To the Editor.
—Losartan potassium (Cozaar, Merck & Co, Inc, West Point, Pa), the first angiotensin II receptor antagonist, has had labeling approved as an oral treatment for hypertension by the US Food and Drug Administration. It has been marketed by the manufacturer since April 1995. A nonpeptide imidazole derivative, losartan blocks binding of angiotensin II to type I angiotensin II receptors in blood vessels and other tissues; therefore, it inhibits the renin-angiotensin system more selectively and more completely than angiotensin-converting enzyme (ACE) inhibitors. In clinical trials, losartan has been very effective for the treatment of hypertension. The manufacturer states that except for a low incidence of dizziness, losartan has caused no adverse effects at a significantly higher rate than those found with placebo.1-5 However, I describe herein a patient who developed a severe classic migrainous headache while receiving losartan therapy.
Report of a Case.
—Losartan potassium (50 mg/d)
Ahmad S. Losartan and Severe Migraine. JAMA. 1995;274(16):1266-1267. doi:10.1001/jama.1995.03530160018018