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Losartan Side Effects & Unbearable Dry Eyes

A number of medications can cause unpleasantly dry eyes as a side effect of taking the drug. One reader reports this with the blood pressure pill losartan.

Half of all American adults (103 million people) are now labeled hypertensive. That’s according to the American Heart Association (2018 update). For most, that will mean blood pressure medications. One of the most prescribed antihypertensive drugs is losartan (Cozaar). At last count nearly 9 million people fill 47 million prescriptions of losartan every year. For the overwhelming majority, losartan side effects are tolerable. But sometimes what seems like a minor side effect turns into a major misery. This reader shares her losartan side effect story:

Q. I was on losartan for a total of 2 months and for 7 weeks of that time, I was miserable with extremely dry eyes.  I was on it for so long because my Dr. didn’t believe the losartan was causing the problem.

Finally I convinced him to prescribe a different blood pressure medicine and my eyes became much better very quickly once I was off the losartan.  I have only seen a few comments about this side effect, though.

A. Losartan (Cozaar) belongs to a class of medicines called ARBs (angiotensin receptor blockers). Other ARBs include: candesartan (Atacand), irbesartan (Avapro), olmesartan (Benicar), telmisartan (Micardis) and valsartan (Diovan).

Dry eyes are not a commonly reported side effect of ARBs. In fact we were not able to find a reference to this complication in the prescribing information, despite the fact that dry mouth, dry skin and dry cough are listed as losartan side effects. Other ARBs have been reported to cause similar adverse reactions.

Other Readers Share Their Stories:

Myriame also experienced dry eyes with an ARB:

“I have been on valsartan for years and now have terrible dry eye. I went off it last month for four weeks. I tried to control my bp naturally without success.

“All month my eyes were wonderfully moist and the first pill I took when I went back on it; dry eyes!! I will see my doctor this week and try another category of drugs as from what I’ve read most ARBs do it.

“I also discovered that valsartan (and probably all ARBs) cause the lower esophageal sphincter (LES) valve in your esophagus to relax leading to reflux. My gastroenterologist confirmed that is true.

“Also, through my own experience, I discovered that acid-suppressing drugs can also cause dry eye! I am sick of side effects of drugs! If anyone has had success with a bp med not causing dry eye, please state what it is! Thanks.”

Carol in Florida had a similar losartan side effect experience:

“I am taking losartan with HCTZ. I noticed that my eyes have been extremely dry and my vision becomes blurry about 30 – 40 mins after taking this medication. There’s no confusion, but there’s drowsiness, which I know is a side effect.

“My eyes will be just fine until I take this particular medication. I then have to keep my eyes squinted in order to see. On some occasions, I have to hold my eyes and gently press them closed for a few minutes to create some comfort.

“I have been watching it for a while now. The results are usually the same. Therefore losartan manufacturers can now add dry-eye to the list of side effects, or thoroughly investigate this clinical finding. I am a living proof.”

Dry Eyes Can Be Disastrous:

Dry eyes may not be a side effect that is perceived as serious. As a result it could easily be overlooked in clinical trial data collection. We would be interested to know whether other people have experienced losartan side effects like dry eyes.

Serious skin reactions linked to another ARB (Diovan aka valsartan) include Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TENS), erythema multiforme, pemphigus and pemphigoid. Any rash deserves immediate medical attention!

It comes as a surprise to many patients to learn that their medicine might be contributing to their symptoms of dry eyes (the medical term for this condition is a tongue twister: xerophthalmia). A large number of diverse drugs can cause this problem. They include:

DRUGS THAT CAUSE DRY EYES ():

  • Accutane (isotretinoin)
  • Advair (fluticasone & salmeterol)
  • Alphagan P (brimonidine)
  • Alrex (loteprednol)
  • Betimol (timolol)
  • Catapres (clonidine)
  • Combigan (brimonidine)
  • Concerta (methylphenidate)
  • Depakote (divalproex)
  • Doxil (doxorubicin)
  • Effexor (venlafaxine)
  • Enablex (darifenacin)
  • Enbrel (etanercept‎)
  • Flonase (fluticasone)
  • Geodon (ziprasidone)
  • Intron A (interferon alfa-2b)
  • Klonopin (clonazepam)
  • Lexapro (escitalopram)
  • Lumigan (bimatoprost)
  • Requip (ropinirole)
  • Soriatane (acitretin)
  • Timoptic (timolol)
  • Toprol XL (metoprolol)
  • Toviaz (fesoterodine)
  • VESIcare (solifenacin)
  • Visudyne (verteporfin)
  • Zyprexa (olanzapine)

Other Losartan Side Effects and Adverse ARB Reactions:

Arb-Related Side Effects 

  • Dizziness, fatigue, low blood pressure
  • Cough
  • Headache
  • Upper respiratory tract infections, sinusitis, stuffy nose,
  • Digestive discomfort, diarrhea, stomach pain, back pain
  • Joint pain, arthritis
  • Swelling of the face, lips, mouth, tongue or throat (Requires immediate emergency medical treatment )
  • Potassium retention and buildup (hyperkalemia)
  • Kidney damage, liver damage
  • Hair loss

Share your own experience with ARBs or other blood pressure medications below. If you have taken such drugs safely and achieved good results we would like to hear your story. If you have experienced losartan side effects, please let us know. And if you would like to know more about natural approaches to controlling blood pressure, check outThe People’s Pharmacy Quick & Handy Home Remedies: Q&As for Your Common Ailments.

Revised 3/1/18

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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