Losartan/Hydrochlorothiazide
Combination product
Pronunciation: hye-droe-klor-oe-THYE-a-zide and loe-SAR-tan
Combination of Hydrochlorothiazide and Losartan.
Each component keeps its own pharmacology page; the combination itself adds no new mechanism.
Micro Hydrant, tie-dyed + Lord Sartan
Components (2)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Hypertension | Adults | 50/12.5 mg QD (also the start after failed losartan 50 mg monotherapy, or in place of HCTZ 25 mg with hypokalemia) | If uncontrolled after ~3 weeks: 2 tablets 50/12.5 QD or 1 tablet 100/25 QD | 100/25 mg QD |
| Hypertension — not controlled on losartan 100 mg monotherapy | Adults | 100/12.5 mg QD | If uncontrolled after ~3 weeks: 100/25 mg QD (or 2x 50/12.5) | 100/25 mg QD |
| Hypertension with left ventricular hypertrophy — not controlled on losartan 50 mg | Adults | 50/12.5 mg QD | Increase to 100/12.5, then 100/25 as needed; add other antihypertensives for further reduction | 100/25 mg QD |
Titration Wait ~3 weeks of therapy before each dose increase
Renal Severe impairment (CrCl <30 mL/min): safety and effectiveness not established; renal-function changes reported in susceptible patients
Hepatic Do not initiate in hepatic impairment — required losartan 25 mg starting dose not available in this combination
Pediatric safety/effectiveness not established
Instructions
- Correct volume or salt depletion before starting (symptomatic hypotension risk)
Available strengths
- tab 12.5/50, 12.5/100, 25/100 mg
Contraindications
- Anuria
- Coadministration with aliskiren in patients with diabetes
Cautions
- Fetal toxicity (boxed) — discontinue when pregnancy detected
- Hypotension in volume- or salt-depleted patients — correct before starting
- Monitor renal function and potassium in susceptible patients
- Fluid/electrolyte imbalance — observe for clinical signs
- Acute angle-closure glaucoma (HCTZ)
- Exacerbation of systemic lupus erythematosus
Adverse reactions
- >=2% and > placebo: dizziness, upper respiratory infection, cough, back pain
Pregnancy Can cause fetal harm; 2nd/3rd-trimester RAS exposure reduces fetal renal function, raises fetal/neonatal morbidity and death; discontinue as soon as pregnancy detected
Lactation Losartan presence in human milk unknown (present in rat milk); thiazides appear in human milk — discontinue nursing or discontinue drug
Cost
Part D rank #100.