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Hypertension/Can i use higher potency medicine? Losartan potassium 200 mg

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Question
Hi Mr. Falkinburg, how are you doing sir. I am 32 years old and have diabetes, i am over weight also. I am using 100 mg losartan potassium daily i.e. 50 mg + 50 mg 2 doses. But i feel that still my blood pressure goes high. Can i take 200 mg dosage daily of Losartan potassium? can i take 100 mg + 100 mg daily? or should i ask my doctor to give me an alternate medicine? Thank you very much.

Answer
Dear Bas,

The maximum dose of lasartan is 100mg per day...no more!

You are presently receiving the maximun dose of losartan.  However, I would NOT stop the medication because it has certain other, complicated, but saluatory effects upon the kidney, that protect it (the kidney) from the renal complications of diabetes.  Therefore, I would continue the medication irrespective of the level of your blood pressure.

Additionally, it may be exerting some effect, just not a perfect effect. In other words, if you were not receiving losartan, your blood pressure might be even higher.

Therefore, I would ADD another medication to your antihypertensive regimen.  The general rule, in hypertensive management, is to add medications rather than replace medicatons.

I would add a medication called hydrochlorothiazide 12.5mg/day then over the next three weeks increase it to 25 mg/day.  If you require further medication (and this is very possible) I would ADD norvasc (amlodipine) 2.5mg/day and titrate the dose up over a month or two, to a maximum dose of 10mg/day or until your BP is LESS THAN 130/80.

Hope this helps.

Thanks for the questiom.

Best of luck to you!

Sincerely,

Dr Falkinburg  

Hypertension

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Newell R. Falkinburg, M.D. FACP

Expertise

Any question regarding hypertension or clinical nephrology

Experience

35 years of experience in the field of nephrology & hypertension. Emeritus Professor of clinical Medicine at a major medical school and director of Nephrology & Hypertension at a university affiliated medical center.

Education/Credentials
M.D. Board certified internal medicine Board certified Nephrology & hypertension

Awards and Honors
Fellow, American College of Physicians

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