What is the maximum recommended dose of Losartan (losartan potassium)?

From the Guidelines

The maximum recommended dose of losartan potassium is 100 mg once daily for adults. This is based on the most recent and highest quality study available, which is the 2022 AHA/ACC/HFSA guideline for the management of heart failure 1. Although this guideline suggests a target dose of 50-150 mg once daily for losartan, the FDA-approved labeling has 100 mg as the maximal dose, as noted in the 2020 ACC/AHA clinical performance and quality measures for adults with heart failure 1. Treatment typically starts at a lower dose of 50 mg once daily for hypertension, which can be increased to the maximum 100 mg daily if blood pressure is not adequately controlled. For patients with heart failure or diabetic nephropathy, the starting dose is often 25 mg once daily, which can be titrated upward to the maximum 100 mg daily as tolerated.

Some key points to consider when prescribing losartan include:

• Patients with hepatic impairment or volume depletion may require lower doses
• Losartan works by blocking angiotensin II receptors, preventing the hormone from binding and causing blood vessel constriction, thereby lowering blood pressure
• This medication can be taken with or without food, and at any time of day, though taking it at the same time each day helps maintain consistent blood levels
• If a dose is missed, it should be taken as soon as remembered, but skipped if it's almost time for the next dose, and never doubled up to make up for a missed dose.

It's essential to follow the recommended dosing guidelines to minimize the risk of adverse effects and maximize the therapeutic benefits of losartan, as supported by the latest clinical guidelines 1.

From the FDA Drug Label

The dosage can be increased to a maximum dose of 100 mg once daily as needed to control blood pressure Doses above 1.4 mg per kg (or in excess of 100 mg) daily have not been studied in pediatric patients

The maximum recommended dose of Losartan is 100 mg once daily 2.

• For adult hypertension, the maximum dose is 100 mg once daily.
• For pediatric hypertension, doses above 1.4 mg per kg (or in excess of 100 mg) daily have not been studied.
• The maximum dose for hypertensive patients with left ventricular hypertrophy and nephropathy in type 2 diabetic patients is also 100 mg once daily.

From the Research

Maximum Recommended Dose of Losartan

The maximum recommended dose of Losartan (losartan potassium) is discussed in several studies:

• The maximum recommended daily dose of losartan is 100mg, which can be given as a once-daily dose or by splitting the same total daily dose into two doses 3.
• In dose-ranging studies, 50 mg once daily has generally been shown to produce near maximum effects and a dose of 100 mg does not produce additional effects 4.
• No dosage adjustment is required in elderly or in patients with mild to moderate renal dysfunction 5.

Key Points

• The maximum recommended dose of losartan is 100mg per day 3, 4.
• Losartan can be administered without regard to food 3.
• No initial dosage adjustment is necessary in the elderly and patients with renal impairment 4, 5.
• Losartan is well tolerated, with a low incidence of adverse events 4, 5, 6.