Intravascular Volume Depletion: In patients who are intravascularly volume depleted (eg, those treated with high-dose diuretics), symptomatic hypotension may occur. Such a condition should be corrected prior to administration of Losartan, or a lower starting dose should be used.
Hepatic Impairment: Based on pharmacokinetic data, which demonstrate significantly increased plasma concentrations of losartan, or a lower starting dose should be considered for patients with history of hepatic impairment.
Renal Artery Stenosis: Other drugs that affect the renin-angiotensin-aldosterone system may increase blood urea and serum creatinine in patients with bilateral renal artery stenosis or stenosis of the artery to a solitary kidney. While not confirmed, this potentially may occur with angiotensin-II receptor antagonists.
Use in children: Safety and efficacy in children have not been established.