CASE REPORT article
Front. Pharmacol.
Sec. Translational Pharmacology
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1679182
Losartan-Associated Toothache in a Patient With Diabetes and Hypertension: A Hypothesis-Generating Case Report
Provisionally accepted
- 1Nanjing University Medical School Affiliated Taikang Xianlin Drum Tower Hospital, Nanjing, China
- 2Department of Health and Civil Affairs, Administrative Committee of Nanjing Jiangbei New Area, Nanjing, China
- 3Nanjing University of Chinese Medicine, Nanjing, China
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Background: Angiotensin II receptor blockers (ARBs) are standard of care for hypertensive patients, particularly those with type 2 diabetes mellitus (T2D). Although generally well tolerated, rare adverse drug reactions (ADRs) can be overlooked. To our knowledge, no prior case report up to 2025 has described isolated toothache attributable to losartan. Case Presentation: A 45-year-old man with T2D and essential hypertension developed a reproducible, diffuse maxillary toothache ≈30 minutes after each 50 mg dose of losartan potassium. Oral examination and panoramic radiography found no odontogenic pathology; routine laboratory tests were unremarkable. Symptoms resolved upon drug withdrawal and reappeared with supervised re-challenge; no recurrence occurred after substitution with candesartan. The Naranjo algorithm yielded a score of 7, supportive of a drug-related event, though causality cannot be proven in a single case. Conclusions: This observation is hypothesis-generating and suggests that losartan may rarely be associated with toothache. Recognizing this possibility may prevent unnecessary dental procedures and guide ARB substitution when appropriate. Systematic pharmacovigilance and mechanistic research are warranted.
Keywords: Losartan, Toothache, Adverse Drug Reaction, Pharmacovigilance, Orofacial Pain
Received: 05 Aug 2025; Accepted: 12 Sep 2025.
Copyright: © 2025 Yuan, Tang, Liao, Xiang, Liu and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Tao Liu, liutao@njucm.edu.cn
Yangtian Wang, sky161632@yahoo.com.cn
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