Hydrochlorothiazide / Losartan Dosage

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Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Hypertension

Initial dose: 1 tablet (12.5 mg-50 mg) orally once a day.
Maintenance dose: If blood pressure remains uncontrolled after about 3 weeks of therapy, the dose may be increased to two tablets of hydrochlorothiazide-losartan 12.5 mg-50 mg orally once daily or one tablet of hydrochlorothiazide-losartan 25 mg-100 mg orally once daily. Daily doses of more than two tablets of hydrochlorothiazide-losartan 12.5 mg-50 mg or one tablet of hydrochlorothiazide-losartan 25 mg-100 mg are not recommended.

The initial dosage of hydrochlorothiazide-losartan recommended for treatment of severe hypertension is 12.5 mg-50 mg orally once a day. In patients who do not respond adequately after 2 to 4 weeks of therapy, the dosage may be increased to 25 mg-100 mg orally once a day. Dosages should not exceed 25 mg-100 mg once daily.

When treating patients with hypertension and left ventricular hypertrophy, treatment should be initiated with losartan 50 mg orally once daily. Hydrochlorothiazide 12.5 mg should be added or hydrochlorothiazide-losartan 12.5 mg-50 mg substituted if the blood pressure reduction is inadequate. If additional blood pressure reduction is needed, losartan 100 mg and hydrochlorothiazide 12.5 mg may be substituted followed by losartan 100 mg and hydrochlorothiazide 25 mg or hydrochlorothiazide-losartan 25 mg-100 mg. If further blood pressure reduction is necessary, other antihypertensives should be added.

Renal Dose Adjustments

CrCl 30 to 80 mL/min:
Initial dose: 1 tablet (12.5 mg-50 mg) orally once a day.
Maintenance dose: Because HCTZ is primarily eliminated by the kidney, it is recommended that dose increases be made cautiously in patients with renal dysfunction.

CrCl less than 30 mL/min:
Not recommended for patients with severe renal insufficiency because HCTZ is not expected to be filtered into the renal tubule.

Liver Dose Adjustments

Not recommended for patients with liver disease.

Precautions

Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).

Dialysis

Neither losartan nor its active metabolite are removed by hemodialysis. The degree to which hydrochlorothiazide is removed by hemodialysis has not been determined.

Other Comments

Hydrochlorothiazide-losartan is not recommended or approved by the FDA for the initial treatment of hypertension. It is usually appropriate to begin combination therapy only after a patient has failed to achieve the desired effect with monotherapy.

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