Can a patient taking losartan (an angiotensin‑II receptor blocker) for hypertension safely undergo cryotherapy?

Can Someone Taking Losartan Safely Undergo Cryotherapy?

Yes, a patient taking losartan can safely undergo cryotherapy, as there are no known contraindications or interactions between losartan (an angiotensin II receptor blocker) and cryotherapy procedures.

Key Safety Considerations

Losartan's Safety Profile

• Losartan is one of the most well-tolerated antihypertensive medications, with dizziness being the only adverse effect reported more frequently than placebo in clinical trials 1
• The drug has an excellent safety profile with withdrawal rates due to adverse effects (2.3%) lower than placebo (3.7%) 2
• First-dose hypotension is uncommon with losartan, likely due to its slower onset of action 2

Cryotherapy and Blood Pressure Effects

• While therapeutic hypothermia can cause hypotension and cardiac arrhythmias in the context of acute stroke or cardiac arrest management 3, these concerns apply to deep systemic cooling (32°C-33°C core temperature) in critically ill patients, not to localized cryotherapy procedures
• Standard cryotherapy for musculoskeletal conditions or dermatologic procedures involves only local tissue cooling and does not produce systemic hypothermia or significant cardiovascular effects

No Documented Contraindications

• The established contraindications for losartan are limited to pregnancy, renovascular disease (use with caution), and combination with other renin-angiotensin system blockers 3, 4, 5
• None of the guideline documents addressing losartan safety mention cryotherapy, cold exposure, or temperature-related procedures as contraindications 3, 6, 1, 2

Practical Recommendations

Proceed with Standard Precautions

• Continue losartan without interruption before or after cryotherapy procedures 6, 1
• Monitor blood pressure if the patient has a history of orthostatic hypotension or is on multiple antihypertensive agents 3
• Ensure adequate hydration, as both cryotherapy and losartan can affect fluid balance

Monitor for Standard Losartan Adverse Effects

• Watch for dizziness, particularly if the patient is elderly or on combination therapy 1, 2
• Be aware that losartan increases uric acid secretion, which is generally beneficial but could theoretically contribute to uric acid stone formation in susceptible patients 2

Common Pitfall to Avoid

• Do not unnecessarily discontinue losartan before cryotherapy procedures, as this could lead to uncontrolled hypertension and increased cardiovascular risk 3, 6