Home  ›  Are Losartan and Candesartan in the Same Family of Medication

Are Losartan and Candesartan in the Same Family of Medication

Written By Friday, March 4, 2022 Add Comment Edit

Blood pressure medication

Losartan
Skeletal formula
Space-filling model
Clinical data
Pronunciation
Merchandise names Cozaar, others
AHFS/Drugs.com Monograph
MedlinePlus a695008
License information
  • US  DailyMed:Losartan
  • US FDA: Losartan
Pregnancy
category
  • AU: D[1]
Routes of
assistants		 Past mouth
Drug grade Angiotensin II receptor antagonist
ATC code
  • C09CA01 (WHO)
Legal condition
Legal status
  • US: ℞-only [2]
  • In full general: ℞ (Prescription only)
Pharmacokinetic data
Bioavailability 25–35%
Protein binding 99.7% (primarily albumin)
Metabolism Liver (CYP2C9, CYP3A4)
Emptying half-life i.5–2 hours
Excretion Kidney 13–25%, bile duct 50–sixty%
Identifiers

IUPAC name

  • (2-butyl-iv-chloro-1-{[2'-(2H-tetrazol-five-yl)biphenyl-4-yl]methyl}-aneH-imidazol-5-yl)methanol
CAS Number
  • 114798-26-iv check Y
PubChem CID
  • 3961
IUPHAR/BPS
  • 590
DrugBank
  • DB00678 check Y
ChemSpider
  • 3824 check Y
UNII
  • JMS50MPO89
KEGG
  • D08146 check Y
ChEBI
  • CHEBI:6541 check Y
ChEMBL
  • ChEMBL191 check Y
CompTox Dashboard (EPA)
  • DTXSID7023227 Edit this at Wikidata
ECHA InfoCard 100.110.555 Edit this at Wikidata
Chemical and physical data
Formula C 22 H 23 Cl N 6 O
Molar mass 422.92 k·mol−1
3D model (JSmol)
  • Interactive image

SMILES

  • CCCCc1nc(Cl)c(CO)n1Cc1ccc(-c2ccccc2-c2nn[nH]n2)cc1

InChI

  • InChI=1S/C22H23ClN6O/c1-ii-iii-8-20-24-21(23)nineteen(14-30)29(20)thirteen-15-nine-11-xvi(12-10-15)17-6-four-v-vii-xviii(17)22-25-27-28-26-22/h4-vii,9-12,30H,ii-3,8,13-14H2,1H3,(H,25,26,27,28)check Y

  • Key:PSIFNNKUMBGKDQ-UHFFFAOYSA-Northwardcheck Y

(verify)

Losartan, sold under the brand name Cozaar amid others, is a medication used to treat high blood pressure (hypertension).[3] It is also used for diabetic kidney illness, center failure, and left ventricular enlargement.[iii] It is taken by mouth.[3] It may be used alone or in improver to other blood pressure level medication.[3] Up to six weeks may be required for the full effects to occur.[3]

Mutual agin effects include muscle cramps, stuffy nose, cough, high blood potassium and anemia.[3] Severe agin effects may include angioedema, low blood pressure, and kidney problems.[iii] Utilize during pregnancy may result in harm to the baby.[3] [ane] Use is not recommended during breastfeeding.[1] It is in the angiotensin receptor blocker family unit of medication. It works past blocking angiotensin II.[3]

Losartan was patented in 1986, and canonical for medical use in the U.s.a. in 1995.[3] [4] It is on the World Health Organisation'southward List of Essential Medicines.[5] It is available as a generic medication.[half-dozen] In 2019, it was the ninth most commonly prescribed medication in the United states of america, with more than 51million prescriptions.[seven] [8] A version combined with hydrochlorothiazide is available[iii] which, in 2019, was the 73rd nigh commonly prescribed medication in the United states of america, with more than than 10meg prescriptions.[7] [9]

Chemical science [edit]

Losartan potassium is chemically described as two-butyl-4-chloro-1-[p-(o-1H-tetrazol-5-ylphenyl)benzyl]imidazole-5-metahnol monopotassium salt. Its empirical formula is C22H22CIKN6O, and its molecular weight is 461.01. [ten]

Losartan is generally marketed as the (basic) potassium salt of the aromatized negatively charged tetrazole, chosen "losartan potassium".[11] The molecule has an extended biphenyl group with a tetrazole which is being used in place of the carboxylic acrid as a bioisostere.[ medical commendation needed ]

Medical uses [edit]

Losartan is used for hypertension, including in people with left ventricular hypertrophy (enlarged middle muscle), and kidney dysfunction amidst type II diabetics.[2] It may besides delay progression of diabetic nephropathy. It is a suitable pharmacological agent for the reduction of renal disease progression in patients with type 2 diabetes, hypertension, and microalbuminuria (>30 mg/24 hours) or proteinuria (>900 mg/24 hours).[12]

Although evidence shows calcium aqueduct blockers and thiazide-type diuretics are preferred first-line treatments for most people (due to both efficacy[ medical commendation needed ] and toll), an angiotensin II receptor adversary such as losartan is recommended every bit first-line treatment in people nether the age of 55 who cannot tolerate an ACE inhibitor.[xiii] 1 report demonstrated losartan was superior to atenolol in the primary prevention of adverse cardiovascular events (myocardial infarction or stroke), with a reduction in cardiovascular morbidity and mortality for a comparable reduction in claret force per unit area. The maximal effects on claret pressure commonly occur inside 3–6 weeks of starting losartan.[14]

Adverse furnishings [edit]

The most common adverse effects for losartan in adults are upper respiratory infections, dizziness, and back pain.[ii] People with type 2 diabetes and kidney disease may experience diarrhea, fatigue, low claret pressure, low blood glucose, elevated potassium, chest pain, or allergic reaction.[2] Losartan should non be taken past people who are diabetic and taking aliskiren.[2] Anemia may occur, due to inhibition of the renin–angiotensin system.[xv] Every bit with other angiotensin receptor blockers, losartan may injure the liver, although this result appears to be rare.[16] Electrolyte imbalances may occur in people with kidney issues who have losartan.[ii] Adverse outcomes practice not differ past sexual practice, age or race.[two]

Pregnancy [edit]

In October 2014, the U.Southward. Nutrient and Drug Administration (FDA) issued a black box warning that losartan can crusade fetal toxicity, and should be discontinued every bit presently every bit pregnancy is detected.[17] [2] Using losartan while pregnant could consequence in fetal injury or decease.[17] [2]

Overdose [edit]

Overdosing would most likely issue in decreased blood force per unit area, which could manifest as an increased heart rate, dizziness, feeling low-cal headed, or loss of consciousness. Mice studies showed that lethality occurred at virtually 44 to 170 times the maximum recommended dose after the mice weights were taken into account.[2]

Interactions [edit]

Losartan may take agin interactions with phenobarbital, rifampin, or fluconazole, possibly inhibiting its claret force per unit area-lowering effects.[2]

Contamination [edit]

Betwixt November 2018 and September 2019, the FDA announced multiple recalls of tablets containing losartan by Sandoz, Torrent Pharmaceuticals, Hetero Labs, Slant Pharmaceuticals, Legacy Pharmaceutical Packaging, Teva Pharmaceuticals, Vivimed Life Sciences, and Macleods Pharmaceutical Limited due to detection of i of the possible carcinogens Due north-nitrosodiethylamine, Due north-methylnitrosobutyric acid, or N-nitroso-N-methyl-4-aminobutyric acid in the active pharmaceutical ingredient (API).[xviii] [19] [20] [21] [22] [23] [24] [25] [26] [27] [28] [29] [30] [31] [32] [33] [34] [35]

Machinery of activity [edit]

Renin-angiotensin-aldosterone system (RAAS)

Losartan is a selective, competitive angiotensin 2 receptor blazon 1 (AT1) antagonist, reducing the finish organ responses to angiotensin 2. Losartan assistants results in a decrease in total peripheral resistance (afterload) and cardiac venous return (preload). All of the physiological effects of angiotensin II, including release of aldosterone, are antagonized in the presence of losartan. Reduction in claret pressure occurs independently of the status of the renin–angiotensin system. Equally a consequence of losartan dosing, plasma renin activity increases due to removal of the angiotensin II feedback. Renin is released from the kidneys when there is reduced renal arterial pressure, sympathetic activation, or increased sodium delivery to the distal renal tubule.[36] Renin and so acts by converting angiotensinogen to angiotensin I; angiotensin converting enzyme (ACE) converts angiotensin I to angiotensin II; angiotensin Ii causes vasoconstriction and aldosterone release.[36] Aldosterone serves to retain sodium from the distal renal tubule. Sodium memory ultimately results in increased blood pressure.[37] Therefore, the utilise of angiotensin Two receptor antagonists like losartan event in blocking the downstream effect of renin, angiotensin II, and ultimately decreasing blood pressure.

Angiotensin II receptor antagonists include losartan, valsartan, azilsartan, candesartan, eprosartan, irbesartan, olmesartan, and telmisartan. They all have the same mechanism of activity and potentially inhibit the actions of angiotensin better than ACE inhibitors, such every bit lisinopril, considering there are other enzymes than ACE that have the capability of producing angiotensin II.[36]

Losartan is a uricosuric. As a specific inhibitor of the urate transporter one (SLC22A12, URAT1), losartan blocks the uptake of uric acid into cells, thus leaving more available in the bloodstream to be filtered and excreted by the kidneys.[38] Because losartan tin crusade hyperkalemia, individuals should not utilise potassium supplements or salt substitutes containing potassium without appropriate monitoring by a doctor.[39]

Pharmacokinetics [edit]

Losartan is well absorbed following oral administration and undergoes significant kickoff-laissez passer metabolism to produce the five-carboxylic acrid metabolite, designated as EXP3174. About fourteen% of an oral dosage is converted to this metabolite, which is long-acting (6 to viii hr) and a noncompetitive antagonist at the AT1 receptor, contributing to the pharmacological furnishings of losartan. EXP3174 is x-40 times more than strong in blocking AT1 receptors than losartan. In addition, the binding to the target enzyme is pH-sensitive, and the negatively-charged tetrazole ring, which is similar in size to the negative carboxylic acrid derivative, may contribute to the activeness of the drug.[40]

Losartan's bioavailability is about 33%.[ medical citation needed ]

Metabolism is primarily by cytochrome P450 isoenzymes CYP2C9 and CYP3A4.[ medical citation needed ] Tiptop plasma concentrations of losartan and EXP3174 occur about one hr and three to four hours, respectively, after an oral dose.[ medical citation needed ] Both losartan and EXP3174 are more 98% bound to plasma proteins.[ medical citation needed ] Losartan is excreted in the urine, and in the feces via bile, as unchanged drug and metabolites.[ medical commendation needed ] About 4% of an oral dose is excreted unchanged in urine, and about six% is excreted in urine equally the active metabolite.[ medical citation needed ] The final elimination one-half lives of losartan and EXP3174 are nigh 1.five to 2.5 hours and three to 9 hours, respectively.[ medical citation needed ]

Losartan and other angiotensin-receptor antagonists exhibit fetal toxicity and should be avoided during pregnancy, particularly in the second and third trimesters.[41]

History [edit]

  • Discovery and evolution of angiotensin receptor blockers

Research [edit]

A hypothesis emerged, in an opinion commentary published in March 2020, that AT1R blockers such every bit losartan may piece of work to mitigate the symptoms of COVID-xix (SARS-CoV-2) infection.[42] Competing hypotheses are that it will make the symptoms worse.[43] [44] A written report of this question was started in March 2020.[45]

References [edit]

  1. ^ a b c "Losartan (Cozaar) Use During Pregnancy". Drugs.com . Retrieved 10 December 2017.
  2. ^ a b c d eastward f 1000 h i j 1000 "Cozaar- losartan potassium tablet, film coated". DailyMed. 14 November 2019. Retrieved 20 March 2020.
  3. ^ a b c d east f g h i j k "Losartan Potassium". The American Lodge of Health-System Pharmacists. Retrieved 8 Dec 2017.
  4. ^ Fischer, Jnos; Ganellin, C. Robin (2006). Counterpart-based Drug Discovery. John Wiley & Sons. p. 470. ISBN9783527607495.
  5. ^ World Health Organization (2019). World Wellness Organization model list of essential medicines: 21st list 2019. Geneva: World Wellness Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC By-NC-SA three.0 IGO.
  6. ^ British national formulary : BNF 69 (69 ed.). British Medical Association. 2015. p. 127. ISBN9780857111562.
  7. ^ a b "The Meridian 300 of 2019". ClinCalc . Retrieved 16 Oct 2021.
  8. ^ "Losartan - Drug Usage Statistics". ClinCalc . Retrieved 16 October 2021.
  9. ^ "Hydrochlorothiazide; Losartan - Drug Usage Statistics". ClinCalc . Retrieved 16 October 2021.
  10. ^ "Pharmaceutical conception of losartan".
  11. ^ see negatively charged tetrazole construction
  12. ^ Boersma C, Atthobari J, Gansevoort RT, de Jong-Van den Berg LT, de Jong PE, de Zeeuw D, Annemans LJ, Postma MJ (2006). "Pharmacoeconomics of angiotensin Two antagonists in blazon 2 diabetic patients with nephropathy: implications for decision making". PharmacoEconomics. 24 (6): 523–35. doi:10.2165/00019053-200624060-00001. PMID 16761901. S2CID 22960961.
  13. ^ "Hypertension in adults: diagnosis and management". National Found for Health and Care Excellence (Prissy) . Retrieved eight Apr 2017.
  14. ^ Abrams A (2007). 'Clinical Drug Therapy Rationales for Nursing Practice. Philadelphia, Pa.: Lippincott Williams & Wilkins. p. 846. ISBN978-0-7817-6263-2.
  15. ^ Cheungpasitporn, W; Thongprayoon, C; Chiasakul, T; Korpaisarn, S; Erickson, SB (Nov 2015). "Renin-angiotensin organisation inhibitors linked to anemia: a systematic review and meta-analysis". QJM: Monthly Periodical of the Association of Physicians. 108 (xi): 879–84. doi:x.1093/qjmed/hcv049. PMID 25697787.
  16. ^ Patti R, Sinha A, Sharma South, Yoon TS, Kupfer Y (May 2019). "Losartan-induced severe hepatic injury: A instance study and literature review". Cureus. eleven (5): e4769. doi:ten.7759/cureus.4769. PMC6663042. PMID 31363450.
  17. ^ a b "Cozaar (losartan potassium) 25 mg, fifty mg, and 100 mg Tablets". U.S. Food and Drug Administration (FDA). 16 October 2014. Archived from the original on 12 January 2017. Retrieved 21 July 2015.
  18. ^ "FDA provides update on its ongoing investigation into ARB drug products; reports on finding of a new nitrosamine impurity in certain lots of losartan and product recall" (Press release). U.S. Food and Drug Administration (FDA). iii October 2019. Archived from the original on 3 October 2019. Retrieved 3 October 2019.
  19. ^ "Sandoz Inc. Issues Voluntary Nationwide Recall of One Lot of Losartan Potassium and Hydrochlorothiazide Due to the Detection of Trace Amounts of NDEA (North-Nitrosodiethylamine) Impurity Found in the Active Pharmaceutical Ingredient (API)". U.S. Nutrient and Drug Administration (FDA). 8 November 2018. Archived from the original on 7 September 2019. Retrieved 5 October 2019.
  20. ^ "Torrent Pharmaceuticals Limited Problems Voluntary Nationwide Recall of Losartan Potassium Tablets, USP". U.S. Food and Drug Administration (FDA). 20 December 2018. Archived from the original on 7 September 2019. Retrieved 5 October 2019.
  21. ^ "Torrent Pharmaceuticals Express Expands Voluntary Nationwide Recall of Losartan Potassium Tablets, USP". U.S. Food and Drug Administration (FDA). 3 Jan 2019. Archived from the original on 7 September 2019. Retrieved 5 October 2019.
  22. ^ "UPDATED: Torrent Pharmaceuticals Limited Issues Voluntary Nationwide Recall of Losartan Potassium Tablets, USP and Losartan Potassium and Hydrochlorothiazide Tablets, USP". U.South. Food and Drug Administration (FDA). 22 January 2019. Archived from the original on 7 September 2019. Retrieved 5 October 2019.
  23. ^ "Updated: Torrent Pharmaceuticals Limited Issues Voluntary Nationwide Recall of Losartan Potassium Tablets, USP and Losartan Potassium /Hydrochlorothiazide Tablets, USP". U.S. Food and Drug Administration (FDA). 1 March 2019. Archived from the original on 7 September 2019. Retrieved 5 October 2019.
  24. ^ "Updated: Torrent Pharmaceuticals Limited Expands Voluntary Nationwide Recall of Losartan Potassium Tablets, USP and Losartan Potassium/Hydrochlorothiazide Tablets, USP". U.South. Food and Drug Administration (FDA). 18 Apr 2019. Archived from the original on six October 2019. Retrieved 5 October 2019.
  25. ^ "Updated: Torrent Pharmaceuticals Express Expands Voluntary Nationwide Think of Losartan Potassium Tablets, USP and Losartan Potassium / Hydrochlorothiazide Tablets, USP". U.Due south. Food and Drug Administration (FDA). 23 September 2019. Archived from the original on six October 2019. Retrieved 23 September 2019.
  26. ^ "Legacy Pharmaceutical Packaging, LLC Expands Voluntary Nationwide Recollect of Losartan Potassium Tablets, USP, 50mg Due to the Detection of Trace Amounts of N-Nitroso N-Methyl 4-amino butyric acid (NMBA) Impurity Found in the Active Pharmaceutical Ingredient (API)". U.Due south. Food and Drug Administration (FDA). 15 July 2019. Archived from the original on 13 September 2019. Retrieved 5 October 2019.
  27. ^ "Macleods Pharmaceutical Limited Problems Voluntary Nationwide Consumer Level Recall of Losartan Potassium 50mg and Losartan Potassium/Hydrochlorothiazide combination Tablets 50mg/12.5mg, 100mg/12.5mg and 100mg/25mg due to detection of NMBA (N-Nitroso-Northward-Methyl-4-aminobutyric acrid) Impurity". U.Due south. Nutrient and Drug Administration (FDA). 26 June 2019. Archived from the original on i October 2019. Retrieved 5 October 2019.
  28. ^ "Teva Pharmaceuticals USA, Inc. Expands Voluntary Nationwide Think of Losartan Potassium to 50 mg and 100 mg Tablets USP, Sold Exclusively to Golden Country Medical Supply, Inc". U.S. Food and Drug Assistants (FDA). 11 June 2019. Archived from the original on 13 September 2019. Retrieved 5 Oct 2019.
  29. ^ "Vivimed Life Sciences Pvt Ltd Bug Voluntary Nationwide Recall of Losartan Potassium 25 mg, 50 mg and 100 mg Tablets, USP Due to the Detection of Trace Amounts of N-Nitroso-N-methyl-four-aminobutyric acid (NMBA) Impurity". U.S. Food and Drug Administration (FDA). iii May 2019. Archived from the original on 13 September 2019. Retrieved five October 2019.
  30. ^ "Teva Pharmaceuticals USA, Inc. Issues Voluntary Nationwide Recall of Losartan Potassium 25 mg and 100 mg Tablets USP, Sold Exclusively to Golden State Medical Supply". U.S. Food and Drug Administration (FDA). 26 April 2019. Archived from the original on 13 September 2019. Retrieved 5 Oct 2019.
  31. ^ "Legacy Pharmaceutical Packaging, LLC Issues Voluntary Nationwide Recall of Losartan Potassium Tablets, USP, 25mg, 50mg, And 100mg Due to The Detection of Trace Amounts Of North-Nitroso N-Methyl 4-Amino Butyric Acid (NMBA) Impurity Found in The Active Pharmaceutical Ingredient (API)". U.Southward. Food and Drug Administration (FDA). 19 March 2019. Archived from the original on vii September 2019. Retrieved 5 October 2019.
  32. ^ "Legacy Pharmaceutical Packaging, LLC Issues Voluntary Nationwide Remember of Losartan Potassium Tablets, USP, 25mg, 50mg, and 100mg Due to the Detection of Trace Amounts of N-Nitroso N-Methyl 4-Amino Butyric Acid (NMBA) Impurity Found in the Active Pharmaceutical Ingredient (API)". U.S. Food and Drug Administration (FDA). 28 March 2019. Archived from the original on 7 September 2019. Retrieved five October 2019.
  33. ^ "Legacy Pharmaceutical Packaging, LLC Issues Voluntary Nationwide Recall of Losartan Potassium Tablets, USP, 50mg Due to the Detection of Trace Amounts of Due north-Nitroso N-Methyl 4-amino butyric acid (NMBA) Impurity found in the Active Pharmaceutical Ingredient (API)". U.S. Food and Drug Administration (FDA). xv March 2019. Archived from the original on 7 September 2019. Retrieved 5 October 2019.
  34. ^ "Camber Pharmaceuticals, Inc. Issues Voluntary Nationwide Remember of Losartan Potassium Tablets, USP, 25 mg, 50 mg and 100 mg Due to the Detection of Trace Amounts of N-Nitroso N-Methyl 4-amino butyric acrid (NMBA) Impurity found in the Active Pharmaceutical Ingredient (API)". U.S. Food and Drug Administration (FDA). 28 February 2019. Archived from the original on vii September 2019. Retrieved 5 Oct 2019.
  35. ^ "Macleods Pharmaceuticals Limited Issues Voluntary Nationwide Consumer Level Call back of One Lot (BLM 715A) of Losartan Potassium/Hydrochlorothiazide Combination Tablets 100mg/25mg Due to detection of NDEA (Due north-Nitrosodiethylamine) Impurity". U.S. Food and Drug Assistants (FDA). 22 Feb 2019. Archived from the original on 7 September 2019. Retrieved five Oct 2019.
  36. ^ a b c Katzung, Bertram Chiliad., editor (30 November 2017). Bones & clinical pharmacology. ISBN9781259641152. OCLC 1048625746. CS1 maint: multiple names: authors list (link)
  37. ^ Graudal, Niels A.; Hubeck-Graudal, Thorbjørn; Jürgens, Gesche (January 2012). "Effects of low-sodium diet vs. high-sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride (Cochrane Review)". American Journal of Hypertension. 25 (ane): 1–15. doi:10.1038/ajh.2011.210. ISSN 1941-7225. PMID 22068710.
  38. ^ Hamada T, Ichida 1000, Hosoyamada Grand, Mizuta East, Yanagihara Thousand, et al. (i October 2008). "Uricosuric activity of losartan via the inhibition of urate transporter 1 (URAT 1) in hypertensive patients". American Periodical of Hypertension. 21 (10): 1157–1162. doi:10.1038/ajh.2008.245. PMID 18670416.
  39. ^ RxList. The Internet Drug Index. Clinical pharmacology of Cozaar. Retrieved 6 January 2014.
  40. ^ Binding of losartan
  41. ^ Sica DA, Gehr TW, Ghosh S (2005). "Clinical pharmacokinetics of losartan". Clin Pharmacokinet. 44 (8): 797–814. doi:10.2165/00003088-200544080-00003. PMID 16029066. S2CID 41326620.
  42. ^ Gurwitz D (March 2020). "Angiotensin receptor blockers as tentative SARS-CoV-2 therapeutics". Drug Evolution Research. 81 (v): 537–540. doi:10.1002/ddr.21656. ISSN 1098-2299. PMC7228359. PMID 32129518.
  43. ^ Watkins, John (28 February 2020). "Preventing a covid-19 pandemic". BMJ. 368: m810. doi:10.1136/bmj.m810. ISSN 1756-1833. PMID 32111649.
  44. ^ Kickbusch, Ilona; Leung, Gabriel (31 January 2020). "Response to the emerging novel coronavirus outbreak". BMJ. 368: m406. doi:10.1136/bmj.m406. ISSN 1756-1833. PMID 32005675.
  45. ^ "Losartan for Patients With COVID-19 Requiring Hospitalization". ClinicalTrials.gov. 17 March 2020. Retrieved 23 March 2020.

Further reading [edit]

  • Al-Majed AR, Assiri E, Khalil NY, Abdel-Aziz HA (2015). "Losartan: Comprehensive Profile". Profiles Drug Subst Excip Relat Methodol. 40: 159–94. doi:10.1016/bs.podrm.2015.02.003. PMID 26051686.
  • Sica DA, Gehr TW, Ghosh S (2005). "Clinical pharmacokinetics of losartan". Clin Pharmacokinet. 44 (eight): 797–814. doi:ten.2165/00003088-200544080-00003. PMID 16029066. S2CID 41326620.

External links [edit]

  • "Losartan". Drug Information Portal. U.Southward. National Library of Medicine.

apontetherip.blogspot.com

Source: https://en.wikipedia.org/wiki/Losartan

0 Response to "Are Losartan and Candesartan in the Same Family of Medication"

Post a Comment

Subscribe to: Post Comments (Atom)

Iklan Atas Artikel

Iklan Tengah Artikel 1

Iklan Tengah Artikel 2

Iklan Bawah Artikel