Side effects of missing a dose of losartan

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Side Effects of Missing a Dose of Losartan

Impact on Blood Pressure Control

Increase in Blood Pressure

Missing a dose of losartan can lead to a significant increase in blood pressure. Studies have shown that when patients miss a dose of losartan, their systolic and diastolic blood pressure tends to rise towards baseline levels. This effect is observed within 24 to 48 hours after the missed dose, indicating a loss of the antihypertensive effect of the medication 123. Specifically, one study noted that systolic blood pressure increased by an average of 3±2 mm Hg and diastolic by 2±1 mm Hg after a 2-day drug holiday .

Comparison with Other Antihypertensive Medications

When compared to other antihypertensive medications like amlodipine and candesartan cilexetil, losartan appears to be less effective in maintaining blood pressure control after a missed dose. For instance, amlodipine was found to be more effective than losartan in maintaining lower blood pressure levels after two missed doses, particularly for systolic blood pressure . Similarly, candesartan cilexetil provided a more consistent antihypertensive effect and better blood pressure control than losartan during the day of a missed dose 23.

Pharmacokinetic Considerations

Interaction with Other Medications

The pharmacokinetics of losartan do not appear to be significantly affected by the co-administration of other medications such as digoxin. Studies have shown that multiple doses of losartan do not alter the pharmacokinetic parameters of digoxin, indicating that losartan is well-tolerated and does not interfere with the metabolism of other drugs .

Conclusion

Missing a dose of losartan can lead to a noticeable increase in both systolic and diastolic blood pressure, reducing the effectiveness of blood pressure control. This effect is more pronounced when compared to other antihypertensive medications like amlodipine and candesartan cilexetil. However, losartan does not significantly interact with other medications like digoxin, making it a safe option in terms of drug interactions. Patients on losartan should be advised to adhere strictly to their dosing schedule to maintain optimal blood pressure control.

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Most relevant research papers on this topic

The effects of missed doses of amlodipine and losartan on blood pressure in older hypertensive patients

Amlodipine is more effective than losartan in lowering blood pressure and maintaining blood pressure control after two missed doses in older hypertensive patients.

RCT

2017·

3citations

·P. Leeuw et al.

Comparison of angiotensin II receptor blockers: impact of missed doses of candesartan cilexetil and losartan in systemic hypertension.

Candesartan cilexetil maintains its antihypertensive effects after a missed dose, while losartan's blood pressure increases after a missed dose.

RCT

1999·

24citations

·G. Mancia et al.

A comparison of the efficacy and duration of action of candesartan cilexetil and losartan as assessed by clinic and ambulatory blood pressure after a missed dose, in truly hypertensive patients: a placebo-controlled, forced titration study. Candesartan/Losartan study investigators.

Candesartan cilexetil effectively reduces ambulatory blood pressure more effectively than losartan, with greater reductions observed even during the day of a missed dose.

RCTHighly Cited

1999·

164citations

·Y. Lacourciére et al.

Effect of multiple doses of losartan on the pharmacokinetics of single doses of digoxin in healthy volunteers.

Multiple oral doses of losartan (50 mg daily) do not alter the pharmacokinetics of immunoreactive digoxin, and co-administration of digoxin with losartan is well-tolerated in healthy male volunteers.

RCT

1995·

22citations

·M. D. Smet et al.

A comparison of the efficacy and duration of action of candesartan cilexetil and losartan as assessed by clinic and ambulatory blood pressure after a missed dose, in truly hypertensive patients: a placebo-controlled, forced titration study. Candesartan/Losartan study investigators.

Candesartan cilexetil provides significant dose-dependent reduction in both clinic and ambulatory blood pressure, with greater effects than losartan even after a missed dose.

RCT

1999·

49citations

·Y. Lacourciére et al.

Effects of high-dose versus low-dose losartan on clinical outcomes in patients with heart failure (HEAAL study): a randomised, double-blind trial

Losartan 150 mg daily reduced the rate of death or admission for heart failure, reduced left-ventricular ejection fraction, and intolerance to ACE inhibitors compared to losartan 50 mg daily.

RCTLarge Human TrialRigorous JournalHighly Cited

2009·

530citations

·M. Konstam et al.

Biochemical effects of losartan, a nonpeptide angiotensin II receptor antagonist, on the renin-angiotensin-aldosterone system in hypertensive patients.

Long-term blockade of the feedback Ang II receptor in hypertensive patients leads to modest increases in plasma renin activity and Ang II, but does not affect the antihypertensive response to the antagonist.

RCTHighly Cited

1995·

126citations

·M. R. Goldberg et al.

Efficacy and safety of losartan.

Losartan is an effective and well-tolerated antihypertensive agent, with a smooth antihypertensive profile and similar effects to other drugs, with dizziness being the most common adverse experience.

RCTLarge Human Trial

1995·

17citations

·A. Goldberg et al.

Clinical Pharmacokinetics of Losartan

Losartan is a rapidly absorbed oral angiotensin-receptor antagonist with a favorable drug-drug interaction profile, reducing blood pressure effectively and offering end-organ protection without significant adverse effects.

Highly Cited

2005·

202citations

·D. Sica et al.

Safety and tolerability of losartan potassium, an angiotensin II receptor antagonist, compared with hydrochlorothiazide, atenolol, felodipine ER, and angiotensin-converting enzyme inhibitors for the treatment of systemic hypertension.

Losartan potassium is an effective and well-tolerated treatment for systemic hypertension, with a better tolerability profile than other antihypertensive agents.

Highly Cited

1995·

270citations

·A. Goldberg et al.

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