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Angioedema due to losartan.
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.
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.