Zosaar Special Precautions

Hypersensitivity: Angioedema. (See Side Effects.)
Hypotension and Electrolyte/Fluid Imbalance: In patients who are intravascularly volume-depleted (e.g., those treated with high-dose diuretics), symptomatic hypotension may occur. These conditions should be corrected prior to administration of Zosaar 50mg Tablet, or a lower starting dose should be used (see Dosage & Administration).
Electrolyte imbalances are common in patients with renal impairment, with or without diabetes, and should be addressed. In a clinical study conducted in type 2 diabetic patients with proteinuria, the incidence of hyperkalaemia was higher in the group treated with Zosaar 50mg Tablet as compared to the placebo group; however, few patients discontinued therapy due to hyperkalaemia (see Laboratory Test Findings under Side Effects).
Liver Function Impairment: Based on pharmacokinetic data which demonstrate significantly increased plasma concentrations of losartan in cirrhotic patients, a lower dose should be considered for patients with a history of hepatic impairment (see Dosage & Administration).
Renal Function Impairment: As a consequence of inhibiting the renin-angiotensin system, changes in renal function including renal failure have been reported in susceptible individuals; these changes in renal function may be reversible upon discontinuation of therapy.
Other medicines that affect the renin-angiotensin system may increase blood urea and serum creatinine in patients with bilateral renal artery stenosis or stenosis of the artery to a solitary kidney. Similar effects have been reported with Zosaar 50mg Tablet; these changes in renal function may be reversible upon discontinuation of therapy.
Use in Children: Safety and effectiveness in children have not been established.
Use in the Elderly: There is no age-related difference in the efficacy or safety profile of losartan.