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Therefore losartan must not be administered in patients with severe hepatic impairment see sections 4. Renal function impairment. As a consequence of inhibiting the renin-angiotensin system, changes in renal function including renal failure have been reported in particular, in patients whose renal function is dependent on the rennin- angiotensin- aldosterone system such as those with severe cardiac insufficiency or pre-existing renal dysfunction. As with other medicinal products that affect the renin-angiotensin-aldosterone system, increases in blood urea and serum creatinine have also been reported in patients with bilateral renal artery stenosis or stenosis of the artery to a solitary kidney; these changes in renal function may be reversible upon discontinuation of therapy. Losartan should be used with caution in patients with bilateral renal artery stenosis or stenosis of the artery to a solitary kidney.
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The dose-response relationship became very obvious in the low dose group compared to the middle dose group period I: The lowest doses studied, 2. These results were confirmed during period II of the study where patients were randomized to continue losartan or placebo, after three weeks of treatment.
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