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| <small>'''''Synonyms / Brand Names:''''' Cozaar</small>
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| | {{Losartan}} |
| | {{CMG}}; {{AE}} {{SS}} |
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| {{CMG}}
| | '''''For patient information about Losartan, click [[Losartan (patient information)|here]].''''' |
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| ==Dosing and Administration==
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| * '''Adult Hypertensive Patients'''
| | ==Overview== |
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| Cozaar may be administered with other antihypertensive agents, and with or without food.
| | ==Category== |
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| Dosing must be individualized. The usual starting dose of Cozaar is 50 mg once daily, with 25 mg used in patients with possible depletion of intravascular volume (e.g., patients treated with [[diuretics]]) and patients with a history of [[hepatic impairment]]. Cozaar can be administered once or twice daily with total daily doses ranging from 25 mg to 100 mg.
| | ==FDA Package Insert== |
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| If the antihypertensive effect measured at trough using once-a-day dosing is inadequate, a twice-a-day regimen at the same total daily dose or an increase in dose may give a more satisfactory response. The effect of losartan is substantially present within one week but in some studies the maximal effect occurred in 3-6 weeks.
| | ''' [[Losartan indications and usage|Indications and Usage]]''' |
| | '''| [[Losartan dosage and administration|Dosage and Administration]]''' |
| | '''| [[Losartan dosage forms and strengths|Dosage Forms and Strengths]]''' |
| | '''| [[Losartan contraindications|Contraindications]]''' |
| | '''| [[Losartan warnings and precautions|Warnings and Precautions]]''' |
| | '''| [[Losartan adverse reactions|Adverse Reactions]]''' |
| | '''| [[Losartan drug interactions|Drug Interactions]]''' |
| | '''| [[Losartan use in specific populations|Use in Specific Populations]]''' |
| | '''| [[Losartan overdosage|Overdosage]]''' |
| | '''| [[Losartan description|Description]]''' |
| | '''| [[Losartan clinical pharmacology|Clinical Pharmacology]]''' |
| | '''| [[Losartan nonclinical toxicology|Nonclinical Toxicology]]''' |
| | '''| [[Losartan clinical studies|Clinical Studies]]''' |
| | '''| [[Losartan how supplied storage and handling|How Supplied/Storage and Handling]]''' |
| | '''| [[Losartan patient counseling information|Patient Counseling Information]]''' |
| | '''| [[Losartan labels and packages|Labels and Packages]]''' |
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| If blood pressure is not controlled by Cozaar alone, a low dose of a diuretic may be added. [[Hydrochlorothiazide]] has been shown to have an additive effect.
| | ==Mechanism of Action== |
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| No initial dosage adjustment is necessary for elderly patients or for patients with [[renal impairment]], including patients on dialysis.
| | ==References== |
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| * '''Pediatric Hypertensive Patients ≥ 6 years of age'''
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| The usual recommended starting dose is 0.7 mg/kg once daily (up to 50 mg total) administered as a tablet or a suspension (see Preparation of Suspension). Dosage should be adjusted according to blood pressure response. Doses above 1.4 mg/kg (or in excess of 100 mg) daily have not been studied in pediatric patients.
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| Cozaar is not recommended in pediatric patients <6 years of age or in pediatric patients with [[glomerular filtration rate]] <30 mL/min/1.73 m2
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| * '''Preparation of Suspension (for 200 mL of a 2.5 mg/mL suspension)'''
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| Add 10 mL of Purified Water USP to an 8 ounce (240 mL) amber polyethylene terephthalate (PET) bottle containing ten 50 mg Cozaar tablets. Immediately shake for at least 2 minutes. Let the concentrate stand for 1 hour and then shake for 1 minute to disperse the tablet contents. Separately prepare a 50/50 volumetric mixture of Ora-Plus™ and Ora-Sweet SF™ Add 190 mL of the 50/50 Ora-Plus™/Ora-Sweet SF™ (Trademarks of Paddock Laboratories, Inc.) mixture to the tablet and water slurry in the PET bottle and shake for 1 minute to disperse the ingredients. The suspension should be refrigerated at 2-8°C (36-46°F) and can be stored for up to 4 weeks. Shake the suspension prior to each use and return promptly to the refrigerator.
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| * '''Hypertensive Patients with Left Ventricular Hypertrophy'''
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| The usual starting dose is 50 mg of Cozaar once daily. [[Hydrochlorothiazide]] 12.5 mg daily should be added and/or the dose of Cozaar should be increased to 100 mg once daily followed by an increase in [[hydrochlorothiazide]] to 25 mg once daily based on blood pressure response.
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| * '''Nephropathy in Type 2 Diabetic Patients'''
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| The usual starting dose is 50 mg once daily. The dose should be increased to 100 mg once daily based on blood pressure response. Cozaar may be administered with [[insulin]] and other commonly used hypoglycemic agents (e.g., [[sulfonylurea]]s, glitazones and glucosidase inhibitors).
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| [[{{PAGENAME}}#FDA Package Insert Resources|FDA Package Insert Resources]]
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| <br></font size><small>Indications, Contraindications, Side Effects, Drug Interactions, etc.</small><font size="4"><br>
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| [http://www.pace-med-apps.com/gfrcalc.htm Calculate Creatine Clearance]
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| <br></font size><small>On line calculator of your patients Cr Cl by a variety of formulas.</small><font size="4"><br>
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| [http://home.earthlink.net/~sensei11/convert.htm Convert pounds to Kilograms]
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| <br></font size><small>On line calculator of your patients weight in pounds to Kg for dosing estimates.</small><font size="4"><br>
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| <br> [[{{PAGENAME}}#Publication Resources|Publication Resources]]
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| <br></font size><small>Recent articles, WikiDoc State of the Art Review, Textbook Information</small><font size="4"><br>
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| [[{{PAGENAME}}#Trial Resources|Trial Resources]]
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| <br></font size><small>Ongoing Trials, Trial Results</small><font size="4"><br>
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| [[{{PAGENAME}}#Guidelines & Evidence Based Medicine Resources|Guidelines & Evidence Based Medicine Resources]]
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| <br></font size><small>US National Guidelines, Cochrane Collaboration, etc.</small><font size="4"><br>
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| [[{{PAGENAME}}#Media Resources|Media Resources]]
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| <br></font size><small>Slides, Video, Images, MP3, Podcasts, etc.</small><font size="4"><br><br>
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| [[{{PAGENAME}}#Patient Resources|Patient Resources]]
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| [[{{PAGENAME}}#International Resources|International Resources]]
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| <br></font size><small>en Español</small><font size="4"><br>
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| ==FDA Package Insert Resources==
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| [[{{PAGENAME}} indications|Indications]]
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| [[{{PAGENAME}} contraindications|Contraindications]]
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| [[{{PAGENAME}} warnings|Warnings]]
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| [[{{PAGENAME}} side effects|Side Effects]]
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| [[{{PAGENAME}} drug interactions|Drug Interactions]]
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| [[{{PAGENAME}} precautions|Precautions]]
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| [[{{PAGENAME}} overdose|Overdose]]
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| [[{{PAGENAME}} instructions for administration|Instructions for Administration]]
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| [[{{PAGENAME}} how supplied|How Supplied]]
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| [[{{PAGENAME}} pharmacokinetics and molecular data|Pharmacokinetics and Molecular Data]]
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| [http://www.fda.gov/ohrms/dockets/dockets/05p0351/05p-0351-cp00001-03-attachment-2-vol1.pdf FDA label-1]
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| [http://www.fda.gov/cder/foi/nda/98/20386-s008_cozaar.pdf FDA label-2]
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| [http://google2.fda.gov/search?q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|{{PAGENAME}}}}}}&x=0&y=0&client=FDA&site=FDA&lr=&proxystylesheet=FDA&output=xml_no_dtd&getfields=* FDA on {{PAGENAME}}]
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| </font size><small>[[{{PAGENAME}}#Dosing and Administration|Return to top]]</small><font size="4">
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| ==Publication Resources==
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| [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&db=pubmed&term={{urlencode:{{#if:{{{1|}}}|{{{1}}}|{{PAGENAME}}}}}} Most Recent Articles on {{#if:{{{1|}}}|{{{1}}}|{{PAGENAME}}}}]
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| [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=search&db=pubmed&term={{urlencode:{{#if:{{{1|}}}|{{{1}}}|{{PAGENAME}}}}}}+AND+%28%28N+Engl+J+Med%5Bta%5D%29+OR+%28Lancet%5Bta%5D%29+OR+%28BMJ%5Bta%5D%29%29 Articles on {{PAGENAME}} in N Eng J Med, Lancet, BMJ]
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| [[WikiDoc state of the art review on {{PAGENAME}}|WikiDoc State of the Art Review]]
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| [http://books.google.com/books?ie=UTF-8&oe=utf-8&q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|{{PAGENAME}}}}}}&qt_s=Search&sa=N&tab=gp Textbook Information on {{PAGENAME}}]
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| ==Trial Resources==
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| [http://clinicaltrials.gov/search/open/condition={{urlencode:{{#if:{{{1|}}}|{{{1}}}|{{PAGENAME}}}}}} Ongoing Trials with {{PAGENAME}} at Clinical Trials.gov]
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| ==Guidelines & Evidence Based Medicine Resources==
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| [http://www.guideline.gov/search/searchresults.aspx?Type=3&txtSearch={{urlencode:{{#if:{{{1|}}}|{{{1}}}|{{PAGENAME}}}}}}&num=20 US National Guidelines Clearinghouse on {{PAGENAME}}]
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| [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=search&db=pubmed&term={{urlencode:({{#if:{{{1|}}}|{{{1}}}|{{PAGENAME}}}}) AND (Cochrane Database Syst Rev[ta])}} Cochrane Collaboration on {{PAGENAME}}]
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| [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=search&db=pubmed&term={{urlencode:({{#if:{{{1|}}}|{{{1}}}|{{PAGENAME}}}}) AND (Cost effectiveness)}} Cost Effectiveness of {{PAGENAME}}]
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| </font size><small>[[{{PAGENAME}}#Dosing and Administration|Return to top]]</small><font size="4">
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| ==Media Resources==
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| [http://www.google.com/search?q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|{{PAGENAME}}}}}}+ppt&ie=utf-8&oe=utf-8&aq=t&rls=org.mozilla:en-US:official&client=firefox-a Powerpoint Slides on {{PAGENAME}}]
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| [http://www.google.com/search?hl=en&client=firefox-a&rls=org.mozilla%3Aen-US%3Aofficial&hs=hPo&q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|{{PAGENAME}}}}}}+podcasts+OR+MP3&btnG=Search Podcasts & MP3s on {{PAGENAME}}]
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| ==Patient Resources==
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| [[{{PAGENAME}} (patient information)|Patient Information from National Library of Medicine]]
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| [http://www.google.com/search?hl=en&q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|{{PAGENAME}}}}}}+more:for_patients&cx=disease_for_patients&sa=N&oi=cooptsr&resnum=0&ct=col3&cd=1 Patient Resources on {{PAGENAME}}]
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| [http://groups.google.com/groups/search?ie=UTF-8&oe=utf-8&q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|{{PAGENAME}}}}}}&qt_s=Search Discussion Groups on {{PAGENAME}}]
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| [http://finance.google.com/finance?ie=UTF-8&oe=utf-8&q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|{{PAGENAME}}}}}}&qt_s=Search&sa=N&tab=te {{PAGENAME}} in the Marketplace]
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| ==International Resources==
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| [http://www.google.com/search?q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|{{PAGENAME}}}}}}+en+espanol&ie=utf-8&oe=utf-8&aq=t&rls=org.mozilla:en-US:official&client=firefox-a {{PAGENAME}} en Español]
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| ----
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| {{FDA}}
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| | [[Category:Cardiovascular Drugs]] |
| [[Category:Drugs]] | | [[Category:Drugs]] |