Should You Take Losartan In The Morning Or Evening?

In our latest question and answer, the pharmacist discusses whether or not losartan needs to be taken in the morning or evening.

Question

I was just prescribed losartan. I have read different things about when the best time to take the drug is. Can you provide some insight?

Asked by Darrell On Nov 09, 2022

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Nov 09, 2022
Last updated Nov 09, 2022

Key points

  • Losartan can be taken in the morning or evening. Studies show that administration timing likely makes no difference in how well the drug works.

Answer

Losartan can be taken in the morning or evening. The time of day you take the drug does not affect how well it works. The considerations for timing should revolve around when is most convenient for you, and potential side effects.

What Do The Studies Say?

I will say that there has long been debate about whether or not the time of day you took you blood pressure medication changed its effects.

Some sources have recommended morning dosing as blood pressure tends to be higher when compared to the evening, but other sources have recommended evening based on older studies pointing to better outcomes (e.g., lower heart attack risk).

However, the most recent, and largest study on the matter (it included over 21,000 adults), published by The Lancet in October of 2022, found that there was no difference in cardiovascular outcomes when comparing administration time for blood pressure medications.

It concluded:

Among patients with hypertension, the timing of blood pressure medications does not affect the incidence of adverse cardiovascular events. Blood pressure tended to be higher in the evening among patients randomized to evening dosing, while blood pressure tended to be higher in the morning among patients randomized to morning dosing. Falls were slightly less frequent in the evening dosing group. There were no safety concerns from evening dosing of antihypertensive therapy. Patients can take antihypertensive medications in the morning or in the evening according to their preference.
Lancet . 2022 Oct 22;400(10361):1417-1425

The study was for a 5-year period, and as the excerpt above states, the rates of cardiovascular outcomes were similar between the morning and evening dosing groups. So, overall this is a good indication that you can take your once-daily blood pressure medication (e.g., losartan) at a time that works best for you.

What About Side Effects?

The overall rate of side effects appears to be similar between those that take losartan in the morning and those that take it in the evening.

However, and this is an important point, blood pressure medication, especially when first started, tends to cause dizziness. The risk of falling due to dizziness has to be taken into consideration, especially if you are elderly.

If you take your blood pressure medication at night, before bed, that somewhat mitigates the dizziness side effect if you're simply going to bed.

Additionally, when taking blood pressure medication, you want to make sure that when you go from a sitting or lying down position to standing up, you do so slowly. This decreases the risk of dizziness. 

Final Words

You can feel safe taking your losartan anytime. This recommendation applies to other once-daily medications that are being used for blood pressure, such as lisinopril and ramipril, as well. Just find a time that works best for you and take it daily at the same time.

I hope you found this helpful!

References

  • Cozaar Prescribing Information, AccessFDA
  • Cardiovascular outcomes in adults with hypertension with evening versus morning dosing of usual antihypertensives in the UK (TIME study): a prospective, randomised, open-label, blinded-endpoint clinical trial, PubMed

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 13 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical, program development, and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Dr. Brian Staiger also has herbalist training and educational certificates in the field of medical ethnobotany. Feel free to send him an email at Hello@HelloPharmacist.com! You can also connect with Dr. Brian Staiger on LinkedIn.

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