From the Guidelines
I strongly advise against withholding hydrochlorothiazide (HCTZ) and losartan for one day without consulting a healthcare provider first, as this could potentially lead to a rise in blood pressure. 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, published in Circulation in 2018 1, these medications are crucial in managing hypertension. Losartan, an angiotensin II receptor blocker (ARB), works by relaxing blood vessels, while hydrochlorothiazide, a thiazide diuretic, reduces fluid volume.
Some key points to consider when taking these medications include:
- The usual dose of hydrochlorothiazide is 25-50 mg/day, taken once daily 1
- The usual dose of losartan is 50-100 mg/day, taken once or twice daily 1
- It is essential to follow the prescribed dosing schedule and consult a healthcare provider before making any changes to medication regimens
If you're considering skipping doses due to side effects, scheduling conflicts, or an upcoming medical procedure, it's crucial to call your doctor's office for specific guidance. They might adjust your dosing schedule based on your individual health needs and the reason for wanting to hold the medication. If you've already missed a dose, follow your doctor's instructions about what to do in this situation, which may involve taking it when you remember or waiting until your next scheduled dose. Never double up on doses to make up for missed ones, as this can increase the risk of adverse effects. Always prioritize consulting a healthcare provider before making any changes to your medication regimen, especially when it comes to managing hypertension with medications like hydrochlorothiazide and losartan 1.
From the Research
Withholding Hydrochlorothiazide (HCTZ) and Losartan
- There is no direct evidence in the provided studies to suggest that HCTZ and losartan can be withheld for one day 2, 3, 4, 5, 6.
- The studies primarily focus on the efficacy, safety, and tolerability of losartan and HCTZ, either alone or in combination, in the treatment of hypertension and related conditions.
- None of the studies discuss the effects of withholding these medications for a short period, such as one day.
Potential Considerations
- Losartan is an angiotensin II receptor antagonist, and HCTZ is a thiazide diuretic, both of which are commonly used to treat hypertension 2, 3, 5.
- The combination of losartan and HCTZ has been shown to be effective in lowering blood pressure and reducing the risk of stroke in patients with hypertension and left ventricular hypertrophy 3, 5.
- However, the safety and efficacy of withholding these medications for a short period are not addressed in the provided studies.
Lack of Direct Evidence
- Due to the lack of direct evidence, it is not possible to provide a definitive answer to the question of whether HCTZ and losartan can be withheld for one day 2, 3, 4, 5, 6.
- Further research or consultation with a healthcare professional would be necessary to determine the potential effects of withholding these medications for a short period.