What time of day should I take losartan and metoprolol?

October 11, 2025 •

4 min read

According to the World Health Organization, an estimated 1.28 billion adults aged 30–79 years worldwide have hypertension. A personalized medication schedule is crucial for managing this condition, but knowing what time of day should I take losartan and metoprolol? can be complex when prescribed both, as the timing can impact efficacy and side effects.

Quick Summary

The optimal timing for losartan and metoprolol depends on individual needs, the specific metoprolol type, and potential side effects. Consistency is paramount for effectiveness, and a healthcare provider can help determine the ideal schedule to minimize risks like dizziness or low blood pressure.

Key Points

Consistency is Key: For both losartan and metoprolol, taking your medication at the same time every day, regardless of morning or evening, is more important for long-term efficacy than the specific time.
Check Your Metoprolol Type: The timing for metoprolol depends on the formulation; metoprolol succinate (ER) is once daily, while metoprolol tartrate (IR) is often twice daily and needs to be spaced out.
Take Metoprolol with Food: To enhance absorption and minimize stomach upset, both forms of metoprolol should be taken with or right after a meal.
Consider Staggering Doses: If prescribed both medications, staggering them—one in the morning, one in the evening—can help reduce the risk of a sharp blood pressure drop and minimize side effects like dizziness.
Monitor for Dizziness: Due to potential dizziness, some doctors may recommend taking your first dose of either medication at night to see how you react.
Personalize Your Schedule: The best schedule is the one that fits your routine and minimizes side effects. Always work with your healthcare provider to find what works best for you.

For individuals prescribed both losartan and metoprolol, managing the dosing schedule is a key part of controlling high blood pressure. Losartan is an angiotensin II receptor blocker (ARB), while metoprolol is a beta-blocker; they work differently to lower blood pressure and are often used together for enhanced effect. The ideal time to take these medications depends on the metoprolol formulation, potential side effects, and personal habits.

Understanding Losartan Dosing

Losartan (brand name Cozaar) is typically taken once a day. For most people, the specific time of day is less important than consistency—taking it at the same time every day helps maintain a steady level of the drug in the body.

Morning vs. Evening: For many patients, taking losartan in the morning is a convenient way to build it into their daily routine. However, some studies have investigated potential benefits of evening dosing for certain cardiovascular outcomes, although recent large trials suggest no significant difference for most people.
Managing Dizziness: Losartan can cause dizziness, especially when first starting the medication. To mitigate this risk, some doctors may recommend taking the first dose at bedtime. If no dizziness occurs, you can then switch to a more convenient time.
With or Without Food: Losartan can be taken with or without food, giving you flexibility. However, taking it around a meal can be a helpful memory cue.

Understanding Metoprolol Dosing

Metoprolol is available in two main forms, which dictate the dosing schedule:

Metoprolol Succinate (extended-release, Toprol XL): This once-a-day formulation is designed to be released slowly into the body over 24 hours. Like losartan, it can be taken in the morning or at night, as long as it is taken consistently at the same time each day.
Metoprolol Tartrate (immediate-release, Lopressor): This medication is shorter-acting and is typically taken twice a day to ensure consistent blood pressure control. Doses should be spaced out, often 12 hours apart, such as once in the morning and once in the evening.

Food is a critical factor for metoprolol. Both the immediate-release and extended-release forms should be taken with or immediately after a meal to aid absorption and reduce stomach-related side effects. Some providers may recommend the first dose at night to assess for side effects like drowsiness or dizziness.

Strategic Timing: Combining Losartan and Metoprolol

Because these medications work differently, combining them can provide comprehensive blood pressure management. However, taking them together can increase the risk of side effects like low blood pressure (hypotension) and dizziness. A strategic dosing schedule can help mitigate this.

Separate Dosing: Many healthcare providers recommend staggering the doses. For instance, you might take one medication in the morning and the other in the evening. This approach ensures smoother blood pressure control throughout the day and night while reducing the risk of a sharp drop in blood pressure caused by both drugs peaking at the same time.
Example Schedule (for Metoprolol Succinate ER): Take Metoprolol Succinate ER in the morning with breakfast. Take Losartan in the evening, with or without food. If dizziness is an issue with losartan, taking it at night can be especially helpful.
Example Schedule (for Metoprolol Tartrate IR): Take Losartan and one dose of Metoprolol Tartrate with breakfast in the morning. Take the second dose of Metoprolol Tartrate with your evening meal. This schedule incorporates the food requirement for metoprolol while splitting the beta-blocker dose for steady control.

Your Individual Dosing Strategy: A Quick Guide

To find the best dosing time for your specific needs, consider the following factors:

Adherence: The single most important factor is consistency. Choose a time that is easy to remember and incorporate into your daily routine. Using a pillbox or setting a phone alarm can improve adherence.
Side Effects: If you experience side effects like dizziness or fatigue, especially when starting a new medication, your doctor might recommend taking it at night. Monitoring your blood pressure at home can provide useful data for these adjustments.
Metoprolol Form: The release mechanism of metoprolol (immediate vs. extended) is the primary determinant of its dosing frequency and timing. Always verify with your pharmacist which type you have.
Blood Pressure Patterns: Your doctor may recommend a 24-hour ambulatory blood pressure monitoring to see how your blood pressure fluctuates throughout the day. This can help decide if morning or evening dosing is more effective for your specific pattern.

Comparison Table: Losartan vs. Metoprolol Dosing


Feature	Losartan	Metoprolol Succinate (ER)	Metoprolol Tartrate (IR)
Medication Class	Angiotensin II Receptor Blocker (ARB)	Beta-Blocker	Beta-Blocker
Frequency	Once daily	Once daily	Usually twice daily
Timing Flexibility	Highly flexible, but consistency is key.	Flexible, but consistency is key.	Doses must be spaced evenly.
Food Requirement	Can be taken with or without food.	Take with or immediately after a meal.	Take with or immediately after a meal.
Side Effect Consideration	Initial dose at bedtime if dizziness occurs.	Initial dose at bedtime if dizziness occurs.	Take with food to lessen stomach upset.

Conclusion

While large-scale studies suggest the specific timing of antihypertensive medication—morning versus evening—may not significantly impact overall cardiovascular outcomes for the general population, the practical considerations and individual patient response are what truly matter. For those taking both losartan and metoprolol, the optimal schedule balances the need for consistent blood pressure control with minimizing side effects like dizziness and hypotension. Separating the doses is a common and effective strategy. Always consult with your healthcare provider or pharmacist to create the best dosing schedule tailored to your specific needs, the type of metoprolol prescribed, and your daily routine.

For more detailed information, consider consulting authoritative sources like the Cleveland Clinic Journal of Medicine.

Frequently Asked Questions

Yes, losartan and metoprolol can be taken at the same time, but many healthcare providers suggest staggering the doses (one in the morning, one at night) to prevent potential side effects like dizziness or a sudden drop in blood pressure.

For most patients, the specific timing (morning vs. evening) doesn't significantly impact cardiovascular outcomes, as long as the medication is taken consistently. However, evening dosing might be beneficial for individuals with specific blood pressure patterns or those experiencing nighttime side effects.

Both immediate-release and extended-release metoprolol should be taken with or immediately after a meal. This helps your body absorb the medication more effectively and can reduce the chance of an upset stomach.

If you miss a dose and remember within a few hours, take it as soon as you can. If it is nearly time for your next dose, skip the missed one and continue with your regular schedule. Never take two doses at once to make up for a missed one.

Concerns about fall risk with nighttime dosing have been raised, but the evidence is mixed. A large study found that patients taking evening doses reported fewer falls than those on morning doses, potentially due to fewer daytime lightheaded episodes.

Strategies like using a pillbox, setting a daily alarm on your phone, or linking medication-taking to a regular daily activity, such as a specific meal, can help improve adherence.

Losartan and metoprolol are often prescribed together because they work through different mechanisms to lower blood pressure. The combination can be more effective than either medication alone for managing hypertension, heart failure, and other cardiovascular conditions.