Dosage for losartan
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Dosage for Losartan: Clinical Insights and Recommendations
Recommended Dosage for Adults
Losartan, an angiotensin II receptor antagonist, is commonly prescribed for managing hypertension and other cardiovascular conditions. The standard recommended dosage for adults is 50 mg once daily, which can be taken with or without food. For patients requiring additional blood pressure control, the dosage can be increased to a maximum of 100 mg per day, either as a single dose or divided into two doses.
Dosage Adjustments in Special Populations
Hepatic and Renal Impairment
Losartan does not require dosage adjustments in patients with mild hepatic impairment or varying degrees of renal insufficiency. However, it is important to note that losartan and its active metabolite, E 3174, are not removed by hemodialysis.
Pediatric Dosage
For hypertensive children aged 6 to 16 years, losartan is administered in a dose-dependent manner. A starting dose of 0.75 mg/kg (up to a maximum of 50 mg) once daily is effective in lowering diastolic blood pressure (DBP) within three weeks. The dosage can be increased up to 1.44 mg/kg (not exceeding 100 mg) once daily, which is generally well tolerated. In children aged 6 months to 6 years, dosages ranging from 0.1 to 0.7 mg/kg per day have shown significant reductions in systolic and diastolic blood pressure, although no clear dose-response relationship was established.
Safety and Tolerability
Losartan is well tolerated across various patient populations, including those with diabetes, renal impairment, and heart failure. Common adverse events include headache, dizziness, and upper respiratory tract infections, but these occur at rates similar to placebo. In clinical trials, losartan has shown a favorable safety profile, with a low incidence of adverse events leading to discontinuation .
Drug Interactions and Contraindications
Losartan has a favorable drug-drug interaction profile and does not interact significantly with hydrochlorothiazide, warfarin, or digoxin. However, it should be avoided during pregnancy due to the risk of serious fetal toxicity, particularly in the second and third trimesters.
Conclusion
Losartan is an effective and well-tolerated antihypertensive agent with a standard adult dosage of 50 mg once daily, which can be increased to 100 mg if necessary. Pediatric dosages vary based on age and weight, with specific guidelines for children aged 6 months to 16 years. Losartan's safety profile and minimal need for dosage adjustments in special populations make it a versatile option for managing hypertension and related conditions.
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