What is the dosing range for Losartan (Angiotensin II Receptor Antagonist)?

From the Guidelines

Losartan is typically dosed between 25 to 100 mg once daily for adults, with 50 mg being the standard starting dose for most patients with hypertension. For patients with volume depletion or those at risk for hypotension, a lower starting dose of 25 mg is recommended. The dose can be titrated upward to a maximum of 100 mg daily based on blood pressure response, usually waiting 1-2 weeks between dose adjustments to assess full effect.

Key Considerations

• For children 6 years and older, dosing is weight-based, starting at 0.7 mg/kg once daily (up to 50 mg) and can be increased to a maximum of 1.4 mg/kg daily (or 100 mg) 1.
• Losartan works by blocking angiotensin II receptors, preventing the hormone's vasoconstrictive effects and reducing blood pressure.
• This medication can be taken with or without food, and consistent timing each day helps maintain steady blood levels.
• Patients with hepatic impairment should generally start at lower doses, as should elderly patients who may have reduced clearance of the medication.

Dosing Recommendations

• The 2020 ACC/AHA clinical performance and quality measures for adults with heart failure recommend a target dose of 100 mg once daily for losartan 1.
• The 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline also recommends a dose range of 50-100 mg daily for losartan 1.
• The KDOQI clinical practice guidelines recommend a dose range of 25-100 mg daily for losartan 1.

From the FDA Drug Label

The usual starting dose of losartan is 50 mg once daily. The dosage can be increased to a maximum dose of 100 mg once daily as needed to control blood pressure A starting dose of 25 mg is recommended for patients with possible intravascular depletion (e.g., on diuretic therapy). Pediatric Hypertension The usual recommended starting dose is 0.7 mg per kg once daily (up to 50 mg total) Doses above 1.4 mg per kg (or in excess of 100 mg) daily have not been studied in pediatric patients The usual starting dose is 50 mg of losartan once daily. Hydrochlorothiazide 12.5 mg daily should be added and/or the dose of losartan should be increased to 100 mg once daily The usual starting dose is 50 mg once daily. The dose should be increased to 100 mg once daily based on blood pressure response In patients with mild-to-moderate hepatic impairment the recommended starting dose of losartan is 25 mg once daily.

The dosing range for losartan is:

• Adults: 25-100 mg once daily
• Pediatric patients: 0.7 mg per kg once daily (up to 50 mg total), with a maximum dose of 1.4 mg per kg (or 100 mg) daily The dosing range may vary depending on the patient's condition and response to treatment 2.

From the Research

Dosing Range for Losartan

• The dosing range for losartan is not explicitly stated in the provided studies, but the studies mention the dosage used in the experiments:
  • 50 to 100 mg once daily 3, 4
• These studies were conducted to assess the role of losartan in patients with type 2 diabetes and nephropathy, and the dosage was used in addition to conventional antihypertensive treatment.
• There is no information available on the dosing range for losartan in the other studies, as they discuss different topics such as drug-induced liver injury 5 and iodoamino acid synthesis in thyroid lobes in vitro 6.
• The studies that mention the dosage of losartan suggest that it is generally well-tolerated, but the optimal dosing range may depend on individual patient factors and the specific clinical context 3, 4.