It is indicated in patients 60 years and over where treatment with ACE inhibitors is contraindicated or not tolerated, especially due to cough. Patients should have a left ventricular ejection fraction greater or equal to 40 per cent and be stabilised with chronic heart failure treatment. Patients with heart failure who have been stabilised with an ACE inhibitor should not be switched to losartan.
The starting dose is 12.5mg daily and can be titrated at weekly intervals to the usual maintenance dose of 50mg daily.
The MHRA have reinstated the black triangle on Cozaar, requesting that intensive monitoring is carried out for the use of Cozaar in heart failure.
Further information: Merck Sharp & Dohme