losartan, Cozaar

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

  • Medical and Pharmacy Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

What is the dosage for losartan?

The starting dose of losartan for adults is 25-50 mg daily. The maximum dose is 100 mg daily. The total daily dose may be divided and administered two doses daily. Losartan may be given with or without food.

The starting dose of losartan for pediatric patients 6 years of age or older is 0.7 mg/kg up to 50 mg once daily. Doses more than 1.4 mg/kg or 100 mg daily have not been evaluated in pediatric patients.

Which drugs or supplements interact with losartan?

Losartan may increase levels of blood potassium (hyperkalemia), which can lead to serious heart problems (arrhythmias). Therefore, concomitant use of other drugs or substances that increase blood-such as potassium-sparing diuretics (for example, spironolactone [Aldactone], triamterene, and amiloride), potassium supplements, or salt substitutes containing potassium may lead to dangerous increases in serum potassium.

Combining losartan or other ARBs with nonsteroidal anti-inflammatory drugs (NSAIDs) in patients who are elderly, fluid-depleted (including those on diuretic therapy), or with poor kidney function may result in reduced kidney function, including kidney failure. These effects usually are reversible.

The antihypertensive effect of losartan may be reduced by aspirin and other NSAIDs such as:

Combining ARBs, ACE inhibitors, or aliskiren (Tekturna) increases risk of hypotension (low blood pressure), hyperkalemia, and reduces kidney function compared to each drug used alone and there is no additional benefit on preventing end stage kidney disease or death.

Aliskiren and losartan should not be combined in patients with diabetes or with renal impairment.

Increases in blood lithium (Eskalith, Lithobid) levels and lithium toxicity have occurred when lithium and ARBa or hydrochlorothiazide were combined. Blood lithium levels should be monitored.

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