How It Works
Losartan and hydrochlorothiazide work together to help your heart and blood vessels function with less stress:
- Relaxing blood vessels: Losartan blocks a hormone in your body called angiotensin II. This hormone normally causes your blood vessels to narrow. By blocking this action, losartan helps your blood vessels relax and widen to allow blood to more easily flow.
- Removing extra fluid: Hydrochlorothiazide works in your kidneys. It helps your body get rid of extra salt (sodium) and water through your urine. This helps lower overall blood pressure.
- Reducing heart workload: With wider blood vessels and less fluid, your heart does not have to pump as hard. This reduced workload helps protect the heart muscle over time.
- Improving overall flow: The combined effect of widening blood vessels and reducing fluid volume helps lower your overall blood pressure numbers and decreases the risk of serious health events like heart attacks or strokes.
| Quick Facts | |
|---|---|
| Common Brands | Hyzaar |
| Drug Class | Angiotensin II Receptor Blocker (ARB) and Thiazide Diuretic |
| Generic Status | Generic is available |
| Availability | Prescription only |
Dosing
Losartan/hydrochlorothiazide is a tablet taken by mouth once per day. Taking it at the same time every day helps keep the medicine levels steady in your system.
Standard guidelines suggest losartan/hydrochlorothiazide tablets are available in three fixed-dose strengths:
- 50 mg / 12.5 mg
- 100 mg / 12.5 mg
- 100 mg / 25 mg
Providers often start treatment with the 50 mg/12.5 mg tablet. If your blood pressure needs more control, your doctor may increase the dose. The maximum recommended dose is 100 mg/25 mg taken once daily.
Note: Dosing information below is educational only. Your prescribing physician will determine your specific dose based on your individual health needs. Always follow your healthcare provider’s instructions for exact dosing.
Uses
FDA-Approved Uses
Losartan/hydrochlorothiazide tablets are FDA-approved for treating high blood pressure (hypertension) and to lower the risk of stroke in patients with high blood pressure and an enlarged heart (left ventricular hypertrophy).
Off-Label Uses
You may see losartan/hydrochlorothiazide tablets prescribed for uses that are not “FDA-approved.” This is a very common and legal practice called “off-label” prescribing, where a doctor uses their clinical judgment to prescribe a drug for a different (but well-researched) purpose.
Health care providers may use the individual components of losartan/hydrochlorothiazide off-label based on clinical judgment, however, there are no off-label uses for the fixed-dose combination formulation.
Side Effects
Most people handle losartan/hydrochlorothiazide tablets well, but side effects can occur as your body adjusts to the new medication.
Common Side Effects
- Dizziness
- Increased urination
- Stuffy nose or sore throat
- Back pain
- Fatigue or unusual tiredness
- Headache
- Upset stomach
Serious Side Effects
Serious side effects are rare, but it’s important to know what to look for if they do occur.
- Serious allergic reaction: Look for swelling of the face, lips, or tongue, and difficulty breathing.
- Low blood pressure (hypotension): This can make you feel faint or lightheaded. It is more likely to happen if you are dehydrated.
- Kidney problems: Signs include a reduction in how much you urinate or swelling in your feet and ankles.
- Electrolyte imbalance: This medicine can change the levels of minerals like potassium or sodium in your blood. Symptoms include muscle cramps, weakness, or an irregular heartbeat.
- Fetal toxicity: This medication can cause serious harm or death to a fetus if taken during pregnancy.
- Gout flare-ups: This medication can raise uric acid levels in the blood, which may cause severe joint pain, redness, or swelling.
- Eye problems: Hydrochlorothiazide can cause sudden eye pain or blurred vision.
Call your doctor immediately if you experience any concerning or prolonged symptoms.
Pharmacist Tips
Stand Up Slowly
To avoid dizziness, take your time when getting up from a sitting or lying position.
Stay Hydrated
Since this medicine contains a diuretic (water pill), make sure you drink enough fluids. However, check with your doctor about how much water is right for you.
Sun Protection
Hydrochlorothiazide can make your skin more sensitive to the sun. It is a good idea to wear sunscreen and avoid tanning beds.
Morning Routine
Try to take your dose in the morning. This prevents the “water pill” effect from waking you up at night.
Monitor at Home
Keep a record of your blood pressure readings at home to show your healthcare provider during your next visit.
Drug Interactions
Certain medications and substances can change how losartan/hydrochlorothiazide works or increase your risk of side effects.
- NSAIDs: Pain relievers like ibuprofen (Advil, Motrin) and naproxen (Aleve) can make this medication less effective and may cause stress on your kidneys.
- Potassium supplements: Losartan can raise potassium levels. Taking extra potassium may lead to levels that are too high.
- Lithium: Losartan/hydrochlorothiazide can increase the amount of lithium in your body, so taking it with lithium may be dangerous.
- Diabetes medication: Hydrochlorothiazide may reduce glucose tolerance, which can lead to higher blood sugar levels in some patients with diabetes. Blood glucose monitoring may be needed, especially in those with pre-existing diabetes.
- Alcohol: Drinking alcohol can increase the risk of dizziness or feeling faint while on this medication.
Always give your doctor and pharmacist a complete list of all your medications, vitamins, and supplements to check for potential interactions.
FAQs
Why can’t you take losartan/HCTZ at bedtime?
Standard guidelines suggest taking losartan/hydrochlorothiazide in the morning. Because it contains a diuretic (water pill), it will make you urinate more often. Taking it at night might cause you to wake up several times to use the bathroom.
What is the difference between regular losartan versus this combo pill?
Regular losartan only contains one medicine to relax your blood vessels. This combo pill adds hydrochlorothiazide, which removes extra fluid from your body. This dual action helps lower blood pressure more than losartan alone.
Can I safely take ibuprofen while taking losartan/HCTZ?
It is generally recommended to avoid NSAID pain relievers while on losartan/hydrochlorothiazide. They can interfere with how your blood pressure medicine works and may hurt your kidneys. Speak with your healthcare provider about other options for pain relief.
Is it true that losartan/HCTZ can trigger a gout attack?
Yes, the hydrochlorothiazide part of the medicine can raise the levels of uric acid in your blood. For some people, this can lead to a painful gout flare-up.
Do I absolutely need to take losartan/HCTZ with food?
No, you can take losartan/hydrochlorothiazide tablets with or without food. However, if it causes an upset stomach, taking it with a meal may be helpful.
How long does it take for my blood pressure numbers to actually drop on losartan/HCTZ?
You may notice an initial drop in blood pressure within a few hours. However, it usually takes 3 to 6 weeks of daily use to see the full effect of the medication.
Can I drink alcohol while taking losartan/HCTZ?
Alcohol can make the dizziness from this medicine worse. It is best to limit alcohol intake while taking losartan/HCTZ.
Will taking losartan/HCTZ cause erectile dysfunction?
While some people have reported this, it is not a common side effect of losartan. However, diuretics like HCTZ can sometimes contribute to this issue. Talk to your doctor if you have concerns.
Is it safe to use this medication if I am currently pregnant, breastfeeding, or trying to conceive?
No. This medication may cause serious harm or death to a fetus. It should be stopped as soon as pregnancy is discovered. It is also not recommended while breastfeeding.
Comparable Medications
Zestoretic, Cozaar, Exforge, or Ziac?
There are several medications that your doctor can prescribe in place of losartan/hydrochlorothiazide. Here are a few possible alternatives below.
Lisinopril/Hydrochlorothiazide Tablets
From $32.99
A combination of an ACE inhibitor and a water pill. It works similarly to losartan/hydrochlorothiazide (Hyzaar) but uses a different type of medicine to relax the blood vessels.
Losartan
From $24.99
This is the same as the first active ingredient found in the combination pill but without the diuretic (water pill). It is used for people with high blood pressure who do not need the extra fluid-removing effect of hydrochlorothiazide.
Amlodipine/Valsartan Tablets
From $27.99
A combination of a calcium channel blocker and an ARB. It relaxes blood vessels using two different methods but does not include a diuretic.
Bisoprolol / Hydrochlorothiazide Tablets
From $37.99
A combination of a beta blocker and a water pill. It lowers blood pressure by slowing the heart rate and removing extra fluid.
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Important: Information on this page is for educational purposes only. Prescribing decisions are made by independent, licensed providers. TelyRx operates technology-enabled pharmacies and a telehealth platform that connects patients with licensed providers. Prescriptions, when provider-approved and issued, are filled and shipped by TelyRx-affiliated pharmacies. We do not employ physicians or make prescribing decisions. Learn more about our editorial standards here.