Angioedema Induced by the Angiotensin II Blocker Losartan

Abstract

Losartan (Cozaar, Merck) is a new, orally effective blocker of the angiotensin II receptor. The currently available angiotensin-converting–enzyme (ACE) inhibitors block the degradation of bradykinin, which is also metabolized by ACE. The accumulation of potent vasodilator kinins is believed to be the cause of cough and angioneurotic edema induced by ACE inhibitors. Because losartan does not have ACE activity, it would not be expected to increase bradykinin levels.¹ The drug has therefore been advocated as being potentially free of these adverse effects. However, angioneurotic edema did occur in 1 patient among 4058 treated.¹ We report another case of angioneurotic edema after the administration of losartan.