Actual State of the Prescription of Losartan, an Angiotensin II Receptor Antagonist, and the Frequency of Its Adverse Effects.

The purpose of this article was to clarify the patient's condition before and after the prescription of Losartan, an angiotensin II receptor antagonist, and the frequency of its adverse effects at Yamaguchi University Hospital. Of the patients receiving Losartan in our hospital over a 9 month period from January 1 to September 30, 1999, 71 were selected based on their prescription records. Most of the patients were both 60 years old or over (72%) and outpatients (68%). Eight patients were prescribed only Losartan as an antihypertensive drug, while the other patients were concomitantly prescribed Losartan along with a mean of 2.4 kinds of other antihypertensive drugs. The main combined medicines were calcium antagonist (47), diuretic (41), ACE inhibitor (41), and beta blocker (24). Thirty-five patients had their prescriptions changed from other antihypertensive drugs to Losartan. The reasons for the prescription changes were 6 cases of coughing, 3 cases of hyperuricemias, 2 cases of itching, one case of hypertension, one case of edema, and an unknown cause in 21 cases. Seventeen patients had their prescriptions changed from Losartan to another drug (24%). The reasons for the change were 2 cases of hypotension, 2 cases of anacatesthesia, one case of coughing, one case of edema, and one case due to an insufficient effect. The frequency of adverse effects due to Losartan administration was 8.5%. The administration period of Losartan in patients who exhibited adverse effects was a mean of 24 days (14-46 days). These results indicate that it is important to be aware of the occurrence of adverse effects due to Losartan treatment at the initial administration stage.