From the Guidelines
The maximum recommended dose of Losartan is 100 mg once daily for adults with hypertension. This dose is supported by the most recent and highest quality study, which is 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, which can be increased as needed to achieve blood pressure control. For patients with heart failure or diabetic nephropathy, the same maximum dose of 100 mg daily applies. Patients with hepatic impairment or volume depletion (such as those on diuretics) should generally start at a lower dose of 25 mg daily. Losartan works by blocking angiotensin II receptors, preventing the hormone from binding and causing blood vessel constriction. This mechanism helps lower blood pressure by allowing blood vessels to remain relaxed and wider. The medication can be taken with or without food, and consistent timing each day helps maintain steady blood levels. Patients should be aware that the full therapeutic effect may take 3-6 weeks to develop, and regular blood pressure monitoring is important, especially when starting treatment or adjusting dosage.
Some key points to consider when prescribing Losartan include:
- The medication is effective in reducing blood pressure and slowing the progression of kidney disease in patients with diabetes and hypertension 1.
- The dose of Losartan can be adjusted based on the patient's response to treatment and their individual characteristics, such as renal function and volume status 1.
- Losartan can be used in combination with other medications, such as diuretics and beta blockers, to achieve optimal blood pressure control 1.
- Regular monitoring of serum creatinine and potassium levels is recommended in patients treated with Losartan, especially those with renal impairment or diabetes 1.
Overall, Losartan is a safe and effective medication for the treatment of hypertension, and its use is supported by a strong evidence base. The maximum recommended dose of 100 mg once daily should be used to achieve optimal blood pressure control and reduce the risk of cardiovascular events.
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 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.
- Losartan 50 or 100 mg/day was significantly more effective than placebo in reducing the incidence of a doubling of serum creatinine, end-stage renal disease (ESRD) or death in patients with type 2 diabetes mellitus and proteinuria 5.
Dosage Administration
- The recommended dosage of losartan 50 mg/day can be administered without regard to food 3.
- No initial dosage adjustment is necessary in the elderly and patients with renal impairment (even those on dialysis) 4, 6.
- No dosage adjustment is required in elderly or in patients with mild to moderate renal dysfunction 6.
Efficacy and Tolerability
- Losartan has been shown to be as effective as other antihypertensive agents in the treatment of elderly patients with hypertension 6.
- The efficacy of losartan was comparable to felodipine, enalapril, and atenolol in reducing blood pressure 4.
- Losartan was well tolerated in patients with moderate-to-severe essential hypertension, with a similar incidence of adverse experiences to placebo 7.