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Losartan is an angiotensin II receptor blocker (ARB) that selectively blocks the AT1 receptor, reducing angiotensin II–mediated vasoconstriction and aldosterone release. It is primarily used to treat high blood pressure and to protect kidney function in people with diabetes.

What Losartan is

Losartan belongs to the angiotensin II receptor blockers, a class of medicines that inhibit the effects of angiotensin II on the AT1 receptor. By blocking this pathway, it helps blood vessels relax and lowers blood pressure, with a direct effect on aldosterone-driven salt and fluid balance.

When taken by mouth, losartan is absorbed and rapidly converted to an active metabolite known as EXP3174, which drives much of the blood-pressure-lowering action. The drug is usually taken once daily, with or without food, depending on individual response and tolerance.

What it is used for

Hypertension is the primary indication for losartan. By lowering vascular resistance, it reduces systolic and diastolic pressures and helps protect the heart and kidneys over time.

In addition, losartan is used to reduce the risk of stroke in adults with hypertension and left ventricular hypertrophy. It also has a role in preserving kidney function in type 2 diabetes with albuminuria and is approved for pediatric hypertension in some age groups.

Contraindications and precautions

Contraindications include pregnancy, since ARBs can harm the fetus. It should not be used in individuals with hypersensitivity to losartan or any component of the formulation, or in patients with bilateral renal artery stenosis due to risk of kidney injury.

In practice, caution is advised for dehydration, low salt levels, or concurrent diuretic use, as these raise the risk of symptomatic hypotension. Regular monitoring of kidney function and electrolytes, especially potassium, helps detect imbalances early.

Other precautions include avoiding use during pregnancy and careful consideration in liver disease or severe kidney impairment. Angioedema, though less common than with ACE inhibitors, can occur, and clinicians advise stopping therapy if facial swelling or throat tightness develops. NSAIDs may blunt the antihypertensive effect and worsen kidney function in some patients.

Side effects by frequency

Common effects include dizziness or lightheadedness, fatigue, nasal congestion, sore throat, back pain, and upper respiratory infections. These often appear early and improve with time or dose adjustment.

Other uncommon effects are low blood pressure, dehydration symptoms, peripheral edema, diarrhea, stomach upset, or a rash. Some people notice changes in sleep or mood or a metallic taste.

Serious but rare events include angioedema (swelling of the face, lips, tongue, or throat) and signs of kidney or liver injury, such as decreased urine output, yellowing of the skin, or unusually dark urine. Seek prompt medical help if swelling or breathing difficulties occur.

Interactions with other substances

Potassium-sparing diuretics (like spironolactone or triamterene) and potassium supplements can raise potassium levels, increasing the risk of abnormal heart rhythms. Use with caution and monitor electrolytes.

Nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce losartan’s blood-pressure effect and can worsen kidney function, especially in dehydrated individuals. Concomitant lithium therapy can alter lithium levels and cause mood or kidney concerns.

Avoid combining losartan with aliskiren in patients with diabetes or kidney impairment. When taken with other antihypertensives, careful monitoring is advised to manage potential additive blood-pressure lowering effects.