You will be fine—this is not a dangerous amount of potassium
With normal kidney function and a normal baseline potassium of 4.4 mEq/L, consuming 1,075 mg of potassium from prune juice followed by losartan 75 mg and a typical dinner is safe and will not cause hyperkalemia. 1, 2
Why This Is Safe
Your diarrhea actually protected you from hyperkalemia. Four bouts of diarrhea cause significant potassium losses through the stool—typically 50-80 mEq per day during acute diarrhea—which would have eliminated much of the potassium you consumed from the prune juice. 3 The 1,075 mg of potassium from prune juice (approximately 27 mEq) is well within normal dietary intake and would have been partially lost through your diarrhea.
Losartan typically raises serum potassium by only about 1 mEq/L in patients without additional risk factors. 1 Starting from your baseline of 4.4 mEq/L, even with losartan's effect, you would reach approximately 5.4 mEq/L at most—still within the safe range (normal is 3.5-5.0 mEq/L, with clinical concern beginning at >5.5 mEq/L). 3
Your Specific Risk Factors Are Minimal
Normal kidney function: This is the most important protective factor. Losartan does not require dose adjustment in patients with normal renal function, and potassium excretion remains intact. 4, 3
Normal baseline potassium (4.4 mEq/L): This indicates your kidneys are effectively regulating potassium balance. 3
Recent diarrhea: This actually depleted your potassium stores, creating a buffer against hyperkalemia. 3
The Dinner You're Planning Is Safe
Your planned meal of steak, rice, and corn contains moderate amounts of potassium:
- Steak (6 oz): ~500 mg potassium
- Rice (1 cup cooked): ~55 mg potassium
- Corn (1 cup): ~390 mg potassium
- Total: ~945 mg potassium (approximately 24 mEq)
This is well within normal daily potassium intake (the typical diet contains 2,000-4,000 mg/day), and your normal kidneys will excrete any excess. 1
When Losartan Actually Causes Hyperkalemia
Losartan causes clinically significant hyperkalemia primarily in specific high-risk situations that don't apply to you: 2, 1
Moderate-to-severe chronic kidney disease (eGFR <45 mL/min/1.73 m²): You have normal kidney function. 1
Concurrent use of potassium-sparing diuretics (spironolactone, amiloride, triamterene): You're not taking these. 3, 2
Dual RAS blockade (combining losartan with ACE inhibitors or aliskiren): You're not doing this. 2, 3
Diabetes with advanced kidney disease: Not mentioned in your case. 2
Monitoring Recommendations for Your Situation
Check serum potassium and creatinine within 1-2 weeks after starting or increasing losartan dose. 3, 1 Since you're taking losartan 75 mg (which is between the typical starting dose of 50 mg and maximum of 100 mg), periodic monitoring is appropriate, but there's no emergency concern from today's potassium intake. 3
If you develop symptoms of hyperkalemia—muscle weakness, palpitations, or irregular heartbeat—seek medical attention. However, these symptoms are extremely unlikely given your normal baseline and kidney function. 3
Common Pitfalls to Avoid
Don't combine losartan with potassium supplements or salt substitutes (which contain potassium chloride) without medical supervision. 1, 2 Your dietary potassium from food is safe, but concentrated potassium supplements are a different story.
Don't stop losartan abruptly if you're concerned about potassium. The medication provides important cardiovascular and renal protection, and your risk of hyperkalemia is minimal with normal kidney function. 3, 1
Be aware that NSAIDs (ibuprofen, naproxen) combined with losartan can impair kidney function and increase hyperkalemia risk. 2 Use these sparingly if needed.