From the Guidelines
The equivalent dose of losartan to olmesartan 40 mg is approximately 100 mg, as indicated by the target doses of guideline-directed medical therapies for adults with heart failure 1. When switching from olmesartan to losartan, patients should take losartan 100 mg once daily to achieve similar blood pressure control. This conversion is based on the target doses outlined in the 2020 ACC/AHA clinical performance and quality measures for adults with heart failure, which lists olmesartan 40 mg and losartan 100 mg as target doses for their respective medications 1. Some key points to consider when making this conversion include:
- Monitoring blood pressure closely for 2-4 weeks after switching to ensure adequate control, as individual patient responses may vary.
- Dosage adjustments may be necessary based on blood pressure readings and patient tolerance.
- Both medications are angiotensin II receptor blockers (ARBs) that work by blocking the action of angiotensin II, a hormone that causes blood vessels to narrow. It's also worth noting that the ACC/AHA Guidelines recommend losartan 150 mg as a target dose, but due to current FDA-approved labeling, the 100-mg dose is used in the performance measure 1.
From the Research
Conversion of Olmesartan to Losartan
- The conversion of olmesartan 40 mg to losartan can be estimated based on the doses used in clinical trials.
- In the study 2, olmesartan 40 mg was compared to losartan 100 mg, suggesting that olmesartan 40 mg may be equivalent to losartan 100 mg.
- Another study 3 compared olmesartan 20 mg to losartan 50 mg, but did not provide a direct comparison to olmesartan 40 mg.
- A meta-analysis 4 found that olmesartan provided greater diastolic and systolic blood pressure reductions compared to losartan, but did not provide a specific dose conversion.
- It is essential to note that the conversion may vary depending on individual patient responses and should be guided by clinical judgment and monitoring of blood pressure.
Dose Comparison
- The study 2 used olmesartan 40 mg and losartan 100 mg as the higher doses in the titration schedule.
- The study 3 used olmesartan 20 mg and losartan 50 mg as the initial doses.
- The meta-analysis 4 compared the efficacy of olmesartan with other angiotensin receptor blockers, including losartan, but did not provide a direct dose comparison.
Clinical Considerations
- When converting between olmesartan and losartan, it is crucial to monitor blood pressure closely and adjust the dose as needed to achieve optimal blood pressure control.
- The conversion should be individualized based on patient response and clinical judgment.
- The studies 2, 3, 4 provide some guidance on the comparison of olmesartan and losartan, but the specific conversion may vary depending on the individual patient.