Losartan

Breastfeeding
CLINICALLY IMPORTANT, POTENTIALLY HAZARDOUS INTERACTIONS WITH:

Aliskiren, Rifampin, Voriconazole

PREGNANCY CATEGORY: D
category C in first trimester; category D in second and third trimesters

Under investigation for treating COVID-19

Hyzaar is losartan and hydrochlorothiazide.

Hydrochlorothiazide is a sulfonamide and can be absorbed systemically. Sulfonamides can produce severe, possibly fatal, reactions such as toxic epidermal necrolysis and Stevens-Johnson syndrome.

CONTRA-INDICATED IN PREGNANCY

See full prescribing information for complete boxed warning.

Anaphylactoid reactions / anaphylaxis (includes anaphylactic shock) <1%

(2017): Nag DS+, Rev Bras Anestesiol (Portuguese) 67(2), 217 (with atenolol, cufuroxime, nicardipine and prazosin)

(2010): Kazim SF+, J Pak Med Assoc 60 (8), 685

Angioedema <1%

(2011): Orgaz-Molina J+, Med Clin (Barc) 137(6), 281

(2010): Kazim SF+, J Pak Med Assoc 60 (8), 685

(2003): MacLean JA+, Arch Intern Med 163(12), 1488

(2002): Abdi R+, Pharmacotherapy 22(9), 1173

(2001): Chiu AG+, Laryngoscope 111(10), 1729 (3 cases)

(1999): Rivera JO, Ann Pharmacother 33(9), 933

(1999): Rupprecht R+, Allergy 54, 81

(1998): van Rijnsoever EW+, Arch Intern Med 158, 2063

(1996): Med Sci Bull 18, 6

(1996): Boxer M, J Allergy Clin Immunol 98, 471

(1995): Acker CG+, N Engl J Med 333, 1572

Dermatitis <1%

(package insert)

Erythema <1%

(package insert)

Facial edema <1%

(2017): Lee HY+, Clin Ther 39(12), 2366 (mild / 1 case) (with amlodipine)

Photosensitivity <1%

(2017): Nakao S+, Biol Pharm Bull 40(12), 2158 (with hydrochlorothiazide)

(2015): Viola E+, Drug Saf 38(10), 889

Pruritus (itching) <1%

(package insert)

Psoriasis 

(2011): Lamba G+, Am J Ther 18(3), e78 [REVIEW]

Purpura 

(2001): Brouard M+, Br J Dermatol 145(2), 362

(1998): Bosch X, Arch Intern Med 158, 191

Rash <1%

(package insert)

Urticaria / hives <1%

(package insert)

Xerosis <1%

(package insert)

Alopecia / hair loss <1%

(package insert)

Melanonychia 

(2004): Packard KA+, Pharmacotherapy 24(4), 546

Nail changes 

(2004): Packard KA+, Pharmacotherapy 24(4), 546

Atrial fibrillation 

(2004): Kingma JH+, J Am Coll Cardiol 44(11), 2117 [REVIEW]

Hypertension 

(2012): Kiernan MS+, Eur J Heart Fail 14(12), 1401

Hypotension 

(2014): E Gullo C+, Recent Pat Cardiovasc Drug Discov 9(1), 28 [REVIEW]

Tachycardia 

(2017): Lee HY+, Clin Ther 39(12), 2366 (mild / 1 case) (with amlodipine)

Headache 

(1996): MacKay JH+, Arch Intern Med 156 (3), 278 (with hydrochlorothiazide)

Hyperesthesia <1%

(package insert)

Paresthesias <1%

(1995): Ahmad S, JAMA 274, 1266

Tremor <1%

(package insert)

Vertigo / dizziness 3%

(1996): MacKay JH+, Arch Intern Med 156 (3), 278 (with hydrochlorothiazide)

Acidosis (includes lactic acidosis) 

(2014): Sakalli H+, Exp Clin Transplant 12(4), 310Pediatric (with enalapril)

Hyperkalemia 

(2015): Kennedy-Dixon TG+, Pharm Pract (Granada) 13(4), 601 (increased risk with amiloride, potassium chloride or spironolactone)

(2014): Clase CM+, Ann Intern Med 160(6), jc3 (with lisinopril)

(2014): E Gullo C+, Recent Pat Cardiovasc Drug Discov 9(1), 28

(2014): Rossignol P+, Int J Cardiol 173(3), 380

(2014): Sakalli H+, Exp Clin Transplant 12(4), 310Pediatric (with enalapril)

(2012): Kiernan MS+, Eur J Heart Fail 14(12), 1401

(2012): Tang SC+, Nephrol Dial Transplant 27(2), 61324% (with aliskiren)

Hyponatremia 

(2015): Das S+, J Pharmacol Pharmacother 6(4), 219 (severe)

Hepatotoxicity / liver injury / acute liver injury / drug-induced liver injury (DILI) 

(2021): Diogo J+, Eur J Case Rep Intern Med Nov, eCollection (1 case / male)

(2019): Patti R+, Cureus 11(5), e4769 (1 case / female)

(2014): Al-Halawani MZ+, J Family Med Prim Care 3(3), 272-4 (1 case / female)

(2002): Tabak F+, J Clin Gastroenterol 34(5), 585-6

(1998): Andrade RJ+, Ann Pharmacother 32(12), 1371

(1997): Bosch X, JAMA 278(19), 1572

Asthenia / fatigue 

(1996): MacKay JH+, Arch Intern Med 156 (3), 278 (with hydrochlorothiazide)

Back pain 2%

(package insert)

Finger clubbing 

(2004): Packard KA+, Pharmacotherapy 24(4), 546

Leg pain 1%

(package insert)

Cough 

(1997): Chan P+, J Clin Pharmacol 37(3), 25318%Geriatric

Sinusitis 1%

(1996): MacKay JH+, Arch Intern Med 156 (3), 278 (with hydrochlorothiazide)

Upper respiratory tract infection 8%

(1996): MacKay JH+, Arch Intern Med 156 (3), 278 (with hydrochlorothiazide)

Adverse effects / adverse reactions 

(2014): E Gullo C+, Recent Pat Cardiovasc Drug Discov 9(1), 28

(2014): Suh SY+, Clin Ther 36(10), 14023–4% (with amlodipine or hydrochlorothiazide)

(2014): Webb NJ+, Clin J Am Soc Nephrol 9(8), 1441Pediatric

(2012): Park CG+, Am J Cardiovasc Drugs 12(1), 358%

(2011): White WB+, J Clin Hypertens (Greenwich) 13(7), 50654%

(2011): Zhenfeng Zheng+, J Renin Angiotensin Aldosterone Syst 12(3), 365 [REVIEW]

(2001): Khazine F+, Nephrologie (French) 22(2), 73 (with mefenamic acid)

Allergic reactions 

(2012): Tang SC+, Nephrol Dial Transplant 27(2), 6138% (with aliskiren)

Death 

(2012): Kiernan MS+, Eur J Heart Fail 14(12), 1401



Adverse reactions attributed to entire drug class Angiotensin II receptor antagonist (blocker)

Pulmonary adverse effect 

(2020): Stafford EG+, J Am Pharm Assoc (2003) Jun, Online ahead of print [REVIEW]

Adverse reactions attributed to entire drug class Antihypertensive

Headache 

(2014): Chaturvedi S+, Cochrane Database Syst Rev 2, CD008117 [REVIEW]Pediatric

Vertigo / dizziness 

(2014): Chaturvedi S+, Cochrane Database Syst Rev 2, CD008117 [REVIEW]Pediatric

Upper respiratory tract infection 

(2014): Chaturvedi S+, Cochrane Database Syst Rev 2, CD008117 [REVIEW]Pediatric

Adverse reactions attributed to entire drug class Covid-19 putative drug

Cardiovascular adverse effect 

(2020): Carpenter A+, Front Cardiovasc Med 7, 85 [REVIEW]

(2020): Giudicessi JR+, Mayo Clin Proc May, Online ahead of print [REVIEW]

(2020): Naksuk N+, Eur Heart J Acute Cardiovasc Care May, Epub ahead of print [REVIEW]

(2020): Sarayani A+, Res Social Adm Pharm Apr, Epub ahead of print [REVIEW]

(2020): Zhang D+, Zhongguo Zhong Yao Za Zhi (Chinese) 45(10), 2275-2286 [REVIEW]

Neuropsychiatric / neuropsychological adverse effect 

(2021): Borah P+, Front Mol Biosci 8, 627723

(2020): García CAC+, Gen Hosp Psychiatry Jun, Online ahead of print [REVIEW]

Gastrointestinal disorder / discomfort 

(2020): Sun J+, Clin Pharmacol Ther Apr, Epub ahead of print23%

Thrombocytopenia 

(2020): Nham E+, Infect Chemother Apr, Epub ahead of print

Adverse effects / adverse reactions 

(2022): Aguilera C+, Diagnostics (Basel) 12(7), 1612

(2022): Chiu MN+, Eur J Clin Pharmacol Jan, Online ahead of print [REVIEW]

(2021): Bérard A+, PLoS One 16(5), e0251746 [REVIEW] (in pregnancy)

(2021): Cheng Q+, Aging (Albany NY) Sep, Online ahead of print [REVIEW]

(2021): Cruciani F+, Recenti Prog Med 112(3), 195-206 [REVIEW]

(2021): Drożdżal S+, Drug Resist Updat Dec, eCollection [REVIEW]

(2021): Ommati MM+, J Biochem Mol Toxicol May, Online ahead of print [REVIEW]

(2021): Qiu R+, Medicine (Baltimore) 100(16), e25532 [REVIEW]

(2021): Wu SS+, Chin Med J (Engl) Jul, Online ahead of print [REVIEW]

(2020): Favilli A+, J Matern Fetal Neonatal Med Jun, Online ahead of print [REVIEW]

(2020): Griffiths G+, Trials 21(1), 544

(2020): Patil VM+, Life Sci May, Epub ahead of print [REVIEW]

(2020): Rhodes NJ+, medRxiv Jun, Preprint

(2020): Sun J+, Clin Pharmacol Ther Apr, Epub ahead of print38%

(2020): Svensson M, Lakartidningen (Swedish) Apr, 117

(2020): Wen CY+, Zhonghua Nei Ke Za Zhi (Chinese) May, Epub ahead of print

(2020): Zekarias A+, Drug Saf Sep, Online ahead of print [REVIEW]

(2020): Zhong H+, Pharmacol Res Apr, Epub ahead of print [REVIEW]

Page last updated 08/01/2022

Drug Eruption Mobile Site

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Incidence info

  • <1%
  • 1-5%
  • 5-10%
  • 10-15%
  • 15-20%
  • 20-30%
  • >30%

Seriousness info

  • Hospitalization possible
  • Life threatening
  • Fatal

Warnings in other populations info

  • Breast feeding
  • Geriatric
  • Pediatric
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