Can I take losartan (angiotensin II receptor antagonist) twice a day?

From the Guidelines

Losartan should be taken once daily, as the standard dosing is 25-100 mg once per day, with the goal of maintaining consistent blood levels and effectiveness throughout a 24-hour period 1. The dosing frequency of losartan is crucial in managing hypertension and preventing potential side effects. According to the guidelines, losartan can be taken in a dose range of 25-100 mg daily, with the option to divide the dose into 1-2 divided doses if necessary 1. However, the most recent and highest quality study suggests that once-daily dosing is sufficient for maintaining blood pressure control 1. Some key points to consider when taking losartan include:

• The standard starting dose is 25-50 mg daily, with the option to increase to 100 mg daily if needed 1
• Losartan has a long half-life, which allows for once-daily dosing and maintains consistent blood levels throughout the day 1
• Taking losartan at the same time each day helps maintain consistent blood levels and effectiveness
• If blood pressure is not adequately controlled, consulting a doctor to adjust the dose or add a different medication may be necessary, rather than splitting the same total daily dose into two administrations 1 It's essential to follow the recommended dosing guidelines and consult a healthcare provider if there are any concerns about losartan dosing or effectiveness.

From the FDA Drug Label

The studies allowed comparisons of two doses (50 to 100 mg/day) as once-daily or twice-daily regimens, comparisons of peak and trough effects, and comparisons of response by gender, age, and race. Twice-daily dosing at 50 to 100 mg/day gave consistently larger trough responses than once-daily dosing at the same total dose.

The answer is yes, losartan can be taken twice a day, as the drug label mentions that twice-daily dosing at 50 to 100 mg/day gave consistently larger trough responses than once-daily dosing at the same total dose 2. Key points to consider:

• Twice-daily dosing is a viable option for losartan administration.
• The recommended dose range for twice-daily dosing is 50 to 100 mg/day.

From the Research

Losartan Administration

• 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.
• Losartan can be administered without regard to food, and there are no clinically significant effects of age, sex, or race on the pharmacokinetics of losartan 3.
• The pharmacokinetics of losartan and its active metabolite E 3174 are linear, dose-proportional, and do not substantially change with repetitive administration 3.

Twice-Daily Administration

• A study compared the effect of once-daily (evening) vs. twice-daily (morning and evening) administration of losartan on the diurnal/nocturnal blood pressure ratio, and found that twice-daily administration was more effective in eliminating the non-dipper phenomenon 4.
• The twice-daily administration of losartan (50mg morning and evening) was found to be more effective compared to the once-daily evening administration (100mg) in reducing blood pressure and improving the diurnal index 4.

Safety and Efficacy

• Losartan is well tolerated, with dizziness being the only drug-related adverse event reported more frequently than with placebo 5, 6.
• Losartan has been shown to be effective in reducing blood pressure and improving cardiovascular outcomes in patients with hypertension, including elderly patients and those with renal impairment 5, 6, 7.