From the Guidelines
Losartan can generally be used safely in patients with a neobladder, but careful monitoring is recommended. Losartan, an angiotensin II receptor blocker (ARB), is primarily metabolized by the liver and excreted through both biliary and renal routes, making it suitable for patients with altered urinary systems like a neobladder 1. The standard dosing of losartan (25-100 mg daily) typically doesn't need adjustment specifically for neobladder patients, but should be tailored based on blood pressure response and kidney function. Patients with a neobladder should have regular monitoring of kidney function, electrolytes (particularly potassium), and blood pressure, as ARBs can affect renal hemodynamics.
Some key points to consider when using losartan in patients with a neobladder include:
- Monitoring for potential changes in kidney function and electrolyte levels, particularly potassium 1
- Adjusting the dosage based on blood pressure response and kidney function
- Considering alternative medications if the patient experiences unusual side effects or inadequate blood pressure control
- Being aware of the potential benefits of losartan in reducing cardiovascular events, particularly in patients with diabetes or left ventricular hypertrophy 1
It's also important to note that the construction of a neobladder using intestinal tissue may affect medication absorption and elimination, although this is not expected to significantly impact losartan's effectiveness 1. Overall, losartan can be a safe and effective treatment option for patients with a neobladder, as long as careful monitoring and adjustments are made as needed.
From the Research
Relationship between Neobladder and Losartan
There is no direct evidence in the provided studies to suggest a relationship between neobladder and losartan.
Losartan's Effects on Renal Function
- Losartan has been shown to have renoprotective effects in patients with hypertension and renal disorders 2, 3.
- Losartan can reduce the progression of advanced renal insufficiency 3.
- Losartan may cause renal dysfunction in some patients, particularly those with bilateral renal artery stenosis or severe congestive heart failure 4.
- The effects of losartan on renal hemodynamics and function can vary depending on the patient population and underlying conditions 5, 6.
Comparison with Other Antihypertensive Agents
- Losartan has been compared to other antihypertensive agents, such as bisoprolol and amlodipine, in terms of its effects on renal function and hemodynamics 5, 6.
- Losartan may have different effects on renal function and TGF-beta(1) levels compared to other antihypertensive agents 6.