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Angioedema due to losartan.

Y J Cha¹, V E Pearson

¹Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, MD 21287, USA.

The Annals of Pharmacotherapy

|September 24, 1999

Summary

Angiotensin II receptor antagonists like losartan can cause angioedema, a serious swelling condition. Patients with prior angioedema from ACE inhibitors may react similarly to these drugs.

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Area of Science:

Pharmacology
Nephrology
Cardiology

Background:

Angiotensin II receptor antagonists (ARBs) are commonly prescribed for hypertension and renal protection.
Angiotensin-converting enzyme (ACE) inhibitors are known to cause angioedema, a potentially life-threatening adverse reaction.

Observation:

A case of a 62-year-old woman with acute renal failure and hypertension who developed angioedema after captopril (an ACE inhibitor).
Upon substitution with losartan (an ARB), the patient experienced recurrent lip swelling, indicating a potential cross-reactivity.

Findings:

Losartan, an ARB, can induce angioedema, similar to ACE inhibitors.
The mechanism may not solely involve bradykinin, as previously hypothesized for ACE inhibitor-induced angioedema.

Implications:

Clinicians must exercise caution when prescribing ARBs to patients with a history of angioedema from ACE inhibitors.
ARBs may not be universally safe alternatives for patients intolerant to ACE inhibitors due to angioedema risk.

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