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Mother Is 94.... One Kidney .... Daily Takes 75 Mg
Question: Mother is 94....
One kidney .... daily
Takes 75 mg of metoprolol
60 mg if nifedipine
100 mg of lossrtan/ pot
25 mg hctz
Recent blood pressure has been 180-200 systolic
Over 68 diastolic ......with heart rate at 65...
Doctor wants to give her 0.1 mg of clonidine. To keep blood pressure down
Is this drug a good idea????
One kidney .... daily
Takes 75 mg of metoprolol
60 mg if nifedipine
100 mg of lossrtan/ pot
25 mg hctz
Recent blood pressure has been 180-200 systolic
Over 68 diastolic ......with heart rate at 65...
Doctor wants to give her 0.1 mg of clonidine. To keep blood pressure down
Is this drug a good idea????
Brief Answer:
Yes that can be done but first increase the dose of nifedipine
Detailed Answer:
Hi,
Welcome.
This is Dr Sameer, cardiologist.
I can understand that your mother is having high BP despite being on significantly high dose of antihypertensive.
Adding Clonidine is a good option but I believe that before adding a new antihypertensive older drug has to be given in highest dose first.
Nifedipine can be given upto 90-120mg per day. As she is currently taking 60mg, its dose can be increased further and if the BP is still not controlled, than add another group of antihypertensive. You should discuss this with your cardiologist. Losartan is already in its maximum dose and increasing dose of Metoprolol won't have much affect on BP (also she is having optimal heart rate, so its dose should not be increased).
Also regularly check her Kidney function test to just confirm it is within normal limits.
Hope this helps.
Thanks and regards
Yes that can be done but first increase the dose of nifedipine
Detailed Answer:
Hi,
Welcome.
This is Dr Sameer, cardiologist.
I can understand that your mother is having high BP despite being on significantly high dose of antihypertensive.
Adding Clonidine is a good option but I believe that before adding a new antihypertensive older drug has to be given in highest dose first.
Nifedipine can be given upto 90-120mg per day. As she is currently taking 60mg, its dose can be increased further and if the BP is still not controlled, than add another group of antihypertensive. You should discuss this with your cardiologist. Losartan is already in its maximum dose and increasing dose of Metoprolol won't have much affect on BP (also she is having optimal heart rate, so its dose should not be increased).
Also regularly check her Kidney function test to just confirm it is within normal limits.
Hope this helps.
Thanks and regards
Above answer was peer-reviewed by :
Dr. Kampana
Dr
One follow up please
The blood pressure drugs I mentioned above——can you comment on the best time of day to take these drugs that she is now taking?? Are some more effective when they are taken in the morning .... some better when taken with or without food???
And...... is there another different blood pressure drug that she’s not now taking that I could mention to the cardiologist that would be more effective to keep down that top systolic number???
Thank you !!!!!!
One follow up please
The blood pressure drugs I mentioned above——can you comment on the best time of day to take these drugs that she is now taking?? Are some more effective when they are taken in the morning .... some better when taken with or without food???
And...... is there another different blood pressure drug that she’s not now taking that I could mention to the cardiologist that would be more effective to keep down that top systolic number???
Thank you !!!!!!
Brief Answer:
Detailed answer ahead
Detailed Answer:
Hi,
Welcome back.
Their is no special time that these medications should be taken that they work better.
But Losartan-HCTZ should be taken in the morning as hctz part is a diuretic which should be taken in morning time to avoid excess urination during night time which becomes problematic for the patient.
So she should take Losartan-hctz in the morning along with Metoprolol and Nifedipine in the evening. If your doctor makes Nifedipine twice daily, than one in the morning and other in evening and than Metoprolol can be shifted to evening.
Their is also one another drug Prazosine (alpha blocker) which is also a good drug for BP and you can discuss this with your doctor.
We generally prefer this before Clonidine as Clonidine has side effect of withdrawal hypertension means if stopped suddenly the BP shoots up suddenly.
You can discuss all this and than finalize her medications.
You should also decrease salt in her diet and get a 2D Echo done for her to see for her valves as such difference in systolic and diastolic BP (pulse pressure) can be associated with leaking valve (Aortic Regurgitation).
I'll happy to help if you have any other questions in future.
Thanks and regards
Detailed answer ahead
Detailed Answer:
Hi,
Welcome back.
Their is no special time that these medications should be taken that they work better.
But Losartan-HCTZ should be taken in the morning as hctz part is a diuretic which should be taken in morning time to avoid excess urination during night time which becomes problematic for the patient.
So she should take Losartan-hctz in the morning along with Metoprolol and Nifedipine in the evening. If your doctor makes Nifedipine twice daily, than one in the morning and other in evening and than Metoprolol can be shifted to evening.
Their is also one another drug Prazosine (alpha blocker) which is also a good drug for BP and you can discuss this with your doctor.
We generally prefer this before Clonidine as Clonidine has side effect of withdrawal hypertension means if stopped suddenly the BP shoots up suddenly.
You can discuss all this and than finalize her medications.
You should also decrease salt in her diet and get a 2D Echo done for her to see for her valves as such difference in systolic and diastolic BP (pulse pressure) can be associated with leaking valve (Aortic Regurgitation).
I'll happy to help if you have any other questions in future.
Thanks and regards
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
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