What is the starting dose for Losartan (Angiotensin II receptor antagonist)?

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From the Guidelines

The starting dose for losartan is typically 50 mg once daily for adults with hypertension. According to the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults 1, losartan is an angiotensin II receptor blocker (ARB) that can be used to treat hypertension. The usual dose range for losartan is 50-100 mg per day, and it can be taken once or twice daily.

  • The medication works by blocking angiotensin II receptors, preventing the hormone from binding and causing blood vessel constriction, which helps lower blood pressure.
  • The dose may be increased after 1-2 weeks if blood pressure control is not adequate, with a maximum daily dose of 100 mg for adults.
  • Patients should be monitored for hypotension, especially when starting therapy, and kidney function and potassium levels should be checked periodically.
  • Blood pressure effects typically begin within a week but may take 3-6 weeks for full effect. It's worth noting that the 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction 1 also mentions ARBs, including losartan, as a treatment option for patients with hypertension, but it does not provide specific dosing information for losartan. However, the more recent and relevant guideline for hypertension management 1 provides the most up-to-date and accurate information on losartan dosing.

From the FDA Drug Label

The usual starting dose of losartan is 50 mg once daily. A starting dose of 25 mg is recommended for patients with possible intravascular depletion (e.g., on diuretic therapy).

The starting dose for losartan is 50 mg once daily for adult hypertension. However, a starting dose of 25 mg is recommended for patients with possible intravascular depletion, such as those on diuretic therapy 2.

From the Research

Starting Dose for Losartan

  • The starting dose for losartan is not explicitly stated in the provided studies, but the dosage range is mentioned in several studies 3, 4, 5.
  • According to the study published in 2005, losartan is usually used at an initial dose of 25 mg a day in Japan, but this dose is apparently insufficient to obtain adequate antihypertensive effect and sufficient duration of action 3.
  • The study published in 2007 mentions that losartan is used at a dose of 50 mg/day in combination with hydrochlorothiazide (12.5 mg/day) 4.
  • Another study published in 2010 discusses the dose of losartan, stating that 150 mg of losartan has favourable effects compared with the currently recommended dose of 50 mg per day 5.
  • It is worth noting that the dosage of losartan may vary depending on the specific condition being treated and the patient's response to the medication, as well as other factors such as age and kidney function.

Dosage Comparison

  • The study published in 2005 compares the efficacy and duration of action of four angiotensin II receptor blockers, including losartan, and finds that losartan has a shorter duration of action compared to other ARBs 3.
  • The study published in 2010 highlights the importance of consistent titration to recommended doses, suggesting that higher doses of losartan (150 mg) may be more effective than lower doses (50 mg) 5.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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