How long does it take for losartan to get out of your system?

What Are the Withdrawal Symptoms of Losartan?

Cozaar (losartan) is an antihypertensive medication. It is classified as an angiotensin II receptor agonist, and its use leads to blood vessels not constricting and lowered blood pressure. It is typically prescribed to treat hypertension in a variety of situations, and it is effective for these uses. People using losartan should not drink alcohol or use other substances that can further lower their blood pressure because this can lead to significant issues with hypotension (low blood pressure) that can be potentially dangerous.

Addiction Potential, Withdrawal, & Other Issues

Losartan is not listed as a controlled substance by the United States Drug Enforcement Administration (DEA). There is no category for antihypertensive abuse listed by the National Institute on Drug Abuse (NIDA), the Substance Abuse and Mental Health Services Administration (SAMHSA), the American Psychiatric Association (APA), the American Society of Addiction Medicine (ASAM), etc. Losartan has generally received positive reviews regarding its effectiveness as a medication, and it is not considered to be a potential drug of abuse.

Numerous studies have failed to document significant withdrawal symptoms in people prescribed the drug who have suddenly discontinued its use. However, according to professional sources such as the book Pharmacology of Antihypertensive Drugs, suddenly discontinuing the drug can lead to a rapid increase in blood pressure that can increase the risk for:

  • Lightheadedness, dizziness, and confusion
  • Stroke
  • Heart attack
  • Nausea and discomfort, in some cases

Abruptly stopping antihypertensive medications may also result in some other effects that are often labeled as withdrawal issues when they occur with other medications, but technically, they are not labeled as withdrawal issues by professional sources when they occur with antihypertensive medications because they are not associated with drug-seeking behaviors and cravings for antihypertensive drugs. Nonetheless, some of these issues include:

  • Tiredness or lethargy
  • Swelling, particularly in the legs or ankles
  • Flushing of the face
  • Slight fever or chills
  • Excessive thirst
  • Irregular heartbeat

Thus, when the drug is discontinued, it is typically done on a tapering schedule to wean the person off the medication and avoid these potential issues.

The appearance of physical and even psychological issues with the sudden discontinuation of losartan and not labeling them as a formal type of withdrawal syndrome is reminiscent of the denial by various medical associations regarding the discontinuation of antidepressant medications, which are drugs that are also not significant drugs of abuse like antihypertensive medications. Various medical organizations claimed that the discontinuation of antidepressants was not associated with significant withdrawal symptoms despite numerous complaints by patients that they experienced physical and psychological symptoms once these drugs were abruptly discontinued. This claim by various medical associations, including APA, continued for quite some time until a formal syndrome was identified as a result of the discontinuation of these medications in a small percentage of individuals. Still, this syndrome is not referred to as a formal withdrawal syndrome. It is most often referred to as an antidepressant discontinuation syndrome, which can be avoided by use of a tapering schedule.

At the current time, most sources do not refer to the symptoms that may result when an individual discontinues an antihypertensive medication like losartan as a form of withdrawal; however, the approach to controlling the symptoms is the same as the approach used to avoid withdrawal symptoms that are associated with many prescription medications. Even though losartan is not a significant drug of abuse, any individual who has been taking the drug should only discontinue it under the supervision of a physician and according to their physician’s instructions.

Losartan

Easy-to-read medicine information about losartan – what it is, how to take losartan safely and possible side effects.

Type of medicine Also called
  • Belongs to a group of medicines called angiotensin receptor blockers (ARBs)
  • Losartan Actavis®
  • Cozaar®

What is losartan?

Losartan has many different effects on the body and is used to treat a variety of conditions. It belongs to a group of medicines called ARBs. Losartan may be used for:

  • high blood pressure (hypertension) by relaxing the blood vessels and lowering your blood pressure
  • heart failure to help your heart pump blood more easily. This can help to relieve symptoms such as shortness of breath and swelling of feet, legs and abdomen
  • diabetic kidney disease (diabetic nephropathy) to protect your kidneys and help them to function.

Losartan can work quickly for high blood pressure (hypertension). If you have heart failure it may be a few weeks before you notice an improvement in your symptoms. Once you have started losartan you will generally keep taking it for life unless you have a side effect. In New Zealand losartan is available as tablets.

Dose

Losartan tablets come in different strengths: 12.5 mg, 25 mg, 50 mg and 100 mg.

  • The dose of losartan will be different for different people. Your doctor will tell you the dose that is right for you. Your dose of losartan will depend on what it is being used for.
  • Your doctor will usually start you on a low dose, and increase the dose depending on how you respond. This allows your body to get used to the medicine and reduces unwanted side effects.
  • Losartan is usually taken once a day.
  • Always take your losartan exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much losartan to take, how often to take it, and any special instructions.
  • Losartan tablets are available in different strengths. If your tablets look different to your last supply speak with your doctor or pharmacist for advice.

How to take losartan

  • Take losartan, once a day, at the same time each day. It is best taken in the morning.
  • You can take losartan with or without food.
  • Limit alcohol intake while you are taking losartan. Alcohol can increase your chance of side effects such as dizziness and lightheadedness.
  • If you forget to take your dose, take it as soon as you remember that day. But, if it is nearly time for your next dose, just take the next dose at the right time. Do not take double the dose.
  • Do not take potassium tablets while you are taking losartan, unless your doctor tells you to.

Precautions – before taking losartan

  • Are you pregnant or planning a pregnancy?
  • Are you breastfeeding?
  • Do you have problems with your kidneys or liver?
  • Have you ever had an allergic reaction with swelling of your lips, eyes or tongue (called angioedema)?
  • Are you are taking or using any other medicines? This includes any medicines you are using which are available to buy from a pharmacy, supermarket or natural health store without a prescription.

If so, it’s important that you tell your doctor or pharmacist before you start taking losartan. Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care.

Cautions while you are taking losartan

Have a sick day plan

If you have diarrhoea or are vomiting from a stomach bug, or have dehydration from other causes, it’s important to let your doctor know, as they may advise you to stop taking your losartan for a few days and restart when you feel better. The reason for this is that losartan can increase the amount of potassium salts in your blood, particularly if you are dehydrated.

Be careful when taking some pain relief medicines

Losartan help to protect your kidneys from damage if you have diabetes. In most cases losartan is protective but if you are taking losartan and diuretics (water pills), the combination of these with NSAIDs (anti-inflammatory pain relief medication) can be very harmful to your kidneys. It can cause acute kidney injury. This combination is called the dangerous trio or triple whammy. You have a higher risk of harm to your kidneys if you are also elderly or are dehydrated.
If you are taking losartan with a diuretic, do not use NSAIDs for pain relief. Ask your doctor or pharmacist for a safer option. Read more about NSAIDs and protecting your kidneys.

Possible side effects

Like all medicines, losartan can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Side effects What should I do?
  • Dizziness
  • Feeling lightheaded
  • Feeling faint when you stand up
  • This is quite common when you first start taking losartan and usually goes away with time.
  • Be careful when getting up from either lying down or sitting to avoid falls. These effects put you at risk of falls and injuries, especially if you are elderly.
  • Stand up slowly. If you do feel dizzy, sit-down or lie down for a few moments.
  • Avoid alcohol.
  • Tell your doctor if this continues.
  • Muscle cramps
  • Muscle weakness
  • Changes in your heartbeateat (either fast, slow or irregular)
  • Tell your doctor.
  • Allergic reaction such as skin rash, itching, swelling of the lips, face, and mouth or difficulty breathing such as chest tightness, or wheezing
  • Tell your doctor immediately or ring HealthLine 0800 611 116
  • Signs of problems with your liver such as yellowing of the skin or eyes, dark urine, pain in the abdomen
  • Tell your doctor immediately or ring HealthLine 0800 611 116

Interactions

  • Losartan may interact with a few medications and herbal supplements so check with your doctor or pharmacist before starting losartan or before starting any new medicines.
  • Also, check with your pharmacist before taking over-the-counter medicines such as anti-inflammatories such as diclofenac (e.g. Voltaren Rapid), ibuprofen (e.g. Nurofen), naproxen (e.g. Naprogesic).

Learn more

The following links have more information on losartan:
Medsafe Consumer Information Sheet: Cozaar

New Zealand Formulary Patient Information: losartan

  1. Losartan New Zealand Formulary

Losartan Side Effects

Medically reviewed by Drugs.com. Last updated on Dec 21, 2018.

  • Overview
  • Side Effects
  • Dosage
  • Professional
  • Tips
  • Interactions
  • More

In Summary

Commonly reported side effects of losartan include: asthenia, chest pain, diarrhea, fatigue, and hypoglycemia. Other side effects include: hyperkalemia, hypotension, and orthostatic hypotension. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to losartan: oral tablet

Warning

Oral route (Tablet)

When pregnancy is detected, discontinue losartan as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury or death to the developing fetus.

Along with its needed effects, losartan may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking losartan:

More common

  • Abdominal or stomach pain
  • anxiety
  • bladder pain
  • bloody or cloudy urine
  • blurred vision
  • chills
  • cold sweats
  • coma
  • confusion
  • cool, pale skin
  • depression
  • difficult breathing
  • difficult, burning, or painful urination
  • dizziness
  • fast heartbeat
  • frequent urge to urinate
  • headache
  • increased hunger
  • irregular heartbeat
  • lower back or side pain
  • nausea or vomiting
  • nightmares
  • numbness or tingling in the hands, feet, or lips
  • pale skin
  • seizures
  • shakiness
  • shortness of breath
  • slurred speech
  • troubled breathing with exertion
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • weakness or heaviness of the legs

Rare

  • Arm, back, or jaw pain
  • chest pain or discomfort
  • chest tightness or heaviness
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • fainting
  • fast, irregular, pounding, or racing heartbeat or pulse
  • inability to speak
  • pain or discomfort in the arms, jaw, back, or neck
  • severe or sudden headache
  • sweating
  • swelling or puffiness of the face
  • temporary blindness
  • unsteadiness or awkwardness
  • weakness in the arm or leg on one side of the body, sudden and severe
  • weakness in the arms, hands, legs, or feet

Incidence not known

  • Black, tarry stools
  • bleeding gums
  • cough
  • dark urine
  • difficulty with swallowing
  • general tiredness and weakness
  • hives
  • itching
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • light-colored stools
  • muscle cramps or spasms
  • muscle pain or stiffness
  • pinpoint red spots on the skin
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • skin rash
  • upper right abdominal or stomach pain
  • yellow eyes and skin

Some side effects of losartan may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Blindness
  • body aches or pain
  • decreased vision
  • dry cough
  • ear congestion
  • loss of voice
  • nasal congestion
  • runny nose
  • sneezing
  • sore throat

Less common

  • Acid or sour stomach
  • back pain
  • belching
  • difficulty with moving
  • heartburn
  • increased sensitivity to pain
  • increased sensitivity to touch
  • indigestion
  • joint pain
  • lack or loss of strength
  • pain in the knees or legs
  • pain or tenderness around the eyes and cheekbones
  • stomach discomfort or upset
  • swollen joints
  • trouble sleeping
  • weight gain

Rare

  • Ankle, knee, or great toe joint pain
  • bloated
  • change or loss of taste
  • depression
  • difficulty having a bowel movement (stool)
  • dry skin
  • excess air or gas in the stomach or intestines
  • full feeling
  • hair loss or thinning of the hair
  • hearing loss
  • increased sensitivity of the skin to sunlight
  • loss of appetite
  • passing gas
  • redness or other discoloration of the skin
  • severe sunburn
  • weight loss

For Healthcare Professionals

Applies to losartan: oral tablet

General

The most common adverse reactions were upper respiratory infection and dizziness.

Respiratory

Common (1% to 10%): Nasal congestion, upper respiratory infection, sinusitis, pharyngitis, cough, sinus disorder

Uncommon (0.1% to 1%): Dyspnea

Frequency not reported: Bronchitis, pharyngeal discomfort, epistaxis, rhinitis, respiratory congestion

Gastrointestinal

Common (1% to 10%): Abdominal pain, nausea, diarrhea, dyspepsia

Uncommon (0.1% to 1%): Obstipation, vomiting

Frequency not reported: Constipation, dental pain, dry mouth, flatulence, gastritis

Musculoskeletal

Common (1% to 10%): Muscle cramp, back pain, leg pain, myalgia

Frequency not reported: Arm pain, hip pain, joint swelling, knee pain, musculoskeletal pain, shoulder pain, stiffness, arthralgia, arthritis, fibromyalgia, muscle weakness

Postmarketing reports: Rhabdomyolysis

Renal

Common (1% to 10%): Renal impairment, renal failure, BUN increased, serum creatinine increased

Nervous system

Common (1% to 10%): Dizziness, headache, vertigo

Uncommon (0.1% to 1%): Somnolence

Rare (less than 0.1%): Paresthesia, syncope, cerebrovascular accident

Frequency not reported: Ataxia, hypesthesia, memory impairment, migraine, peripheral neuropathy, tremor, taste perversion, tinnitus

Other

Common (1% to 10%): Asthenia/fatigue, edema/swelling, chest pain

Frequency not reported: Facial edema, fever, orthostatic effects

Postmarketing reports: Malaise

Metabolic

Common (1% to 10%): Hyperkalemia, serum potassium increased, hypoglycemia

Frequency not reported: Anorexia, gout

Postmarketing reports: Hyponatremia

Cardiovascular

Common (1% to 10%): Orthostatic hypotension

Uncommon (0.1% to 1%): Palpitation, angina pectoris

Rare (less than 0.1%): Atrial fibrillation

Frequency not reported: Second degree atrioventricular block, hypotension, myocardial infarction, sinus bradycardia, tachycardia, ventricular tachycardia, ventricular fibrillation, flushing

Postmarketing reports: Vasculitis

Psychiatric

Common (1% to 10%): Insomnia

Uncommon (0.1% to 1%): Sleep disorder

Frequency not reported: Anxiety, anxiety disorder, confusion, depression, dream abnormality, libido decreased, nervousness, panic disorder

Hematologic

Common (1% to 10%): Anemia

Rare (less than 0.1%): Hemolysis

Postmarketing reports: Thrombocytopenia, hemoglobin decreased, hematocrit decreased

Dermatologic

Uncommon (0.1% to 1%): Urticaria, pruritus, rash

Rare (less than 0.1%): Angioedema, superficial peeling of palms

Frequency not reported: Alopecia, dermatitis, dry skin, ecchymosis, erythema, photosensitivity, sweating

Postmarketing reports: Erythroderma

Hepatic

Rare (less than 0.1%): ALT increased

Postmarketing reports: Hepatitis, liver enzymes increased, serum bilirubin increased, pancreatitis, liver function abnormalities

Genitourinary

Frequency not reported: Impotence, nocturia, urinary frequency, urinary tract infection

Ocular

Frequency not reported: Blurred vision, burning/stinging in the eye, conjunctivitis, visual acuity decreased

Immunologic

Frequency not reported: Flu-like symptoms

Postmarketing reports: Anaphylactic reactions, hypersensitivity reactions

1. Cerner Multum, Inc. “Australian Product Information.” O 0

2. “Product Information. Cozaar (losartan).” Merck & Co, Inc, West Point, PA.

3. Cerner Multum, Inc. “UK Summary of Product Characteristics.” O 0

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

Related questions

  • Are losartan and losartan potassium the same drug or two different ones?
  • Does losartan cause rapid heart rate, irregular heartbeat or low blood pressure?
  • Losartan vs Valsartan – What’s the difference between them?

Medical Disclaimer

More about losartan

  • During Pregnancy or Breastfeeding
  • Dosage Information
  • Patient Tips
  • Drug Images
  • Drug Interactions
  • Compare Alternatives
  • Support Group
  • Pricing & Coupons
  • En Español
  • 414 Reviews
  • Drug class: angiotensin receptor blockers
  • FDA Alerts (17)

Consumer resources

  • Losartan
  • Losartan (Advanced Reading)

Other brands: Cozaar

Professional resources

  • Losartan Potassium (AHFS Monograph)
  • … +2 more

Related treatment guides

  • Diabetic Kidney Disease
  • High Blood Pressure
  • Alport Syndrome

Resistant Hypertension: Get Your Questions Answered

Besides the standardized use of automated blood pressure devices in our outpatient clinics, we have a large cohort of patients who undergo 24-hour ambulatory blood pressure measurements to help with diagnosis of white coat hypertension, masked hypertension, labile hypertension, and assessment of nocturnal dipping and efficacy of therapy. We also use noninvasive hemodynamic testing with impedance cardiography to help guide treatment decisions and tailor therapy by assessing neuro-humoral profiles and hemodynamic parameters in our hypertension lab. We assess central blood pressure indices using applanation tonometry, including pulse wave analysis and pulse wave velocity. We also have the capability to study endothelial function non-invasively, which could help early detection of endothelial dysfunction for assessment of cardiovascular risk.

The Center has expertise in the field of secondary hypertension management, specifically related to the diagnosis and management of primary hyperaldosteronism, pheochromocytoma, and renal artery stenosis; as well as electrolyte disorders.

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Reviewed: 05/14

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Valsartan (Diovan), and losartan (Cozaar) are commonly prescribed blood pressure medications. Which one is better, and are there any differences? Here’s the scoop.

  • Both valsartan and losartan are ARBs (angiotensin receptor blockers), and losartan has been around the longest. Both are available as cheap generic medications, so cost should not be a problem.
  • The benefits of both losartan and valsartan include controlling blood pressure, slowing the progression of diabetic kidney disease (nephropathy), and decreasing stroke risk in patients with left ventricular hypertrophy. This is true for all of the ARBs (olmesartan, irbesartan, telmisartan).
  • Losartan is different from other ARBs including valsartan and irbesartan because it has a shorter duration of action.
  • This is important. Losartan, taken once daily, does not last the full 24 hours at lower doses like 25 or 50 mg. At 100 mg daily losartan does last the full 24 hours. If you take Losartan 50 mg in the morning, you may notice your blood pressure rises at night, because it’s not covering you for a full 24 hours.
  • Valsartan does provide 24-hour coverage with once-daily dosing.
  • Both losartan and valsartan may raise your potassium and require blood test monitoring after you’ve started on it.
  • Both losartan and valsartan are available in a combination pill with hydrochlorothiazide a diuretic. Losartan/HCTZ and valsartan/HCTZ in different dose combinations are available and these combos are great because the two meds work together to lower blood pressure. Another bonus of the combination pills is that hydrochlorothiazide lowers potassium while losartan/valsartan raises it so the end result is less risk of potassium abnormalities as they “cancel” each other out.
  • Valsartan also comes in a combination with sacubitril in a medication called Entresto, which has been shown to reduce hospitalizations and save lives from heart failure in certain patients. Entresto is a mixture of valsartan and sacubitril which is a neprilysin inhibitor.

Dr. O

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