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Can Losartan Be Discontinued Without Doctor's Consent?
Question: I'm 62, male, normal weight, non-smoker, exerciser. Went to a doctor other than my regular one with chest cold. BP was elevated. Never great at doctor...but always below 150/90. She put me on 25mg Losartan. After 11 days, BP 128/78...13 days, 124/75. Think that would be fast reaction to this drug. Would it be safe for me to stop taking it, and see if my BP stays in normal range without it?
Brief Answer:
Information.
Detailed Answer:
Hello XXXXXXX,
The decision of whether to start a patient on an anti-hypertensive medication should be either based on multiple elevated blood pressure readings (at least 3) or on one dangerously high blood pressure reading. Do you know what your blood pressure was when you went in? Was it the 150/90 that you wrote above? Also, did this physician have access to previous records where BP was over 130/90?
It is possible for Losartan or other antihypertensives to lower blood pressure as you described within a couple of weeks.
I'll write more after I hear back about these questions.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Bonnie Berger-Durnbaugh, General & Family Physician
Information.
Detailed Answer:
Hello XXXXXXX,
The decision of whether to start a patient on an anti-hypertensive medication should be either based on multiple elevated blood pressure readings (at least 3) or on one dangerously high blood pressure reading. Do you know what your blood pressure was when you went in? Was it the 150/90 that you wrote above? Also, did this physician have access to previous records where BP was over 130/90?
It is possible for Losartan or other antihypertensives to lower blood pressure as you described within a couple of weeks.
I'll write more after I hear back about these questions.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Bonnie Berger-Durnbaugh, General & Family Physician
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Out of 11 past examinations (spread over several years) all but one were over 130/90. Blood pressure was above 160/90 when I went in with the cold. The biggest side effects i seem to notice with this drug is feeling colder than usual, and occasional heartburn. Tomorrow, i'm scheduled for a blood test and EKG. Follow up with my primary care giver (a p.a.) 2 weeks after that. Go with the protocol then?
Brief Answer:
Information.
Detailed Answer:
Hi,
Given that you have a history of at least 3 (and many more) BP readings of over 130/90, you would be considered to have hypertension, and yes, I'd stick with the Losartan 25 mg if you are tolerating it. Twenty-five milligrams is a low starting dose, so the doctor who prescribed it was being fairly cautious.
Some people do get "white coat hypertension" from the stress of going in to the doctor's office and because of that, if blood pressure is running high in the office, I often would recheck it at the end of the appointment, and also ask the patient to have it checked and record it, several times (minimum of 3) in non-doctor office environments.
But unless you are especially nervous when you go in to see the doctor, and it is almost always over 130 systolic or 90 diastolic, then you can trust those numbers, and the medication is indicated.
I know you mentioned you don't smoke, are not overweight, and you exercise, but one other thing to consider if it applies to you. I've had patients whose blood pressures were fairly sensitive to alcohol intake and reducing alcohol made all the difference in their blood pressures. Just a thought.
So in summary, yes, stay on the low dose Losartan, be sure to have blood pressure checked again in a few weeks (takes Losartan about 3-6 weeks for maximal effect) to make sure it isn't going too low.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Bonnie Berger-Durnbaugh, General & Family Physician
Information.
Detailed Answer:
Hi,
Given that you have a history of at least 3 (and many more) BP readings of over 130/90, you would be considered to have hypertension, and yes, I'd stick with the Losartan 25 mg if you are tolerating it. Twenty-five milligrams is a low starting dose, so the doctor who prescribed it was being fairly cautious.
Some people do get "white coat hypertension" from the stress of going in to the doctor's office and because of that, if blood pressure is running high in the office, I often would recheck it at the end of the appointment, and also ask the patient to have it checked and record it, several times (minimum of 3) in non-doctor office environments.
But unless you are especially nervous when you go in to see the doctor, and it is almost always over 130 systolic or 90 diastolic, then you can trust those numbers, and the medication is indicated.
I know you mentioned you don't smoke, are not overweight, and you exercise, but one other thing to consider if it applies to you. I've had patients whose blood pressures were fairly sensitive to alcohol intake and reducing alcohol made all the difference in their blood pressures. Just a thought.
So in summary, yes, stay on the low dose Losartan, be sure to have blood pressure checked again in a few weeks (takes Losartan about 3-6 weeks for maximal effect) to make sure it isn't going too low.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Bonnie Berger-Durnbaugh, General & Family Physician
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I do use alcohol, and based on what you said, have now cut myself from 1 1/2 to two drinks a day to one.
I see my doctor on Mar. 23. I had an EKG a few days ago, and it is normal.
My main side effect from Losartan is feeling cold...especially feet. Will
this fade away...or indicate I should try something else?
I see my doctor on Mar. 23. I had an EKG a few days ago, and it is normal.
My main side effect from Losartan is feeling cold...especially feet. Will
this fade away...or indicate I should try something else?
Brief Answer:
Thoughts on this.
Detailed Answer:
Hello XXXXXXX,
Feeling cold isn't a major side effect of Losartan or it's class of medication (ACE inhibitor) but can occur. In general, it can take 8-12 weeks for some of the side effects to resolve, but sometimes they don't. If the feeling of coldness is intense, not mild, then I would recommend that you talk with your doctor about trying something else. Some doctors use Triamterene/Hydrochlorothiazide to start out within people newly diagnosed with hypertension. But a low dose of Losartan is reasonable too and not unusual.
So do tell your doctor about the experience of feeling cold when you see him/her on March 23.
Hope I have answered your query.
Regards,
Dr. Bonnie Berger-Durnbaugh, General & Family Physician
Thoughts on this.
Detailed Answer:
Hello XXXXXXX,
Feeling cold isn't a major side effect of Losartan or it's class of medication (ACE inhibitor) but can occur. In general, it can take 8-12 weeks for some of the side effects to resolve, but sometimes they don't. If the feeling of coldness is intense, not mild, then I would recommend that you talk with your doctor about trying something else. Some doctors use Triamterene/Hydrochlorothiazide to start out within people newly diagnosed with hypertension. But a low dose of Losartan is reasonable too and not unusual.
So do tell your doctor about the experience of feeling cold when you see him/her on March 23.
Hope I have answered your query.
Regards,
Dr. Bonnie Berger-Durnbaugh, General & Family Physician
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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