Drug interactions
Losartan + Sacubitril / valsartan
Severity: Major
Losartan and Sacubitril / valsartan: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Combining losartan with sacubitril/valsartan gives dual angiotensin receptor blockade, since valsartan is already an ARB. This adds to the risk of hypotension, hyperkalemia and renal impairment without added benefit. The combination is generally considered therapeutic duplication.
What this interaction means in plain words
Losartan and Sacubitril / valsartan can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Duplicate angiotensin II type 1 receptor blockade produces additive effects on blood pressure, potassium and renal hemodynamics.
What to do
Avoid the combination and stop losartan when sacubitril/valsartan is started. If the two are ever overlapped, monitor potassium, creatinine and blood pressure closely.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Losartan
- Aliskiren + Losartan Contraindicated
- Losartan + Sparsentan Contraindicated
- Amifostine + Losartan Major
- Amiloride + Losartan Major
- Amlodipine-benazepril + Losartan Major
- Amlodipine-hydrochlorothiazide-valsartan + Losartan Major
Frequently asked questions
Can I take Losartan with Sacubitril / valsartan?
MediHelp rates the interaction as major. Losartan and Sacubitril / valsartan can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Combining losartan with sacubitril/valsartan gives dual angiotensin receptor blockade, since valsartan is already an ARB. This adds to the risk of hypotension, hyperkalemia and renal impairment without added benefit. The combination is generally considered therapeutic duplication.
How serious is the interaction between Losartan and Sacubitril / valsartan?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and stop losartan when sacubitril/valsartan is started. If the two are ever overlapped, monitor potassium, creatinine and blood pressure closely.
What other medicines interact with Losartan?
MediHelp also lists interactions of Losartan with, for example, Aliskiren, Sparsentan, Amifostine. The full list is on the Losartan page.
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