Losartan hctz side effects

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Common Side Effects of Losartan HCTZ Combination Therapy

Clinical studies show that the combination of losartan and hydrochlorothiazide (HCTZ) is generally well-tolerated, with side effects similar to those seen with placebo. The most commonly reported side effect is dizziness, which occurs slightly more often than with placebo (2.4% vs. 1.3%) . Other undesirable symptoms are less frequent with losartan/HCTZ compared to other antihypertensive therapies, and overall withdrawal rates due to side effects are low 12.

Losartan HCTZ and Uric Acid Metabolism

A unique aspect of losartan is its ability to lower serum uric acid levels, which can help counteract the tendency of HCTZ to increase uric acid. Studies in patients with hypertension and thiazide-induced hyperuricemia found that losartan, alone or in combination with HCTZ, decreases serum uric acid and increases its excretion without raising the risk of acute urate nephropathy or related kidney problems 345. This makes losartan/HCTZ a favorable option for patients at risk of high uric acid or gout 45.

Comparison with Other Antihypertensive Combinations

When compared to other combinations, such as enalapril/HCTZ, losartan/HCTZ is associated with fewer side effects, especially a lower incidence of cough. Additionally, unlike enalapril/HCTZ, losartan/HCTZ does not significantly increase serum uric acid levels, making it a safer choice for patients concerned about hyperuricemia .

Considerations for Patients with Metabolic Disorders

Losartan/HCTZ is particularly useful for hypertensive patients who also have metabolic disorders like diabetes, dyslipidemia, or hyperuricemia. The combination provides effective blood pressure control while minimizing the metabolic side effects often seen with diuretics alone, due to losartan’s uric acid-lowering effect .

Conclusion

The losartan and HCTZ combination is effective for blood pressure control and is generally well-tolerated. Dizziness is the most common side effect, but overall side effects are mild and infrequent. Importantly, losartan’s ability to lower uric acid helps offset the increase caused by HCTZ, making this combination especially suitable for patients at risk of hyperuricemia or metabolic complications 1234+1 MORE.

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Most relevant research papers on this topic

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·

18citations

·A. Goldberg et al.

The Canadian journal of cardiology

Increased efficacy and tolerability with losartan plus hydrochlorothiazide in patients with uncontrolled hypertension and therapy-related symptoms receiving two monotherapies.

Losartan 100 mg/HCTZ 25 mg improves blood pressure control and reduces side effects in patients with moderate to severe hypertension.

RCT

1999·

21citations

·D. Naidoo et al.

Advances in therapy

Safety of losartan in hypertensive patients with thiazide-induced hyperuricemia.

Losartan safely decreased serum uric acid and increased uric acid excretion without increasing urinary dihydrogen urate, the primary risk factor for acute urate nephropathy.

RCTHighly Cited

1999·

91citations

·Shahnaz Shahinfar et al.

Kidney international·

DOI

563 COMPARISON OF EFFECTS OF LOSARTAN 50 MG/HYDROCHLOROTHIAZIDE 12.5 MG AND CANDESARTAN 8 MG/ HYDROCHLOROTHIAZIDE 6.25 MG ON PLASMA LEVELS AND URINARY EXCRETION OF URIC ACID IN JAPANESE HYPERTENSIVE PATIENTS WITH TYPE 2 DIABETES MELLITUS

Losartan 50 mg may have a greater ability to decrease uric acid levels than 6.25 mg of hydrochlorothiazide, highlighting the importance of considering small differences in HCTZ dosage for hypertensive patients with hyperuricemia and chronic kidney disease.

Non-RCTVery Rigorous Journal

2012·

0citations

·T. Ohori et al.

Journal of Hypertension·

DOI

[Combination therapy of ARB with diuretics in Japanese hypertensive patients].

Combination therapy of ARB and diuretics effectively reduces blood pressure in Japanese hypertensive patients, while minimizing metabolic side effects and promoting cardiovascular events prevention.

2009·

1citation

·T. Tsuchihashi

Nihon rinsho. Japanese journal of clinical medicine

Efficacy, safety, and effects on hypertension-associated symptoms of losartan, alone or in combination with hydrochlorothiazide, versus amlodipine in patients with mild-to-moderate hypertension

Losartan is as effective as amlodipine for reducing blood pressure in patients with mild-to-moderate hypertension, but has fewer drug-related side effects.

RCTLarge Human Trial

1998·

9citations

·R. Tiebel et al.

Current Therapeutic Research-clinical and Experimental·

DOI

Evaluation of losartan plus hydrochlorothiazide combination therapy against amlodipine monotherapy in patients of hypertension

Losartan plus hydrochlorothiazide combination therapy has a similar effect on blood pressure as amlodipine monotherapy, but a better safety profile and superior effect on microalbuminuria reduction.

RCT

2019·

0citations

·S. Sawant et al.

International Journal of Basic & Clinical Pharmacology·

DOI

Antihypertensive and metabolic effects of hydrochlorothiazide versus amlodipine when added to losartan in patients with type 2 diabetes

Hydrochlorothiazide and amlodipine both reduce blood pressure in type 2 diabetes patients, but hydrochlorothiazide may have less favorable effects on metabolic profiles than amlodipine.

RCT

2016·

2citations

·N. Tanaka et al.

Diabetology International·

DOI

Differential effects of strict blood pressure lowering by losartan/hydrochlorothiazide combination therapy and high-dose amlodipine monotherapy on microalbuminuria: the ALPHABET study.

Losartan/hydrochlorothiazide combination therapy and high-dose amlodipine both effectively lower blood pressure, but losartan/HCTZ has a greater impact on urinary albumin/creatinine ratio reduction.

RCT

2011·

11citations

·M. Fukutomi et al.

Journal of the American Society of Hypertension : JASH·

DOI

Controlled trial of losartan given concomitantly with different doses of hydrochlorothiazide in hypertensive patients.

Losartan combined with hydrochlorothiazide 12.5 or 25 mg significantly reduces diastolic blood pressure in hypertensive patients, with similar drug-related adverse experiences across all treatment groups.

RCTLarge Human TrialHighly Cited

1996·

80citations

·L. M. Ruilope et al.

Blood pressure·

DOI

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