Hi,

Thanks for your query.

The heart rate (pulse) is within normal range, But its the systolic BP which is on the higher side and this is not to be expected when on a potent antiHypertensive like Toprol.With his background of heart ischemia , I consider there is a need to be evaluated well.

I would ask you to get his BP examined by a possessional on three consecutive days and formulate a better antihypertensive for the same if it remains high in all readings.

I do not say there is need for alteration or removal of Toprol but need to evaluate the necessity for a additional anti hypertensive drug.The rest medications are good and can continue with the same.

Hope I have answered your query. If you have any follow up queries I will be available to answer them.

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Hi again,

Thanks for following me up.

Yes, Nuvigil does have effect on BP , but its rare.

It can rise or even drop the BP.But the effect is very inconsistent.Hence I suggest you to get multiple BP measure which rule out the transient effect of Nuvigil.

Hope I answered your doubts clearly.

Wish him good health.

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