Losartan Dosing and Administration for Hypertension

Introduction to Losartan Therapy

The American College of Cardiology recommends administering losartan without regard to food, and timing can be based on patient convenience to improve adherence 1

For pediatric patients aged 6 and older, the maximum dose of losartan should not exceed 100 mg daily, with a starting dose of 0.7 mg/kg once daily (up to 50 mg total) 2

The target blood pressure for most adults with hypertension is <130/80 mm Hg to reduce cardiovascular risk, and combination therapy with hydrochlorothiazide 12.5-25 mg daily can be added if blood pressure remains uncontrolled on losartan 100 mg alone 1, 3

In the context of heart failure with reduced ejection fraction, target doses of 150 mg daily have been studied, showing superior outcomes compared to 50 mg daily 4, 1
It is crucial to monitor potassium and renal function within 1-2 weeks after initiation of losartan, especially in patients with baseline renal impairment or very low systolic BP (<80 mm Hg) 4
Losartan should never be combined with ACE inhibitors due to increased risk of hyperkalemia and renal dysfunction 4, 1
Abrupt withdrawal of losartan should be avoided to prevent rebound hypertension 1