Acker CG, Greenberg A
Angioedema induced by the angiotensin II blocker losartan

N Engl J Med (Dec) 333:1572, 1995

Angioedema, which is rare but which can be severe with ACE inhibitors, is thought to be due to potentiation of bradykinin effects by these drugs. One of the putative advantages of angiotensin receptor blockers such as losartant would be an absence of this troubling side effect. However, one case of angioedema has been reported by the manufacturer, and here another case is reported occurring within 30 min of a single dose of 50 mg of losartan. A feeling of something stuck in the throat was accompanied by facial flushing and swelling of the lips and right side of the face.

Comment: Whereas this may have been due to a non-specific allergic reaction to some component of the tablet, the results suggest that losartan be used with caution in patients with a history of sensitivity to ACE inhibitors. The mechanism of angioedema during use of ACE inhibition may need to be revisited. (jtd)

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