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These results were confirmed during period II of the study where patients were randomised to continue losartan or placeboafter three weeks of treatmentThe difference in blood pressure increase as compared to placebo was largest in the middle dose group6.70 mmHg middle dose vs5.38 mmHg high doseThe rise in trough diastolic blood pressure was the same in patients receiving placebo and in those continuing losartan at the lowest dose in each groupagain suggesting that the lowest dose in each group did not have significant antihypertensive effect.

Electrolyte imbalances are common in patients with renal impairmentwith or without diabetesand should be addressedIn a clinical study conducted in type 2 diabetic patients with nephropathythe incidence of hyperkalaemia was higher in the group treated with losartan as compared to the placebo groupsee section 4.8Thereforethe plasma concentrations of potassium as well as creatinine clearance values should be closely monitoredespecially patients with heart failure and a creatinine clearance between 30-50 ml/min should be closely monitored.

If you are using the liquid form of this medicationshake the bottle well before each doseCarefully measure the dose using a special measuring device/spoonDo not use a household spoon because you may not get the correct dose.

In rare caseslosartan can cause a condition that results in the breakdown of skeletal muscle tissueleading to kidney failureCall your doctor right away if you have unexplained muscle paintendernessor weakness especially if you also have feverunusual tirednessand dark colored urine.

If symptomatic hypotension should occursupportive treatment should be instituted.

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