Losartan diarrhea

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Losartan and Diarrhea: Understanding the Connection

Introduction to Losartan and Gastrointestinal Effects

Losartan, an angiotensin II receptor blocker (ARB), is widely used for managing hypertension and protecting renal function in patients with diabetes. However, like many medications, it can have adverse effects, including gastrointestinal disturbances such as diarrhea. This article explores the connection between losartan and diarrhea, drawing on recent research findings.

Case Study: Sprue-like Enteropathy Associated with Losartan

A notable case study highlights a severe instance of sprue-like enteropathy linked to losartan use. A 67-year-old man experienced chronic diarrhea and significant weight loss over nine months while on losartan. Despite extensive testing, no other cause for his symptoms was found. Upon discontinuing losartan, his symptoms resolved rapidly, and follow-up biopsies showed recovery of intestinal villi . This case suggests that losartan, like other ARBs, can cause severe gastrointestinal issues, potentially as a class effect.

Mechanisms of Losartan-Induced Gastrointestinal Disturbances

The exact mechanisms by which losartan induces gastrointestinal symptoms are not fully understood. However, preclinical studies using rat models have provided some insights. Losartan was found to modulate intestinal smooth muscle tone, affecting gastrointestinal motility. Specifically, it interfered with the cholinomimetic pathway, reducing contractions induced by acetylcholine and other agents . This modulation of smooth muscle activity could explain the diarrhea and other gastrointestinal symptoms observed in patients.

Broader Implications and Considerations

While losartan has been shown to offer significant renal and cardiovascular benefits, particularly in patients with type 2 diabetes and nephropathy , its potential to cause gastrointestinal disturbances should not be overlooked. Clinicians should be aware of these possible side effects and consider them when diagnosing and treating patients presenting with unexplained gastrointestinal symptoms.

Conclusion

Losartan, while beneficial for managing hypertension and protecting renal function, can cause significant gastrointestinal disturbances, including diarrhea. Both clinical case studies and preclinical research suggest that these effects may be due to losartan's impact on intestinal smooth muscle motility. Awareness of these potential side effects is crucial for healthcare providers to ensure appropriate diagnosis and management of affected patients.

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Most relevant research papers on this topic

A Case of Severe Sprue-like Enteropathy Associated With Losartan.

Losartan may be associated with severe sprue-like enteropathy, suggesting it may be a class effect rather than a specific angiotensin II receptor blocker.

Case Report

2015·

23citations

·A. Negro et al.

Modulation of Gastrointestinal Smooth Muscle Motility by Losartan in Rats

Losartan modulates intestinal smooth muscle tone in rats by interfering with various pathways involved in gastrointestinal motility, potentially optimizing its therapeutic benefit.

2018·

0citations

·F. Aigbe et al.

Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy.

Losartan significantly reduces the risk of kidney damage and end-stage renal disease in patients with type 2 diabetes and nephropathy, while maintaining overall cardiovascular health.

RCTLarge Human TrialHighly Cited

2001·

5887citations

·B. Brenner et al.

Safety of losartan in hypertensive patients with thiazide-induced hyperuricemia.

Losartan safely decreased serum uric acid and increased uric acid excretion without increasing urinary dihydrogen urate, the primary risk factor for acute urate nephropathy.

RCTHighly Cited

1999·

78citations

·S Shahinfar et al.

Renal Impairment Associated with Losartan

Losartan may cause renal impairment in patients at risk for renal failure, so clinicians should be aware of this potential risk when prescribing the drug.

Case Report

1996·

31citations

·D. Saine et al.

Clinical Pharmacokinetics of Losartan

Losartan is a rapidly absorbed oral angiotensin-receptor antagonist with a favorable drug-drug interaction profile, reducing blood pressure effectively and offering end-organ protection without significant adverse effects.

Highly Cited

2005·

221citations

·D. Sica et al.

Safety and tolerability of losartan potassium, an angiotensin II receptor antagonist, compared with hydrochlorothiazide, atenolol, felodipine ER, and angiotensin-converting enzyme inhibitors for the treatment of systemic hypertension.

Losartan potassium is an effective and well-tolerated treatment for systemic hypertension, with a better tolerability profile than other antihypertensive agents.

Highly Cited

1995·

272citations

·A. Goldberg et al.

Losartan

Losartan effectively reduces the risk of developing kidney disease and death in type 2 diabetes patients, with similar effects to enalapril on kidney function.

2012·

3citations

·C. Carswell et al.

Clinical safety and tolerability of losartan.

Losartan is a safe and tolerable treatment for hypertension, even in patients with concomitant illnesses, and can be considered as a first-line therapy or alternative therapy for those experiencing side effects with other agents.

RCTLarge Human Trial

1997·

52citations

·Michael Weber

Effect of 1-week losartan administration on bile duct-ligated cirrhotic rats with portal hypertension.

Losartan treatment for one week in bile duct-ligated cirrhotic rats decreased portal pressure and improved hyperdynamic circulation, with reduced aortic eNOS protein expression potentially playing a partial role in its action.

RCTAnimal Study

2002·

33citations

·Ying-Ying Yang et al.

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