Losartan (Cozaar®)

Losartan is an angiotensin II receptor blocker approved for the treatment of hypertension and diabetic nephropathy.  The drug antagonizes the angiotension II type I (AT1) receptor, inhibiting Gq, Ras, STAT, and growth factor-related tyrosine kinase signaling pathways.  This leads to decreased smooth muscle contraction and vasodilation, as well as decreased aldosterone secretion from the adrenal gland.

Losartan is often prescribed for patients with hypertension who develop a bradykinin-associated cough during angiotensin-converting enzyme (ACE) inhibitor therapy.  It is also indicated for reducing stroke risk in patients with hypertension and left ventricular hypertrophy, although some studies have shown that this effect is attenuated in black patients (beta-blockade may be more effective at lowering thromboembolic risk in this population).  Losartan is also prescribed off-label for the treatment of heart failure with reduced ejection fraction and may mitigate pathological myocardial remodeling associated with chronic heart failure.




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