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Have Inerstitial Cystitis, Overweight, Blood Pressure And Cholestrol. Suffered Drop Attacks. Advised To Stop Lostran. What To Do?

Posted on Sun, 7 Jul 2013

Question: after suffering for drop attacks for several months, my doctor has advised me to stop my losartan as we have ruled out cardio, TIA, Tumarkin, and drug interactions. She thinks it may be a problem with that drug

Answered by Dr. Luchuo Engelbert Bain (1 hour later)

Hi and thanks for the query,

Management of hypertension, a chronic disease, might at times be difficult in identifying the drug a patient has the least side effects to, and responds well with respect to blood pressure control. I would love to know your response to Losartan, with regards to tolerance and blood pressure control. If you have good a good response and tolerate the drug, you might need to take a few considerations before actually withdrawing from this drug.

The other conditions you present with in your past history make Losartan a perfect choice of anti hypertensive drug. I am afraid Losartan has not been associated with drop attacks. It might no be a good idea to stop Losartan at this stage, I would suggest you concert again with the doctor with respect to this.

The issue here to me is actually getting a consultation with a neurologist for a proper neurologic evaluation and management. Other causes of potentiators of this condition should be investigated and managed first.

Thanks and hope this helps. Please, feel very free asking any further questions for clarifications. I will be very glad contributing to your well being. I wish you good health.

Bain LE, MD.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Luchuo Engelbert Bain (53 minutes later)

I have seen a neurologist, cardiologist and 3 ENTs and have had several MRI's, heart echos and cartiod artery ultrasounds as well as EKG, EEG and several (unfortunately for me caloric tests) and blood tests to rule out almost everything. I have researched cozaar extensively as well as the other drugs that I am on. I found three studies, one from England, one from Australia and one from Argentina that hypothised that cozaar has been associated with drop attacks in women over 62 and on the drug for more than 3 years. My doctor and I do not know where else to go. She has tried everything and I remain bruised and battered. Do you have any suggestions

Answered by Dr. Luchuo Engelbert Bain (4 hours later)

Hi and thanks for the comprehensive update,

I honestly think the management plan at this point in time should go very simple and be basic, as your doctor remains very keen on outcomes. After searching through published literature too and pharmacology clear houses, the rare proposed studies carry lots of biases and are methods used to come these conclusions are for sure not similar. It s true it should raise some concern in this respect. I still think at this point could be a real justification to stop the drug, if a risk - benefit analysis is done. However, it could be worth attempting, provided your BP control shall be tightened with the next new antihypertensive drug that shall be considered.

For now I suggest a fairly balanced diet, XXXXXXX in vegetables and fruits, exercise, continue your usual Aspirin and other drugs, add to the regimen Gamalate B6 and serum electrolyte balance when done regularly is helpful. IN case your doctor decides to change Cozaar, regular and tight blood pressure control. But the evidence is still too weak, but worth trying under supervision.

Best regards, wishing you the best of health.

Bain Le, MD.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar