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Losartan - an angiotensin receptor blocker

Cozaar

Take losartan once each day. You can take your doses either before or after a meal.

Any side-effects are usually mild, and can include feeling dizzy or light-headed.

Some painkillers can interfere with losartan and increase the risk of side-effects, so ask a pharmacist for advice before you buy any medicines 'over the counter'.

Do not drink grapefruit juice whilst taking losartan. It can interact with the medicine and alter its effect.

Clinical author's note: Michael Stewart 15/11/2018: Following an MHRA update, new advice has been added to this leaflet for people also taking the blood pressure medicine hydrochlorothiazide. Hydrochlorothiazide is only available in the UK in combination with other medicines used to treat high blood pressure. It may be available on its own in other countries. For more information see the warning below in 'can this medicine cause problems?' or view the MHRA Alert.

At a glance

  • Losartan is a medicine often prescribed for high blood pressure, heart failure, or kidney disease linked to diabetes.

  • It works by blocking a substance in your body called angiotensin II, which helps lower blood pressure.

  • Take losartan once a day, at the same time each day, with or without food.

  • Tell your doctor if you are pregnant, breastfeeding, or have kidney, heart, or liver problems.

  • Common side effects can include feeling tired or dizzy when standing up.

  • Avoid certain anti-inflammatory painkillers and salt substitutes while taking this medicine.

  • If you are taking losartan with hydrochlorothiazide, protect your skin from the sun.

Continue reading below

About losartan

Type of medicine

An angiotensin-II receptor antagonist

Used for

High blood pressure; heart failure; kidney disease associated with diabetes

Also called

Cozaar®;
Combination brand: Cozaar-Comp® (losartan with hydrochlorothiazide)

Available as

Tablets

Losartan is an angiotensin receptor blocker. It is also called an angiotensin-II receptor antagonist, or an AIIRA. You will have been prescribed losartan for one of the following reasons:

Losartan works by blocking the effect of a substance in your body called angiotensin II. Angiotensin II causes your blood vessels to narrow and also leads to the production of another substance called aldosterone, which increases the amount of fluid in your blood. By preventing the action of angiotensin II, losartan reduces how much work your heart has to do and lowers your blood pressure. It also has a protective effect on your kidneys.

You may be prescribed losartan to take on its own, or alongside other medicines to help your condition. There is a combination tablet available called Cozaar-Comp® which contains losartan with a diuretic called hydrochlorothiazide. This combination tablet can be prescribed to people with high blood pressure to help reduce the total number of tablets that need to be taken each day.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking losartan it is important that your doctor knows:

  • If you are pregnant or breastfeeding.

  • If you know you have a blockage of the artery which supplies blood to your kidneys, a condition called renal artery stenosis.

  • If you have any problems with your heart valves or heart muscle.

  • If you have a problem with the way your liver works.

  • If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.

  • If you have ever had an allergic reaction to a medicine, or if you have had any other type of allergic reaction.

Continue reading below

  • Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about losartan and will provide you with a full list of the side-effects which you could experience from taking it.

  • Take losartan once each day, exactly as your doctor tells you to. There are several different strengths of tablet available. When you first start treatment your doctor may gradually increase the strength of the tablets to suit your condition. Each time you collect a fresh supply, it's a good idea to check the strength on the packet to make sure they are what you are expecting.

  • Try to take losartan at the same time of day each day. For most people this will be in the morning. Taking your doses at the same time each day will help you to remember to take losartan regularly.

  • Swallow the tablet whole with a drink of water. You can take losartan either before or after a meal.

  • If you forget to take a dose, take it as soon as you remember. If you do not remember until the following day, miss out the forgotten dose. Do not take two doses at the same time to make up for a forgotten dose.

  • Try to keep your regular appointments with your doctor. This is so your progress can be monitored. Your doctor may want you to have some blood tests from time to time to check on your kidneys, and also how much potassium is in your blood.

  • If you buy any medicines, check with a pharmacist that they are suitable to take with losartan. This is because some anti-inflammatory painkillers (such as aspirin and ibuprofen) can interfere with the way it works, and also may increase the risk of side-effects.

  • It is very important that you follow any dietary and lifestyle advice that you have been given by your doctor, such as eating a healthy diet, not smoking, and taking regular exercise.

  • If you drink alcohol, ask your doctor for advice. Your doctor may recommend that you do not drink alcohol while you are on losartan because it will increase the risk of side-effects, such as feeling dizzy or faint.

  • Try to avoid salt substitutes which contain potassium. This is because the substitutes will increase the amount of potassium in your blood and this can cause problems.

  • If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking losartan. This is because your blood pressure may drop too low if you are given some anaesthetics.

  • Treatment with losartan is usually long-term unless you experience an adverse effect. Continue to take the tablets regularly, unless you are advised otherwise by your doctor.

Continue reading below

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with losartan. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

Common losartan side-effects (these affect fewer than 1 in 10 people)

What can I do if I experience this?

Feeling tired, or dizzy and light-headed when you stand up (due to low blood pressure)

Getting up and moving more slowly should help. If you begin to feel dizzy, sit for a few minutes before you stand up again

Changes in the amount of potassium in your blood

You will have blood tests from time to time to check for this

If you are also taking hydrochlorothiazide in combination with this medicine:

  • Studies have suggested that taking higher doses of hydrochlorothiazide for long periods of time may increase the risk of certain skin cancers.

  • Tell your doctor if you have ever been treated for skin cancer before.

  • Tell your doctor about any new or changed moles or worrying marks on your skin.

  • Use a sunscreen in strong sunlight. Do not use sunbeds.

If you experience any other symptoms which you think may be due to the medicine, speak with your doctor or pharmacist for further advice.

  • Keep all medicines out of the reach and sight of children.

  • Store the tablets in a cool, dry place, away from direct heat and light.

Important information about all medicines

Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.

This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.

Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.

If you have any questions about this medicine ask your pharmacist.

Report side effects to a medicine or vaccine

If you experience side effects, you can report them online through the Yellow Card website.

symptom checker

Unsure about mixing medicines?

Check for possible interactions between medicines, supplements and foods before taking them together.

Frequently asked questions

How does losartan actually help my heart if it's not beating well?

Losartan works by blocking the effects of a substance in your body called angiotensin II. Angiotensin II narrows your blood vessels and also increases the amount of fluid in your blood by triggering the production of aldosterone. By preventing angiotensin II from acting, losartan reduces the effort your heart has to make, which helps if your heart isn't beating as effectively as it should.

Can I switch the time of day I take my losartan if my routine changes?

It is recommended to take losartan at the same time each day to help you remember to take it regularly. While for most people this is in the morning, the article doesn't specify if changing the time is problematic, but it does say if you forget a dose, take it as soon as you remember, unless it's nearly the next day. Consistency is the key.

Is it safe to use salt substitutes if I'm trying to reduce my salt intake while on losartan?

No, you should try to avoid salt substitutes that contain potassium. Losartan can affect the amount of potassium in your blood, and these substitutes would further increase potassium levels, which could lead to problems.

What should I do if I notice any new skin changes, especially if I'm taking the combination tablet?

If you are taking losartan in combination with hydrochlorothiazide, you should tell your doctor about any new or changed moles or worrying marks on your skin. Studies suggest that higher doses of hydrochlorothiazide over long periods may increase the risk of certain skin cancers. It's also important to use sunscreen in strong sunlight and avoid sunbeds.

How long will I need to take losartan?

Treatment with losartan is usually considered long-term. You should continue to take the tablets regularly unless your doctor advises you otherwise, for example, if you experience an adverse effect.

If I feel dizzy when I stand up after taking losartan, what should I do?

If you experience dizziness or light-headedness when you stand up, which can happen due to low blood pressure, try getting up and moving more slowly. If you start to feel dizzy, sit for a few minutes before you attempt to stand up again.

Further reading and references

Continue reading below

About the authorView full bio

Author image

Michael Stewart, MRPharmS

Medicine Leaflet Review Manager – Contractor, Pharmacist

BPharm (Hons), MRPharmS

Michael is a community pharmacist practicing in the Midlands and South Yorkshire with more than 20 years’ experience advising on medicines and medical conditions. He has a strong background in healthcare training, having produced and delivered training courses for pharmacy teams and staff of residential care settings, including nurses. He has also contributed to pharmacy advisory boards for the management of low acuity conditions in the community.

About the reviewer

Author image

Sid Dajani

Sultan Dajani qualified at the London School of Pharmacy in 1994 and became the youngest elected member of the Royal Pharmaceutical Society council since its founding in 1842.

Article history

The information on this page is written and peer reviewed by qualified clinicians.

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