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Is It Safe To Have Losartan And Clonidine While Suffering From Renal Disease?

Posted on Fri, 20 May 2016

Question: I'm a 59 year old black man with HBP. My doctor have put me on the following meds: nefedipine 90mg, atenolol 50mg x2, hydralazine 50mg x3, doxazosin 4mg, losartan 100mg, clonidine 0.1 x2, and crestor 40mg. My BP still not stable and still run from 118/78,140/86, and 158/90. My last lab test shows increase Proteinuria, creatinine 2.21, eGFR 36 and BUN/creatinine ratio of 10.9. I want to know if these group of meds are best for my condition or other combinations that will be better help to suggest to my doctor.

Answered by Dr. Ilir Sharka (2 hours later)

Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

I understand your concern and would explain that would explain that your tests are compatible with chronic renal disease.

Uncontrolled high blood pressure could be explained by this commorbidity, besides other risk factors.

I would recommend discussing with your doctor on the possibility of making some changes to your actual therapy:

1- Stop taking Losartan. It can lead to increased levels of potassium, and is not recommended in chronic renal disease

2- Add a central antihypertensive drug like methyldopa 250mg three times daily.
Another option would be Monoxidine 0.4mg daily.

3- Consider reducing or even stopping clonidine, because of it adverse effects in your clinical situation

4- Add a diuretic like furosemide 40 mg daily or torasemide 10 mg daily, which are recommended for the preservation of renal function.

You should also consider some diet modifications : reduce salt and proteins intake.

You should consult with a nephrologist and perform periodically scheduled follow ups to monitor your kidney function.

Hope you will find this answer helpful!

Kind regards,

Dr. Iliri

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

Follow up: Dr. Ilir Sharka (9 hours later)

Hi Dr. Ilir,
Thanks a lot for your reply to my question and you esteemed recommendation. I'll meet with my doctor tomorrow to present those options. I'll keep you posted as to my progress and further advice.
Sincerely, XXXXXXX XXXX

Answered by Dr. Ilir Sharka (3 minutes later)

Brief Answer:
You are welcome!

Detailed Answer:
You are welcome!

I am glad to have been helpful!

You can ask me directly at any time at the link below:

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69765

Best wishes,

Dr. Iliri

Note: For further queries related to coronary artery disease and prevention, click here.

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