Losartan (Cozavan) 25 mg and 50 mg tablets — the first generic angiotensin II-receptor antagonist in Australia — were listed on the Pharmaceutical Benefits Scheme on 1 December 2011 for the treatment of hypertension. The Pharmaceutical Benefits Advisory Committee recommended listing generic losartan on a cost-minimisation basis — that is, similar efficacy and cost — compared with irbesartan.1
In a meta-analysis of short-term trials against placebo all angiotensin II-receptor antagonists, including losartan, reduced trough blood pressure to a similar extent.2 However, meta-analyses of head-to-head trials found that losartan reduced systolic blood pressure by slightly less (around 3 mmHg) than candesartan3 and telmisartan4.
The branded formulation of losartan (Cozaar) is only available as a 50 mg tablet on private prescription. If switching to the generic formulation ensure that the patient takes only the generic tablets and returns any remaining branded tablets to their pharmacist for safe disposal.
- Positive Recommendations made by the PBAC – July 2010. Canberra: Australian Government Department of Health and Ageing, 2010. http://www.health.gov.au/internet/main/publishing.nsf/Content/pbacrec-jul10-positive .
- Blood pressure lowering efficacy of angiotensin receptor blockers for primary hypertension. Cochrane Database Syst Rev 2008:CD003822. [PubMed] .
- Meredith PA, Murray LS, McInnes GT. Comparison of the efficacy of candesartan and losartan: a meta-analysis of trials in the treatment of hypertension. J Hum Hypertens;24:525–31. [PubMed] .
- Xi GL, Cheng JW, Lu GC. Meta-analysis of randomized controlled trials comparing telmisartan with losartan in the treatment of patients with hypertension. Am J Hypertens 2008;21:546–52. [PubMed] .