From the FDA Drug Label
For people who already have kidney problems, you may see a worsening in how well your kidneys work. Call your doctor if you get swelling in your feet, ankles, or hands, or unexplained weight gain The adverse events, regardless of drug relationship, reported with an incidence of ≥4% of patients treated with losartan and occurring with ≥2% difference in the losartan group vs placebo on a background of conventional antihypertensive therapy, were ... back pain, muscular weakness, and urinary tract infection.
Edema is a possible side effect of Losartan, as it may cause swelling in the feet, ankles, or hands in people with pre-existing kidney problems 1. Additionally, Losartan may worsen kidney function, leading to edema 1. However, the exact incidence of edema is not explicitly stated in the drug label. It is essential to monitor for signs of edema, such as swelling or unexplained weight gain, and report them to your doctor 1.
From the Research
Losartan can cause edema, although it is less likely to do so compared to other blood pressure medications like calcium channel blockers. Losartan is an angiotensin II receptor blocker (ARB) that typically works to reduce fluid retention by blocking the effects of angiotensin II, which normally causes blood vessels to constrict and promotes sodium and water retention. However, in some patients, losartan can paradoxically cause edema (swelling) in the extremities, particularly in the ankles, feet, and legs. This side effect occurs in approximately 2-4% of patients taking the medication, as reported in a study comparing losartan with nifedipine GITS 2. The mechanism behind losartan-induced edema isn't fully understood but may involve changes in capillary pressure or local vascular effects. If you experience significant swelling while taking losartan, you should consult your healthcare provider, as they may need to adjust your medication or consider alternative treatments. The edema is usually mild and often resolves with continued use or dosage adjustment, but persistent or severe swelling should not be ignored. Some studies have also reported cases of angioedema associated with losartan use 3, 4, 5, highlighting the importance of monitoring for this potentially life-threatening condition. Overall, while losartan is generally well-tolerated, it is essential to be aware of the potential for edema and angioedema, especially in patients with a history of angioedema or those taking other medications that may increase this risk. Key points to consider:
- Losartan can cause edema, although the incidence is relatively low
- The mechanism of losartan-induced edema is not fully understood
- Patients should be monitored for signs of edema and angioedema, especially those with a history of these conditions
- Alternative treatments may be necessary if edema or angioedema occurs.