive Profile |journal=Profiles Drug Subst Excip Relat Methodol |volume=40 |pages=159–94 |doi=10.1016/bs.podrm.2015.02.003 |pmid=26051686}}
• {{Cite journal |vauthors=Sica DA, Gehr TW, Ghosh S |date=2005 |title=Clinical pharmacokinetics of losartan |journal=Clin Pharmacokinet |volume=44 |issue=8 |pages=797–814 |doi=10.2165/00003088-200544080-00003 |pmid=16029066 |s2cid=41326620}}

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