Switching from Amlodipine to Losartan

Clinical Context Requiring the Switch

• The American College of Rheumatology conditionally recommends switching to losartan when feasible for patients with gout, due to its modest urate-lowering effects 1, 2
• The risk of switching to losartan appears sufficiently low in most patients to merit this change when blood pressure control can be maintained, as per the American College of Rheumatology guidelines 1

Safety Considerations When Switching

• The American College of Cardiology recommends monitoring serum potassium and creatinine within 2-4 weeks of initiating losartan, particularly in patients with chronic kidney disease or those taking potassium supplements 4, 5
• The American College of Cardiology advises checking for hyperkalemia risk, especially with concomitant use of potassium-sparing agents, and assessing for acute renal failure risk in patients with severe bilateral renal artery stenosis 4
• The American College of Cardiology states that losartan should not be used in combination with ACE inhibitors or aliskiren, as dual RAS blockade increases risks of hypotension, hyperkalemia, and acute kidney injury without additional benefit 4
• The American College of Cardiology recommends avoiding losartan in pregnancy due to fetal harm 4