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Epidemiological evidence regarding the risk of teratogenicity following exposure to ACE inhibitors during the first trimester of pregnancy has not been conclusivehowever a small increase in risk cannot be excludedWhilst there is no controlled epidemiological data on the risk with Angiotensin II Receptor InhibitorsAIIRAssimilar risks may exist for this class of medicinal productsUnless continued AIIRA therapy is considered essentialpatients planning pregnancy should be changed to alternative anti-hypertensive treatments which have an established safety profile for use in pregnancyWhen pregnancy is diagnosedtreatment with losartan should be stopped immediately andif appropriatealternative therapy should be started.
CommentsIf hypertensive patients with left ventricular hypertrophy or type 2 diabetic nephropathy patients require titration from initial doseincrease to 100 mg orally once a dayAntihypertension is substantially present within 1 week but in some studies the maximal effect occurred in 3 to 6 weeks.
Reduction in the risk of stroke in hypertensive patients with left ventricular hypertrophy documented by ECG.
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