Calcium channel blockers are available in short-acting and long-acting forms. [10], Although evidence shows calcium channel blockers and thiazide-type diuretics are preferred first-line treatments for most people (due to both efficacy[medical citation needed] 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. Both losartan and EXP3174 are more than 98% bound to plasma proteins. "These data may have practical implications for choosing the appropriate antihypertensive drugs in patients with hypertension, a common comorbidity of gout. Reduction in blood pressure occurs independently of the status of the renin–angiotensin system. CCBs. [13] As with other angiotensin receptor blockers, losartan may injure the liver, although this effect appears to be rare. [36] Because losartan can cause hyperkalemia, individuals should not use potassium supplements or salt substitutes containing potassium without appropriate monitoring by a physician. [2][3] It is on the World Health Organization's List of Essential Medicines. Losartan and other angiotensin-receptor antagonists exhibit fetal toxicity and should be avoided during pregnancy, particularly in the second and third trimesters. Losartan administration results in a decrease in total peripheral resistance (afterload) and cardiac venous return (preload). It is a suitable pharmacological agent for the reduction of renal disease progression in patients with type 2 diabetes, hypertension, and microalbuminuria (>30 mg/24 hours) or proteinuria (>900 mg/24 hours). [37], Losartan is well absorbed following oral administration and undergoes significant first-pass metabolism to produce the 5-carboxylic acid metabolite, designated as EXP3174. Keywords: Search for Brand or Generic Name. For instance, in commonly used dual therapy combinations including diuretics, the gout risk was greater with ACE inhibitors and with beta blockers than with CCBs, and in combined use of beta blockers the risk was higher with ACE inhibitors than with CCBs, while the risk was nonsignificant for the combination of ACE inhibitors and CCBs. 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.[38]. [9], Losartan may have adverse interactions with phenobarbital, rifampin, or fluconazole, possibly inhibiting its blood pressure-lowering effects. The combination was patented by Novartis Pharmaceuticals and sold under the brand name Exforge. Dihydropyridine calcium Channel Blocker. This study compared the efficacy and safety of combination angiotensin‐receptor blocker (ARB)/calcium‐channel blocker (CCB) with hydrochlorothiazide (valsartan/amlodipine/HCTZ 160/5/25 mg) vs maximal available combination doses of an ARB with HCTZ (losartan/HCTZ 100/25 mg) in the management of stage 2 hypertension. Ishimitsu T(1), Ohno E, Nakano N, Furukata S, Akashiba A, Minami J, Numabe A, Matsuoka H. Free full text. ... For the treatment of Hypertension, management of angina pectoris and Raynaud's syndrome: Losartan: An angiotensin receptor blocker used to treat hypertension and diabetic nephropathy, and is used to reduce the risk of stroke. Saving you time. Dr. Calvin Weisberger answered. Further analysis showed that the relative risk for gout was associated with duration of CCB use, at 1.04 for less than 1 year, 0.89 for 1-1.9 years, and 0.77 for 2 years or more. Losartan, sold under the trade name Cozaar among others, is a medication mainly used to treat high blood pressure. These medications are used in adults and children over the age of six to lower mild-to-moderate hypertension (high blood pressure).Angiotensin II is a chemical that the body releases to cause the constriction of blood vessels. [6][7] A version combined with hydrochlorothiazide is available[2] and, in 2017, it was the 67th most commonly prescribed medication in the United States, with more than eleven million prescriptions. [9] Anemia may occur, due to inhibition of the renin–angiotensin system. [9] It may also delay progression of diabetic nephropathy. [34] Aldosterone serves to retain sodium from the distal renal tubule. [34] There is limited data on what dosage is considered toxic in humans; toxicity would most likely result in decreased blood pressure and an increased heart rate. Losartan is a type of blood pressure medication that works by blocking receptors for angiotensin, an enzyme that can cause blood pressure to increase. 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