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Taking losartan and chlortalidone. Advised to increase the dosage. Reason?

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Emergency Medicine Specialist
Practicing since : 2006
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I was previously prescribed Losartan Potassium 100 mg 1/day with chlorthalidone 50mg 1/2 every other day and now I have been given Losartan 50mg 1/day with chlorthalidone 50mg 1/day. What is the difference, if any?
Posted Fri, 15 Feb 2013 in Medicines and Side Effects
Answered by Dr. Sheeba Stephen 1 hour later
Hello and welcome to Healthcare Magic. Thanks for your query.

Both Losartan and Chlortalidone are anti-hypertensive medication, i.e. medication used to control your blood pressure. However, each one has a different mechanism of action.

Losartan acts by blocking the action of a chemical-hormone (called angiotensin), which in turn causes a constriction of blood vessels and an increase in blood pressure. So, the end result of Losartan is a lowering of blood pressore.

Chlortalidone is a diuretic - i.e. a "water pill". It encourages the kidneys to remove the excess water and salts in the body. Water and salt retention can result in hypertension, and so by improving the water and salt excretion, Chlortalidone ends up lowering the blood pressure.

This combination of medication is frequently prescribed and is particularly beneficial when given together. This is because the actions of both these medication not only complement each other, but also even out each other's side effects.

Now, regarding the dosage and schedule, the change appears to be a decrease in the overall dose of Losartan and an increase in the overall dose of Chlortalidone. The reason could be that your doctor could have felt that you may be retaining more water (which is usually seen as swelling of the feet or a decrease in urine output), and hence wanted to give you more of the water pill (diuretic). Another possible reason could be that he would have wanted to avoid an abnormally high level of potassium in your body. This is because Losartan Potassium can sometimes result in high levels of potassium in the body, and Chlortalidone (the diuretic) actually helps in excretion of not only water but also potassium, thereby preventing an abnormally high level of potassium in the body.

So, though there has been a change in medication dosages (increase in one and decrease in the other), I think that it will still ensure that you blood pressure is kept under control.

I hope this information has been helpful to you and has clarified your doubt.

Wish you all the best.

Dr. Sheeba Stephen
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