Losartan Does Not Cause Increased Urination
Taking losartan 100 mg daily with escitalopram (Lexapro) will not make you pee more. Losartan is not a diuretic and does not increase urine output through direct mechanisms.
Why Losartan Does Not Increase Urination
Losartan has uricosuric effects—meaning it increases uric acid excretion in the urine—but this does not translate to increased urine volume or frequency. 1
The uricosuric action of losartan works by blocking specific renal transporters for uric acid, causing more uric acid to be eliminated per unit of urine, not by producing more urine overall. 2, 3
In clinical studies, losartan increased uric acid excretion by 2.6- to 3.9-fold without causing symptoms of increased urination or polyuria. 2
No Drug Interaction Between Losartan and Escitalopram Affecting Urination
There is no known pharmacologic interaction between losartan and escitalopram (Lexapro) that would increase urine output. The provided evidence contains no guideline or research data linking this combination to increased urination.
Escitalopram is a selective serotonin reuptake inhibitor (SSRI) that does not affect renal water handling or interact with losartan's mechanism of action at the angiotensin II receptor.
What Losartan Actually Does to the Kidneys
Losartan causes efferent arteriolar vasodilation in the kidney, which can temporarily reduce glomerular filtration rate by 10-20% in some patients—this is a hemodynamic effect, not kidney injury. 4
This effect may cause a modest, transient rise in serum creatinine but does not increase urine production. 4
In patients with diabetic kidney disease, losartan reduces proteinuria by 13-43% and preserves renal function over time. 4, 5
Common Pitfalls to Avoid
Do not confuse losartan's uricosuric effect (increased uric acid in urine) with diuretic effect (increased urine volume). These are entirely different mechanisms. 1, 2
If you are experiencing increased urination, consider other causes such as:
- Uncontrolled diabetes or hyperglycemia
- Urinary tract infection
- Overactive bladder or other urologic conditions
- Concurrent use of actual diuretics (e.g., hydrochlorothiazide, furosemide)
- Excessive fluid intake
Losartan is sometimes prescribed instead of diuretics in patients with gout because diuretics increase uric acid levels, whereas losartan lowers them. 1
When to Seek Medical Attention
- If you are experiencing new or increased urination while taking losartan and escitalopram, discuss this with your healthcare provider to rule out:
- Diabetes or worsening glycemic control
- Urinary tract infection
- Concurrent diuretic use that you may not be aware of
- Other unrelated urologic conditions