Cozaar

Package Leaflet: Information for the User

COZAAR, 12.5 mg, film-coated tablets

COZAAR, 50 mg, film-coated tablets

COZAAR, 100 mg, film-coated tablets

Losartan Potassium

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor, pharmacist, or nurse.
• This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
• If you get any side effects, talk to your doctor, pharmacist, or nurse. This includes any possible side effects not listed in this leaflet. See section 4.

Contents of the pack and other information

• 1. What COZAAR is and what it is used for
• 2. What you need to know before you take COZAAR
• 3. How to take COZAAR
• 4. Possible side effects
• 5. How to store COZAAR
• 6. Contents of the pack and other information

1. What COZAAR is and what it is used for

Losartan (COZAAR) belongs to a group of medicines known as angiotensin II receptor antagonists.
Angiotensin II is a substance produced in the body that binds to receptors in the blood vessel walls, causing them to narrow. This results in an increase in blood pressure. Losartan prevents angiotensin II from binding to these receptors, causing the blood vessels to widen and thereby lowering the blood pressure. Losartan slows the progression of kidney disease in patients with high blood pressure and type 2 diabetes.
COZAAR is used

• to treat high blood pressure (hypertension) in adults and in children and adolescents from 6 to 18 years of age.
• to protect the kidneys in patients with high blood pressure and type 2 diabetes with laboratory evidence of kidney damage and proteinuria ≥ 0.5 g/day (a condition in which the urine contains an abnormal amount of protein).
• to treat patients with chronic heart failure when treatment with certain other medicines called ACE inhibitors is not considered suitable by your doctor. If heart failure has been stabilised with an ACE inhibitor, the treatment should not be switched to losartan.
• in patients with high blood pressure and thickening of the left ventricle of the heart, as it has been shown that COZAAR reduces the risk of stroke (the "LIFE indication").

2. What you need to know before you take COZAAR

Do not take COZAAR:

• if you are allergic to losartan or any of the other ingredients of this medicine (listed in section 6),
• if you are more than 3 months pregnant (it is also recommended to avoid COZAAR in early pregnancy - see section "Pregnancy"),
• if you have severe liver disease,
• if you have diabetes or kidney disease and are treated with a blood pressure lowering medicine containing aliskiren.

Warnings and precautions

Before you start taking COZAAR, tell your doctor, pharmacist, or nurse.
Tell your doctor if you think you might be pregnant or are planning to get pregnant. Your doctor will normally advise you to stop taking COZAAR before you become pregnant or as soon as you know you are pregnant and will advise you to take another medicine instead of COZAAR. You must not take COZAAR if you are more than 3 months pregnant as it may seriously harm your baby (see section "Pregnancy").
It is important to tell your doctor before taking COZAAR:

• if you have had angio-oedema (swelling of the face, lips, throat, and/or tongue),
• if you have severe vomiting or diarrhoea leading to excessive loss of body water and salts,
• if you are taking diuretics (water tablets) or if you are on a low salt diet, leading to excessive loss of body water and salts (see section 3 "Dose in special patient groups"),
• if you have narrowing or blockage of blood vessels leading to your kidneys or if you have recently had a kidney transplant,
• if you have liver disease (see sections 2 "Do not take COZAAR" and 3 "Dose in special patient groups"),
• if you have heart failure with or without kidney problems or with a life-threatening abnormal heart rhythm. Special caution is needed when you are also taking beta-blockers,
• if you have valve problems or heart muscle disease,
• if you have coronary heart disease (caused by reduced blood flow in the blood vessels of the heart) or cerebrovascular disease (caused by reduced blood flow in the blood vessels of the brain),
• if you have primary hyperaldosteronism (a condition where you have high blood pressure and a high level of aldosterone, a hormone produced by your adrenal glands),
• if you are taking any of the following medicines used to treat high blood pressure: an ACE inhibitor (such as enalapril, lisinopril, ramipril), especially if you have kidney disease associated with diabetes, or aliskiren. Your doctor may check your kidney function, blood pressure, and the amount of electrolytes (such as potassium) in your blood. See also the information under the heading "Do not take COZAAR".
• if you are taking other medicines that may increase potassium levels in your blood (see section 2 "COZAAR with other medicines").

If you take COZAAR and get any of the following side effects, talk to your doctor: abdominal pain, nausea, vomiting, or diarrhoea. Your doctor will decide what to do.

Children and adolescents

COZAAR has been studied in children. For more information, please contact your doctor.
COZAAR is not recommended for children with kidney or liver problems, as there is not enough data available for these patient groups. COZAAR is not recommended for children under 6 years of age, as the efficacy has not been established in this age group.

COZAAR with other medicines

Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines.
Tell your doctor or pharmacist if you are taking potassium supplements, potassium-sparing diuretics (such as amiloride, triamterene, spironolactone), or other medicines that may increase potassium levels in your blood (such as heparin, trimethoprim-containing medicines), as you should not take COZAAR with these medicines.

• other medicines to lower your blood pressure, as the effect of low blood pressure may be increased. Other medicines that lower blood pressure include tricyclic antidepressants, antipsychotics, baclofen, amifostine,
• non-steroidal anti-inflammatory medicines (such as indomethacin, including COX-2 inhibitors, which are medicines used to reduce inflammation and/or pain), as they may reduce the blood pressure-lowering effect of losartan.

Your doctor may need to change your dose and monitor your blood pressure and kidney function:

• if you take an ACE inhibitor or aliskiren (see also the information under the headings "Do not take COZAAR" and "Warnings and precautions").

In patients with kidney problems, taking these medicines together may lead to kidney problems.
Do not take lithium with COZAAR without consulting your doctor. Special precautions, such as blood tests, may be needed.

COZAAR with food and drink

COZAAR can be taken with or without food.
You should avoid drinking grapefruit juice while taking COZAAR.

Pregnancy and breast-feeding

Pregnancy

Tell your doctor if you think you might be pregnant or are planning to get pregnant. Your doctor will normally advise you to stop taking COZAAR before you become pregnant or as soon as you know you are pregnant and will advise you to take another medicine instead of COZAAR. You must not take COZAAR if you are more than 3 months pregnant as it may seriously harm your baby.

Breast-feeding

Tell your doctor if you are breast-feeding or about to start breast-feeding. COZAAR is not recommended for breast-feeding mothers, especially during the first few weeks after delivery. Your doctor may prescribe another medicine for you. Ask your doctor or pharmacist for advice before taking any medicine while breast-feeding.

Driving and using machines

COZAAR has not been shown to affect your ability to drive or use machines. However, as with many other medicines used to treat high blood pressure, losartan may cause dizziness or tiredness in some people. If you experience these symptoms, do not drive or use machines until they have disappeared.

COZAAR contains lactose

COZAAR contains lactose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.

3. How to take COZAAR

Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.
Your doctor will determine the appropriate dose of COZAAR depending on your condition and any other medicines you are taking. It is important to continue taking COZAAR for as long as your doctor prescribes it to maintain control of your blood pressure.
Adult patients with high blood pressure
Treatment usually starts with 50 mg losartan (one COZAAR 50 mg tablet) once daily. The maximum effect on blood pressure usually occurs within 3 to 6 weeks after starting treatment. For some patients, a dose of 100 mg losartan (two COZAAR 50 mg tablets or one COZAAR 100 mg tablet) once daily may be needed.

Dose in children and adolescents

Children under 6 years of age
COZAAR is not recommended for children under 6 years of age, as the efficacy has not been established in this age group.
Children from 6 to 18 years of age
The recommended starting dose is 0.7 mg losartan per kg body weight per day (up to 25 mg COZAAR per day) given once daily. Your doctor may increase the dose if your blood pressure is not controlled.

Dose in special patient groups

Your doctor may prescribe a lower dose, especially if you are taking diuretics, have liver disease, or are over 75 years old. Do not take losartan if you have severe liver disease (see section "Do not take COZAAR").

Administration

Swallow the tablets with a glass of water. Try to take your daily dose at the same time each day. It is important to continue taking COZAAR until your doctor tells you to stop.

If you take more COZAAR than you should

If you take too many tablets, contact your doctor or pharmacist immediately. Symptoms of overdose include low blood pressure, fast or slow heart rate.

If you forget to take COZAAR

If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a forgotten dose. If you are unsure, ask your doctor or pharmacist for advice.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.
If you experience any of the following side effects, stop taking COZAAR and contact your doctor or go to the emergency department at your nearest hospital immediately:
Severe allergic reactions (rash, itching, swelling of the face, lips, throat, and/or tongue, which may cause difficulty in swallowing or breathing).
This is a serious but rare side effect that affects between 1 in 10,000 and 1 in 1,000 people. You may need urgent medical attention or hospitalisation.
The following side effects have been reported with COZAAR:

• dizziness,
• low blood pressure (especially after excessive loss of body water, e.g. in patients with severe heart failure or in patients treated with high doses of diuretics),
• dose-related orthostatic effects, such as lowering of blood pressure when rising from a lying or sitting position,
• weakness,
• fatigue,
• low blood sugar (hypoglycaemia),
• high levels of potassium in the blood (hyperkalaemia),
• changes in kidney function, including kidney failure,
• low red blood cell count (anaemia),
• increased levels of urea, creatinine, and potassium in the blood in patients with heart failure.

Uncommon (may affect up to 1 in 100 people):

• drowsiness,
• headache,
• sleep disorders,
• fast heart rate (palpitations),
• severe chest pain (angina pectoris),
• shortness of breath (dyspnoea),
• abdominal pain,
• constipation,
• diarrhoea,
• nausea,
• vomiting,
• hives (itching),
• itching (pruritus),
• rash,
• local swelling (oedema),
• cough.

Rare (may affect up to 1 in 1,000 people):

• allergic reactions,
• angio-oedema,
• angio-oedema of the intestine: intestinal angio-oedema with symptoms such as abdominal pain, nausea, vomiting, and diarrhoea,
• vasculitis (inflammation of blood vessels),
• numbness or tingling (paraesthesia),
• fainting,
• very fast or irregular heart rate (atrial fibrillation),
• stroke,
• liver inflammation (hepatitis),
• increased liver enzymes in the blood, usually returning to normal after stopping treatment.

Frequency not known (cannot be estimated from the available data):

• low platelet count,
• migraine,
• liver problems,
• muscle and joint pain,
• flu-like symptoms,
• back pain and urinary tract infections,
• increased sensitivity to the sun (photosensitivity),
• unexplained muscle pain with dark (tea-coloured) urine (rhabdomyolysis),
• impotence,
• pancreatitis,
• low sodium levels in the blood (hyponatraemia),
• depression,
• general feeling of being unwell,
• ringing, buzzing, hissing, or other persistent noises in the ears (tinnitus),
• taste disorders.

Side effects in children are similar to those in adults.
If you get any side effects, talk to your doctor, pharmacist, or nurse. This includes any possible side effects not listed in this leaflet.

Reporting of side effects

If you get any side effects, talk to your doctor, pharmacist, or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the national reporting system listed in the "Contact" section below.
By reporting side effects, you can help provide more information on the safety of this medicine.

5. How to store COZAAR

Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the carton or blister after "EXP". The expiry date refers to the last day of that month.
Blisters:
Store COZAAR in the original package in order to protect from light and moisture.
Do not open the blisters until you are ready to take the medicine.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

6. Contents of the pack and other information

What COZAAR contains

The active substance is losartan potassium.
Each COZAAR 12.5 mg tablet contains 12.5 mg losartan potassium.
Each COZAAR 50 mg tablet contains 50 mg losartan potassium.
Each COZAAR 100 mg tablet contains 100 mg losartan potassium.
The other ingredients are microcrystalline cellulose (E460), lactose monohydrate (see section 2 "COZAAR contains lactose"), maize starch, magnesium stearate (E572), hydroxypropylcellulose (E463), hypromellose (E464).
COZAAR 12.5 mg, 50 mg, and 100 mg contain potassium in the following amounts: 1.06 mg (0.027 mEq), 4.24 mg (0.108 mEq), and 8.48 mg (0.216 mEq), respectively.
COZAAR 12.5 mg tablets also contain carnauba wax (E903), titanium dioxide (E171), and indigo carmine (E132) aluminium lake.
COZAAR 50 mg tablets also contain carnauba wax (E903) and titanium dioxide (E171).
COZAAR 100 mg tablets also contain carnauba wax (E903) and titanium dioxide (E171).

What COZAAR looks like and contents of the pack

COZAAR 12.5 mg is available as film-coated tablets containing 12.5 mg losartan potassium.
COZAAR 50 mg is available as film-coated tablets with a score line containing 50 mg losartan potassium. The score line is only to facilitate breaking the tablet for ease of swallowing and not to divide it into equal doses.
COZAAR 100 mg is available as film-coated tablets containing 100 mg losartan potassium.
The following pack sizes are available: COZAAR 12.5 mg - PVC/PE/PVDC blister packs with aluminium foil lidding in packs of 21 or 28 tablets, COZAAR 50 mg - PVC/PE/PVDC blister packs with aluminium foil lidding in packs of 28 tablets, COZAAR 100 mg - PVC/PE/PVDC blister packs with aluminium foil lidding in packs of 14 and 28 tablets.

Not all pack sizes may be marketed.

Marketing Authorisation Holder and Manufacturer

Marketing Authorisation Holder

Organon Polska Sp. z o.o.
Marszałkowska 126/134
00-008 Warszawa
Tel.: + 48 22 105 50 01
organonpolska@organon.com

Manufacturer

Merck Sharp & Dohme B.V.
Waarderweg 39
2031 BN Haarlem
Netherlands
Organon Heist bv
Industriepark 30
2220 Heist-op-den-Berg
Belgium

This medicinal product is authorised in the Member States of the European Economic Area under the following names:

Member State

Marketing Authorisation Holder

Austria
Cosaar 12,5 mg - Filmtabletten
Austria
Cosaar 50 mg - Filmtabletten
Austria
Cosaar 100 mg - Filmtabletten
Belgium
COZAAR 12,5 mg
Belgium
COZAAR 50 mg
Belgium
COZAAR 100 mg
Bulgaria
COZAAR 12,5 mg film-coated tablets
Cyprus
COZAAR
Czech Republic
COZAAR 50 mg
Czech Republic
COZAAR 100 mg
Denmark
Cozaar
Finland
Cozaar 12,5 mg kalvopäällysteiset tabletit
Finland
Cozaar 50 mg kalvopäällysteiset tabletit
Finland
Cozaar 100 mg kalvopäällysteiset tabletit
France
COZAAR 50 mg scored coated tablets
France
COZAAR 100 mg film-coated tablets
Germany
LORZAAR PROTECT 100 mg Filmtabletten
Germany
LORZAAR PROTECT 50 mg Filmtabletten
Germany
LORZAAR START 12,5 mg Filmtabletten
Greece
COZAAR
Hungary
COZAAR
Iceland
COZAAR
Ireland
COZAAR 12,5 mg film-coated tablets
Ireland
COZAAR 50 mg film-coated tablets
Ireland
COZAAR 100 mg film-coated tablets

Member State

Marketing Authorisation Holder

Italy
LORTAAN 12,5 mg compresse rivestite con film
Italy
LORTAAN 50 mg compresse rivestite con film
Italy
LORTAAN 100 mg compresse rivestite con film
Luxembourg
COZAAR 12,5 mg
Luxembourg
COZAAR 50 mg
Luxembourg
COZAAR 100 mg
Malta
COZAAR 12,5 mg film-coated tablets
Malta
COZAAR 50 mg film-coated tablets
Malta
COZAAR 100 mg film-coated tablets
Netherlands
COZAAR 12,5 mg
Netherlands
COZAAR 50 mg
Netherlands
COZAAR 100 mg
Norway
Cozaar
Poland
COZAAR
Portugal
Cozaar
Portugal
Cozaar 100 mg
Portugal
Cozaar IC
Spain
COZAAR 12,5 mg Inicio comprimidos recubiertos con película
Spain
COZAAR 50 mg comprimidos recubiertos con película
Spain
COZAAR 100 mg comprimidos recubiertos con película
Sweden
COZAAR 12,5 mg filmdragerade tabletter
Sweden
COZAAR 50 mg filmdragerade tabletter
Sweden
COZAAR 100 mg filmdragerade tabletter

Date of last revision of the leaflet: 01/2025