Drug interactions
Bumetanide + Losartan
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Overview
Increased risk of symptomatic hypotension (especially first-dose) and acute kidney injury in volume-depleted patients on a loop diuretic when initiating or uptitrating an ARB.
Mechanism of action
Pharmacodynamic: additive BP lowering; hemodynamic drop in GFR from efferent arteriolar dilation by ARB in the setting of diuretic-induced volume depletion.
Clinical management
Correct volume depletion before starting/increasing losartan; consider lower starting dose; monitor serum creatinine and potassium within 1–2 weeks of initiation or dose change; hold/reduce diuretic if severe hypotension or AKI occurs.
Drug reference
References
- Cozaar (losartan) Prescribing Information — FDA Label
- Bumetanide: Drug Interactions — Lexicomp
Frequently asked questions
Can I take Bumetanide with Losartan?
The interaction is rated: Moderate. Increased risk of symptomatic hypotension (especially first-dose) and acute kidney injury in volume-depleted patients on a loop diuretic when initiating or uptitrating an ARB.
How serious is the interaction between Bumetanide and Losartan?
The interaction is rated: Moderate. Evidence level: High.
How is the interaction between Bumetanide and Losartan managed?
Correct volume depletion before starting/increasing losartan; consider lower starting dose; monitor serum creatinine and potassium within 1–2 weeks of initiation or dose change; hold/reduce diuretic if severe hypotension or AKI occurs.
Why do Bumetanide and Losartan interact?
Pharmacodynamic: additive BP lowering; hemodynamic drop in GFR from efferent arteriolar dilation by ARB in the setting of diuretic-induced volume depletion.
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