Cozaar dosage, forms, and strengths

Cozaar is a brand-name prescription drug used alone or in combination with other drugs to treat high blood pressure, kidney problems due to diabetes, and to prevent stroke in people diagnosed with both high blood pressure andleft ventricular hypertrophy. 

The active ingredient in Cozaar is losartan potassium. This ingredient belongs to a class of drugs called angiotensin II receptor blockers (ARBs). ARBs prevent the hormone angiotensin II from tightening blood vessels. By blocking angiotensin II, losartan causes blood vessels to widen, lowering blood pressure. Cozaar is taken as a tablet once or twice a day with or without food. For children or people unable to swallow tablets, a pharmacist can prepare an oral suspension from the tablets.

RELATED: What is Cozaar? | Get Cozaar discounts

Cozaar forms and strengths

Cozaar is taken as a film-coated tablet in one of three dose strengths:

• Tablets: 25 (mg), 50 mg, 100 mg

For people unable to swallow a tablet, a pharmacist can prepare a 5 mg per 2 mL oral solution from Cozaar 50 mg tablets.

Cozaar dosage for adults

Cozaar is FDA approved to treat high blood pressure (hypertension), kidney problems associated with Type 2 diabetes (diabetic nephropathy), and to reduce the risk of stroke in people who have both high blood pressure and a thickened heart muscle (left ventricular hypertrophy or LVH). Some healthcare professionals may prescribe Cozaar off-label to treat heart failure or other conditions. For hypertension and other conditions, Cozaar can be used alone or with other drugs.

Sources: Epocrates, Prescriber’s Digital Reference

Cozaar dosage for high blood pressure

Cozaar is FDA approved as a first-line treatment for high blood pressure. It is frequently prescribed alone or with other drugs such as thiazide diuretics, or calcium channel blockers. Losartan, the active ingredient in Cozaar, is an angiotensin II receptor antagonist (ARB). It works by blocking angiotensin II, a hormone produced by the renin-angiotensin system that causes blood vessels to constrict. By blocking this hormone, losartan causes blood vessels to widen, lowering blood pressure. Losartan also increases the body’s secretion of aldosterone, another renin-angiotensin system hormone that increases the body’s elimination of water and electrolytes through the kidneys. Increased water and salt excretion lowers blood pressure by reducing the volume of fluids in the blood vessels.

• Standard dosage for high blood pressure: 100 mg taken once per day or in two divided doses

• Maximum dosage for high blood pressure: 100 mg per day

Cozaar dosage for diabetic nephropathy

Diabetic kidney disease (diabetic nephropathy) is a common complication of both Type 1 and Type 2 diabetes, affecting 30% to 40% of people with diabetes mellitus. Both conditions damage small blood vessels in the kidneys. As the damage accumulates, the filters in the kidneys become damaged, and protein begins to pass through these filters into the urine, where it should not be. The primary treatments involve controlling blood sugar levels, loweringblood pressure, and initiating therapy with an ACE inhibitor or ARB. Even patients who do not have high blood pressure should be prescribed an ACE inhibitor or ARB (such as Cozaar) because these drugs protect kidney function regardless of blood pressure status. Cozaar is FDA approved to slow the progress of diabetic nephropathy in people diagnosed with Type 2 diabetes who also have high blood pressure, but it is also commonly prescribed for kidney disease like CKD (chronic kidney disease) in patients with high or normal blood pressure. 

• Standard dosage for diabetic nephropathy: 50-00 mg taken once per day

• Maximum dosage for diabetic nephropathy: 100 mg per day

Cozaar dosage for the prevention of stroke

Cozaar is prescribed to reduce the risk of stroke in people diagnosed with both high blood pressure and a heart condition called left ventricular hypertrophy (LVH). The left ventricle is the chamber of the heart that pumps blood to the body. LVH occurs when the walls of the left ventricle become thicker with muscle. In most cases, the heart is changing shape (increasing muscle fibersto adapt to high blood pressure: two-thirds of people diagnosed with LVH are hypertensive. High blood pressure creates more resistance and makes it harder for the heart to pump blood, so the left ventricular muscles develop in response to this resistance. . This helps the heart pump blood, but people who develop LVH are at an increased risk of heart failure, heart rhythm problems, stroke, and cardiovascular death. Cozaar is prescribed to reduce hypertension and give the heart a chance to recover its normal structure (LVH regression).

• Standard dosage for hypertension and LVH: 50–100 mg taken once per day

• Maximum dosage for hypertension and LVH: 100 mg per day

Cozaar dosage for children

Cozaar is approved to treat children as young as 6 years of age for high blood pressure, although healthcare providers may prescribe it off-label to prevent aortic aneurysm in children diagnosed with Marfan syndrome. Dosages are based on weight. However, healthcare providers will adjust the dose depending on how well blood pressure responds, so some children may receive doses higher than the recommended dose. Most healthcare professionals, however, will add a second drug, like hydrochlorothiazide, rather than raise the losartan doses to get blood pressure under control. 

Although Cozaar is only available as tablets, a pharmacist can prepare an oral suspension from the tablets for use in children.

• Standard dosage for children 6 years of age and older: 0.7 mg/kg up to 50 mg per day

• Maximum dosage for children 6 years of age and older: 1.4 mg/kg up to 100 mg per day

Source: U.S. National Library of Medicine

Cozaar dosage restrictions

In general, no dose adjustments are required for pre-existing conditions. People with renal impairment (kidney disease) will usually not require a dose adjustment. However, losartan is not recommended in children who have a glomerular filtration rate (GFR) of less than 30 mL per minute. People with mild to moderate hepatic impairment (liver problems) will have a lower starting dose (25 mg daily) and require monitoring for adverse reactions. People on diuretics will also be started at 25 mg per day.

Losartan may have less of an effect on blood pressure in people of African descent, so it is usually combined with a thiazide diuretic such as hydrochlorothiazide or a calcium channel blocker in African American patients.

Because of potentially severe problems, Cozaar is never prescribed to people who have allergic reactions to the drug.

Cozaar dosage for pets

ARBs such as losartan are not commonly used in animals, but veterinarians may use losartan as an antihypertensive to treat high blood pressure, kidney problems, or heart disease in a pet. Unfortunately, the side effects of losartan in cats and dogs have not been studied. Dosages have not been standardized, either, so the dose prescribed will vary by practitioner.

How to take Cozaar

Cozaar is taken as a tablet on an empty stomach or with a meal. For children or adults who have problems swallowing a tablet, a pharmacist can prepare an oral suspension from the tablets.

• Take this medicine as directed. The dose may be changed based on your blood pressure, so be careful to make sure the right dose is taken.

• Read the Patient Information insert that comes with this medicine both when the medicine is first prescribed and each time it’s refilled. This insert contains valuable information about how to take Cozaar and how to spot potentially serious problems.

• Swallow Cozaar tablets with a drink of water.

• Store the tablets in a closed container at room temperature (59°F to 86°F) protected from light and out of the reach of children.

• If a pharmacist prepares a Cozaar oral suspension, follow all the directions given by the pharmacist for administering doses.

• Store Cozaar oral suspension in a refrigerator (36-46°F) in a closed, child-proof container for no longer than four weeks.

Cozaar dosage FAQs

What happens if I miss a dose of Cozaar?

Take a missed dose as soon as it’s remembered. If it is almost time for the next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.

How long can you take Cozaar?

Losartan and other ARBs are intended for long-term treatment as long as the drug works and side effects are minimal. However, losartan, when taken for a long time, may affect the health of the kidneys. A healthcare provider will regularly test the blood for serum potassium levels, electrolyte imbalances, serum creatinine, and other indicators of kidney function. If losartan starts adversely affecting the kidneys, a healthcare provider may switch to another antihypertensive.

What is the maximum dosage for Cozaar?

The maximum FDA approved dosage for Cozaar is 100 mg per day, although healthcare providers may prescribe up to 150 mg off-label to people being treated for heart failure.

Can you overdose on Cozaar?

Taking too much losartan can cause dangerously low blood pressure (hypotension) resulting in shock. . If too much Cozaar has been taken, or if you suspect someone has overdosed on medication, seek emergency medical treatment.

What interacts with Cozaar?

Cozaar has several drug interactions that can cause problems. There are two drugs healthcare providers will never combine with Cozaar because of the potential hazards: aliskiren and isocarboxazid. Both can cause dangerously low blood pressure when combined with Cozaar. Aliskiren, a diabetes drug, works a lot like Cozaar, so the combination could seriously impair kidney function.

Healthcare professionals will also avoid prescribing ACE inhibitors and other ARBs (for example, valsartan). These drugs work similarly on the renin-angiotensin-aldosterone system (RAAS), so combining them increases the risks of side effects of losartan such as low blood pressure (hypotension), high serum potassium (hyperkalemia), swelling (angioedema), or kidney dysfunction. As far as other types of blood pressure medications, Cozaar is commonly prescribed with them, but hypotension is always a risk.

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, naproxen, and ibuprofen, are another type of drug to avoid. They’re good pain relievers, but combining them with drugs like Cozaar can damage the kidneys. Lithium, a drug used to treat bipolar disorder, is also avoided because Cozaar increases its toxicity. Finally, because losartan can raise potassium levels, people taking Cozaar should avoid potassium supplements, salt substitutes, or potassium-sparing diuretics such as spironolactone.

This is not an exhaustive list of all drug interactions involving Cozaar. Always consult a physician or pharmacist with questions about how medications may interact.

Is it safe to take Cozaar during pregnancy?

Because of fetal toxicity, losartan is should not be used in pregnant women. Taking Cozaar in the second or third trimesters can harm or kill the fetus. Using losartan during the second or third trimester is associated with neonatal skull hypoplasia, anuria, kidney failure which may be irreversible, fetal limb contractures, craniofacial deformation, hypoplastic lung development, and death. When patients become pregnant, physicians should have the patient discontinue losartan as soon as possible.

Women who are breastfeeding should be cautious about taking losartan. There is no information on whether losartan is present in human breast milk, affects lactation, or causes problems in a nursing baby. Because losartan could affect the baby’s kidneys, healthcare professionals typically advise taking a different drug such as captopril or enalapril.

Related resources for Cozaar dosages:

• Angiotensin II receptor blockade in Marfan syndrome, The Lancet

• Cozaar, Epocrates

• Cozaar prescribing information, U.S. National Library of Medicine

• Diabetic nephropathy, StatPearls

• Left ventricular hypertrophy, StatPearls

• Losartan, Plumb’s Veterinary Medication Guides

• Losartan potassium drug summary, Prescriber’s Digital Reference

• Regression of left ventricular hypertrophy and improved prognosis, Circulation