Recommended Starting Dose for Losartan
Losartan, used primarily for hypertension, starts at 50 mg once daily for most adults. Doctors may adjust based on blood pressure response, up to a maximum of 100 mg daily.[1]
Starting Dose for Specific Conditions
- Hypertension in adults: 50 mg orally once daily. Can increase to 100 mg after 2-6 weeks if needed.
- Hypertensive patients with left ventricular hypertrophy: 50 mg once daily, often combined with hydrochlorothiazide.
- Type 2 diabetes with nephropathy: 50 mg once daily, titrated to 100 mg if tolerated.[1][2]
Dosing Adjustments for Special Populations
- Elderly (65+): Start at 25-50 mg once daily due to potential slower drug clearance.
- Volume- or salt-depleted patients: Begin at 25 mg to avoid hypotension.
- Liver impairment: Use 25 mg starting dose; severe cases may need alternatives.
- Renal impairment: No initial adjustment needed, but monitor potassium and creatinine.[1][3]
Pediatric Dosing (6-16 years, hypertension)
Initial dose is 0.7 mg/kg up to 50 mg once daily, based on weight. Maximum 1.4 mg/kg or 100 mg daily.[1]
How Quickly Does It Take Effect?
Blood pressure lowering starts within 2 weeks, with full effect by 3-6 weeks. Take consistently at the same time daily.[2]
Common Side Effects at Starting Dose
Dizziness (4%), upper respiratory infection (8%), nasal congestion (2%). Monitor for hyperkalemia or acute kidney issues, especially with diuretics.[1][3]
Interactions Affecting Starting Dose
Reduce to 25 mg with potassium-sparing diuretics, ACE inhibitors, or aliskiren (in diabetes). Avoid NSAIDs if possible, as they blunt antihypertensive effects.[2]
[1]: FDA Label for Cozaar (losartan)
[2]: Drugs.com - Losartan Dosage
[3]: Medscape - Losartan Dosing