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Losartan
Also known as: 124750-99-8, Cozaar, Erythropoietin, Losartan potassium salt, Lorzaar, Losacar
Molecular Formula
C22H22ClKN6O
Molecular Weight
461.0  g/mol
InChI Key
OXCMYAYHXIHQOA-UHFFFAOYSA-N
FDA UNII
3ST302B24A

An antagonist of ANGIOTENSIN TYPE 1 RECEPTOR with antihypertensive activity due to the reduced pressor effect of ANGIOTENSIN II.
1 2D Structure

Losartan

2 Identification
2.1 Computed Descriptors
2.1.1 IUPAC Name
potassium;[2-butyl-5-chloro-3-[[4-[2-(1,2,3-triaza-4-azanidacyclopenta-2,5-dien-5-yl)phenyl]phenyl]methyl]imidazol-4-yl]methanol
2.1.2 InChI
InChI=1S/C22H22ClN6O.K/c1-2-3-8-20-24-21(23)19(14-30)29(20)13-15-9-11-16(12-10-15)17-6-4-5-7-18(17)22-25-27-28-26-22;/h4-7,9-12,30H,2-3,8,13-14H2,1H3;/q-1;+1
2.1.3 InChI Key
OXCMYAYHXIHQOA-UHFFFAOYSA-N
2.1.4 Canonical SMILES
CCCCC1=NC(=C(N1CC2=CC=C(C=C2)C3=CC=CC=C3C4=NN=N[N-]4)CO)Cl.[K+]
2.2 Other Identifiers
2.2.1 UNII
3ST302B24A
2.3 Synonyms
2.3.1 MeSH Synonyms

1. 2-butyl-4-chloro-1-((2'-(1h-etrazol-5-yl) (1,1'-biphenyl)-4-yl)methyl)-1h-imidazole-5-methanol

2. Cozaar

3. Dup 753

4. Dup-753

5. Dup753

6. Losartan

7. Losartan Monopotassium Salt

8. Mk 954

9. Mk-954

10. Mk954

11. Monopotassium Salt, Losartan

12. Potassium, Losartan

13. Salt, Losartan Monopotassium

2.3.2 Depositor-Supplied Synonyms

1. 124750-99-8

2. Cozaar

3. Erythropoietin

4. Losartan Potassium Salt

5. Lorzaar

6. Losacar

7. Losaprex

8. Hyzaar

9. Dup 753

10. Nu-lotan

11. Mk 954

12. Lortaan

13. Losata

14. Tancin

15. Mk-0954

16. Losartanpotassium

17. Losartan Potassium (dup 753)

18. Mk0954

19. L-158086

20. Losartan Monopotassium Salt

21. 3st302b24a

22. Aradois

23. Zaart

24. Dup-753

25. Presartan-50

26. E-3340

27. 2-butyl-4-chloro-1-(p-(o-1h-tetrazol-5-ylphenyl)benzyl)imidazole-5-methanol, Monopotassium Salt

28. 124750-99-8 (ka+)

29. Potassium;[2-butyl-5-chloro-3-[[4-[2-(1,2,3-triaza-4-azanidacyclopenta-2,5-dien-5-yl)phenyl]phenyl]methyl]imidazol-4-yl]methanol

30. Lifezar

31. Lorzaan

32. Losacor

33. Tenopres

34. Lotim

35. Niten

36. Ocsaar

37. Du Pont-753

38. Neo Lotan

39. 1h-imidazole-5-methanol, 2-butyl-4-chloro-1-((2'-(1h-tetrazol-5-yl)(1,1'-biphenyl)-4-yl)methyl)-, Monopotassium Salt

40. 2-butyl-4-chloro-1-[[2'-(1h-tetrazol-5-yl)[1,1'-biphenyl]-4-yl]methyl]-1h-imidazole-5-methanol, Monopotassium Salt

41. Mfcd09850721

42. Mk-954

43. Du Pont 753

44. Losartan Potassium [usan]

45. Covance

46. Unii-3st302b24a

47. Losartan Potassium [usan:usp]

48. Potassium 5-(4'-((2-butyl-4-chloro-5-(hydroxymethyl)-1h-imidazol-1-yl)methyl)biphenyl-2-yl)tetrazol-1-ide

49. Cozaar (tn)

50. Dup-753 Potassium

51. Mk 0954

52. Losartan Potassium,(s)

53. Schembl42079

54. Mls001401407

55. Ex-89

56. Dtxsid3044209

57. Losartan Potassium [jan]

58. Losartan Potassium (jp17/usp)

59. Losartan Potassium [hsdb]

60. Hms2051m12

61. Hms2090o22

62. Hms2235f20

63. Hms3369f08

64. Hms3393m12

65. Losartan Potassium [vandf]

66. Losartan Potassium [mart.]

67. Act02618

68. Bcp05332

69. Bcp29397

70. Losartan Potassium [usp-rs]

71. Losartan Potassium [who-dd]

72. Akos015955543

73. Akos025310168

74. Ac-1072

75. Ccg-100869

76. Losartan Potassium, Analytical Standard

77. Nc00119

78. 2-butyl-4-chloro-1-(2'-(tetrazol-5-yl)biphenyl-4-ylmethyl)-1h-imidazole-5-methanol Potassium

79. Losartan Monopotassium Salt [mi]

80. Losartan Potassium [orange Book]

81. Losartan Potassium [ep Monograph]

82. 2-butyl-4-chloro-1-[[2'-(1h-tetrazol-5-yl)-1,1'-biphenyl-4-yl]methyl]imidazole-5-methanol Potassium Salt

83. Bl164642

84. Epo

85. Hyzaar Component Losartan Potassium

86. Losartan Potassium [usp Monograph]

87. Smr000469593

88. Ft-0625705

89. L-185

90. L0232

91. Losartan Potassium Component Of Hyzaar

92. D00357

93. Ab01275507-01

94. 750l998

95. A805291

96. Sr-05000001514

97. Sr-05000001514-1

98. Q27257991

99. Losartan Potassium, European Pharmacopoeia (ep) Reference Standard

100. Losartan Potassium Is Known As A Potent, Synthetic At1 Receptor Antagonist.

101. Losartan Potassium, United States Pharmacopeia (usp) Reference Standard

102. Losartan Potassium, Pharmaceutical Secondary Standard; Certified Reference Material

103. [2-butyl-5-chloro-3-[[4-[2-(1,2,3-triaza-4-azanidacyclopenta-2,5-dien-5-yl)phenyl]phenyl]methyl]imidazol-4-yl]methanol; Potassium;losartan Potassium

104. 1h-imidazole-5-methanol, 2-butyl-4-chloro-1-((2-(1h-tetrazol-5-yl)(1,1-biphenyl)-4-yl)methyl)-, Monopotassium Salt

105. Potassium;[2-butyl-5-chloro-3-[[4-[2-(1,2,3-triaza-4-azanidacyclopenta-2,5-dien-5-yl)phenyl]phenyl]methyl]imidazol-4-yl]methanol.

2.4 Create Date
2006-10-26
3 Chemical and Physical Properties
Molecular Weight 461.0 g/mol
Molecular Formula C22H22ClKN6O
Hydrogen Bond Donor Count1
Hydrogen Bond Acceptor Count6
Rotatable Bond Count8
Exact Mass460.1180685 g/mol
Monoisotopic Mass460.1180685 g/mol
Topological Polar Surface Area77.7 Ų
Heavy Atom Count31
Formal Charge0
Complexity526
Isotope Atom Count0
Defined Atom Stereocenter Count0
Undefined Atom Stereocenter Count0
Defined Bond Stereocenter Count0
Undefined Bond Stereocenter Count0
Covalently Bonded Unit Count2
4 Drug and Medication Information
4.1 Drug Information
1 of 4  
Drug NameCozaar
PubMed HealthLosartan (By mouth)
Drug ClassesCardiovascular Agent, Renal Protective Agent
Drug LabelCOZAAR1(losartan potassium) is an angiotensin II receptor (type AT1) antagonist. Losartan potassium, a non-peptide molecule, is chemically described as 2-butyl-4-chloro-1-[p-(o-1H-tetrazol-5-ylphenyl)benzyl]imidazole-5-methanol monopotassium salt.Its...
Active IngredientLosartan potassium
Dosage FormTablet
RouteOral
Strength100mg; 25mg; 50mg
Market StatusPrescription
CompanyMerck Sharp Dohme

2 of 4  
Drug NameLosartan potassium
Drug LabelLosartan potassium tablets USP are an angiotensin II receptor (type AT1) antagonist. Losartan potassium, USP a non-peptide molecule, is chemically described as 2-butyl-4-chloro-1-[p-(o-1H-tetrazol-5-ylphenyl)benzyl]imidazole-5-methanol monopotassium...
Active IngredientLosartan potassium
Dosage FormTablet
RouteOral
Strength25mg; 100mg; 50mg
Market StatusPrescription
CompanyUpsher Smith; Teva; Apotex; Alembic Pharms; Aurobindo Pharma; Torrent Pharms; Lupin; Sandoz; Prinston; Roxane; Watson Labs; Macleods Pharms; Ipca Labs; Vivimed Labs; Micro Labs Ltd India; Cadista Pharms; Zydus Pharms Usa; Mylan

3 of 4  
Drug NameCozaar
PubMed HealthLosartan (By mouth)
Drug ClassesCardiovascular Agent, Renal Protective Agent
Drug LabelCOZAAR1(losartan potassium) is an angiotensin II receptor (type AT1) antagonist. Losartan potassium, a non-peptide molecule, is chemically described as 2-butyl-4-chloro-1-[p-(o-1H-tetrazol-5-ylphenyl)benzyl]imidazole-5-methanol monopotassium salt.Its...
Active IngredientLosartan potassium
Dosage FormTablet
RouteOral
Strength100mg; 25mg; 50mg
Market StatusPrescription
CompanyMerck Sharp Dohme

4 of 4  
Drug NameLosartan potassium
Drug LabelLosartan potassium tablets USP are an angiotensin II receptor (type AT1) antagonist. Losartan potassium, USP a non-peptide molecule, is chemically described as 2-butyl-4-chloro-1-[p-(o-1H-tetrazol-5-ylphenyl)benzyl]imidazole-5-methanol monopotassium...
Active IngredientLosartan potassium
Dosage FormTablet
RouteOral
Strength25mg; 100mg; 50mg
Market StatusPrescription
CompanyUpsher Smith; Teva; Apotex; Alembic Pharms; Aurobindo Pharma; Torrent Pharms; Lupin; Sandoz; Prinston; Roxane; Watson Labs; Macleods Pharms; Ipca Labs; Vivimed Labs; Micro Labs Ltd India; Cadista Pharms; Zydus Pharms Usa; Mylan

4.2 Drug Indication

Indicated in adult and paediatric patients for the: - treatment of anemia due to Chronic Kidney Disease (CKD) in patients on dialysis and not on dialysis. - treatment of anemia due to zidovudine in patients with HIV-infection. - treatment of anemia due to the effects of concomitant myelosuppressive chemotherapy, and upon initiation, there is a minimum of two additional months of planned chemotherapy. - reduction of allogeneic RBC transfusions in patients undergoing elective, noncardiac, nonvascular surgery.


FDA Label


Proteinuria, Treatment of heart failure, Treatment of hypertension


5 Pharmacology and Biochemistry
5.1 Pharmacology

Erythropoietin and epoetin alfa are involved in the regulation of erythrocyte differentiation and the maintenance of a physiological level of circulating erythrocyte mass. It is reported to increase the reticulocyte count within 10 days of initiation, followed by increases in the RBC count, hemoglobin, and hematocrit, usually within 2 to 6 weeks. Depending on the dose administered, the rate of hemoglobin increase may vary. In patients receiving hemodialysis, a greater biologic response is not observed at doses exceeding 300 Units/kg 3 times weekly. Epoetin alfa serves to restore erythropoietin deficiency in pathological and other clinical conditions where normal production of erythropoietin is impaired or compromised. In anemic patients with chronic renal failure (CRF), administration with epoetin alfa stimulated erythropoiesis by increasing the reticulocyte count within 10 days, followed by increases in the red cell count, hemoglobin, and hematocrit, usually within 2 to 6 weeks. Epoetin alfa was shown to be effective in increasing hematocrit in zidovudine-treated HIV-infected patients and anemic cancer patients undergoing chemotherapy.


5.2 MeSH Pharmacological Classification

Angiotensin II Type 1 Receptor Blockers

Agents that antagonize ANGIOTENSIN II TYPE 1 RECEPTOR. Included are ANGIOTENSIN II analogs such as SARALASIN and biphenylimidazoles such as LOSARTAN. Some are used as ANTIHYPERTENSIVE AGENTS. (See all compounds classified as Angiotensin II Type 1 Receptor Blockers.)


Anti-Arrhythmia Agents

Agents used for the treatment or prevention of cardiac arrhythmias. They may affect the polarization-repolarization phase of the action potential, its excitability or refractoriness, or impulse conduction or membrane responsiveness within cardiac fibers. Anti-arrhythmia agents are often classed into four main groups according to their mechanism of action: sodium channel blockade, beta-adrenergic blockade, repolarization prolongation, or calcium channel blockade. (See all compounds classified as Anti-Arrhythmia Agents.)


Antihypertensive Agents

Drugs used in the treatment of acute or chronic vascular HYPERTENSION regardless of pharmacological mechanism. Among the antihypertensive agents are DIURETICS; (especially DIURETICS, THIAZIDE); ADRENERGIC BETA-ANTAGONISTS; ADRENERGIC ALPHA-ANTAGONISTS; ANGIOTENSIN-CONVERTING ENZYME INHIBITORS; CALCIUM CHANNEL BLOCKERS; GANGLIONIC BLOCKERS; and VASODILATOR AGENTS. (See all compounds classified as Antihypertensive Agents.)


5.3 FDA Pharmacological Classification
5.3.1 Pharmacological Classes
Angiotensin 2 Receptor Blocker [EPC]; Angiotensin 2 Receptor Antagonists [MoA]
5.4 ATC Code

B - Blood and blood forming organs

B03 - Antianemic preparations

B03X - Other antianemic preparations

B03XA - Other antianemic preparations

B03XA01 - Erythropoietin


5.5 Absorption, Distribution and Excretion

Absorption

The time to reach peak concentration is slower via the subcutaneous route than the intravenous route which ranges from 20 to 25 hours, and the peak is always well below the peak achieved using the intravenous route (510% of those seen with IV administration). The bioavailability of subcutaneous injectable erythropoietin is much lower than that of the intravenously administered product and is approximately 20-40%. **Adult and paediatric patients with CRF:** Following subcutaneous administration, the peak plasma levels are achieved within 5 to 24 hours. **Cancer patients receiving cyclic chemotherapy:** The average time to reach peak plasma concentration was approximately 13.3 12.4 hours after 150 Units/kg three times per week (TIW) subcutaneous (SC) dosing. The Cmax is expected be 3- to 7- fold higher and the Tmax is expected to be 2- to 3-fold longer in patients receiving a 40,000 Units SC weekly dosing regimen.


Route of Elimination

Erythropoietin and epoetin alfa are cleared via uptake and degradation via the EPO-R-expressing cells, and may also involve other cellular pathways in the interstitium, probably via cells in the reticuloendothelial scavenging pathway or lymphatic system. Only a small amount of unchanged epoetin alfa is found in the urine.


Volume of Distribution

In healthy volunteers, the volume of distribution of intravenous epoetin alfa was generally similar to the plasma volume (range of 4063.80 mL/kg), indicating limited extravascular distribution.


Clearance

**Healthy volunteers: *

In male volunteers receiving intravenous epoetin alfa, the total body clearance was approximately 8.12 1.00 mL/h/kg. **Cancer patients receiving cyclic chemotherapy:*

The average clearance was approximately 20.2 15.9 mL/h/kg after 150 Units/kg three times per week (TIW) subcutaneous (SC) dosing. The patients receiving a 40,000 Units SC weekly dosing regimen display a lower clearance (9.2 4.7 mL/h/kg).


5.6 Metabolism/Metabolites

Binding of erythropoietin and epoetin alfa to EPO-R leads to cellular internalization, which involves the degradation of the ligand. Erythropoietin and epoetin alfa may also be degraded by the reticuloendothelial scavenging pathway or lymphatic system.


5.7 Biological Half-Life

**Healthy volunteers:*

The half life is approximately 4 hours in healthy volunteers receiving an intravenous injection. A half-life of approximately 6 hours has been reported in children. **Adult and paediatric patients with CRF:*

The elimination half life following intravenous administration ranges from 4 to 13 hours, which is about 20% longer in CRF patients than that in healthy subjects. The half life is reported to be similar between adult patients receiving or not receiving dialysis. **Cancer patients receiving cyclic chemotherapy:*

Following subcutaneous administration, the average half life is 40 hours with range of 16 to 67 hours.


5.8 Mechanism of Action

Erythropoietin or exogenous epoetin alfa binds to the erythropoietin receptor (EPO-R) and activates intracellular signal transduction pathways. The affinity (Kd) of EPO for its receptor on human cells is 100 to 200 pM. Upon binding to EPO-R on the surface of erythroid progenitor cells, a conformational change is induced which brings EPO-R-associated Janus family tyrosine protein kinase 2 (JAK2) molecules into close proximity. JAK2 molecules are subsequently activated via phosphorylation, then phosphorylate tyrosine residues in the cytoplasmic domain of the EPO-R that serve as docking sites for Src homology 2-domain-containing intracellular signaling proteins. The signalling proteins include STAT5 that once phosphorylated by JAK2, dissociates from the EPO-R, dimerizes, and translocates to the nucleus where they serve as transcription factors to activate target genes involved in cell division or differentiation, including the apoptosis inhibitor Bcl-x. The inhibition of apoptosis by the EPO-activated JAK2/STAT5/Bcl-x pathway is critical in erythroid differentiation. Via JAK2-mediated tyrosine phosphorylation, erythropoietin and epoetin alfa also activates other intracellular proteins involved in erythroid cell proliferation and survival, such as Shc , phosphatidylinositol 3-kinase (PI3K), and phospholipase C-1.


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