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Is losartan plus amlodipine combination safe?

Tuesday, 18 February 2003
Answered by: Chandra M. Gulhati
Editor,
MIMS,
New Delhi
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Q. Is losartan + amlodipine safe for treating hypertension in persons of 35-40 age group?

A.  An attempt should be made to control blood pressure with just one drug. Losartan (sold under various brand names such as Losacar) can be started at 50 mg once daily and increased to 100mg once daily, if necessary. Only if the blood pressure is not controlled with 100 mg, should one add another drug such as amlodipine (sold under various brand names such as Myodura) at the lowest dose of 2.5 mg and increased to 5 mg or even 10 mg if required. One should use the two drugs, if required at all, separately and not in a combination form because it is not possible to titrate dosage. In a fixed-dose combination, a patient consumes either too much or too little of one of the two drugs. Combination of losartan with amlodipine is irrational and hence is not permitted in any advanced country such as UK, Canada, Australia, etc.

A.  An attempt should be made to control blood pressure with just one drug. Losartan (sold under various brand names such as Losacar) can be started at 50 mg once daily and increased to 100mg once daily, if necessary. Only if the blood pressure is not controlled with 100 mg, should one add another drug such as amlodipine (sold under various brand names such as Myodura) at the lowest dose of 2.5 mg and increased to 5 mg or even 10 mg if required. One should use the two drugs, if required at all, separately and not in a combination form because it is not possible to titrate dosage. In a fixed-dose combination, a patient consumes either too much or too little of one of the two drugs. Combination of losartan with amlodipine is irrational and hence is not permitted in any advanced country such as UK, Canada, Australia, etc.

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