hydrochlorothiazide × losartan

Synergistic BP reduction, a target combination in hypertension (losartan/hydrochlorothiazide fixed-dose product). In older patients with hypovolemia and RAAS activation, the first sartan dose can cause orthostatic hypotension and acute kidney injury.

Start losartan at 25–50 mg (25 mg in older patients) and hydrochlorothiazide at 12.5 mg. Check BP with an orthostatic measurement, creatinine, potassium, and sodium at 7–14 days.