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Suggest Remedy For Palpitations When On Telmisartan

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Posted on Tue, 30 Jun 2015
Question: DEar doctor Ji
Namaste. I am 72 year old male. Ihave been taking Atenol and Amlodipine in fom or the other since 30 years. and iam happy with the drug because my bp level is always below 140/80 or 85. Recently i went to a a Physician who is a diabetologist.and have asked him whether it i time to change over to a different drug over Stamlobeta which i am now taking. He said since i have prediabetes since 3 years, he suggested me first Cresar 40mg and asked me to stop stamlobeta . I took it for a week only. After that i had palpitations . Immediately i went to the doc and told him. He has prescribed Met XL T 50 and asked me to stop stamlobeta . Immediately the palpitations disappeared. For the past 3 months only i have been taking this, but i have got my bp checked often by my doctor brother. always the bp is hovering around 170/90 to 150/90.Which was not previously for the past 30 years when i took stamlobeta.So i went again to the doc and he checked my bp and recorded 160/90. So he asked me what i used before changing to this new drug. I told him it is stamlobeta. Then he said i can start taking again stamlobeta and discontinume met xl T 50 and observe for one month. even then if it is not regularised, i should take plain telmisartan.He said i need not taper the Met XL T 50.,where i am little bit confused, because, i read in the internet, i should not stop the Met Xl all of a sudden and it should be tapered. But my doc said not necessary. Hence i request your valuable advise in whether i am right in taking again stamlobeta as previously ? whether i need not taper the Met XL, since i am taking another subsituted drug ? Kindly advise.
doctor
Answered by Dr. Prasanna Heijebu (2 hours later)
Brief Answer:
Stop Stamlobeta

Detailed Answer:
Hi Sir.

I understand your concern.

Since you are in pre-diabetic stage and reported side effects with Stamlobeta,its use is not warranted in your case again.

Also sudden withdrawal of Metolar XL is not advised.

In order to maintain your blood pressure under 130/80 mm of Hg,I advise you to go for Tab Metolar XL 50 mg twice a day and Tab Telmisartan 40 mg once a day.

Both these drugs together can produce excellent control of your blood pressure.

Post your further queries if any.
Thank you.

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Prasanna Heijebu (3 hours later)
Doctor, you misread my explanation. I am happy with stamlobeta for last 30 years. No side effects. The palpitarions and thumping is due to telmisartan (cresar 40 mg) which I have mentioned.i am non taking Metolar xl but my doc prescribed Met xl 50 which was again stopped by my doc and started stamlobeta with which I am happy. If the bp is regularised I was asked to continue, if not regularised asked me to take plain telmisartan.in the light of the above please advise.raise in bp is also due to Met xl T 50.



doctor
Answered by Dr. Prasanna Heijebu (25 hours later)
Brief Answer:
Continue stamlobeta.Regular ECG monitoring is advisable

Detailed Answer:
Hi Sir,

Welcome again,

Normally Telmesartan is an excellent drug advised in patients with Diabetes and pre diabetes.So your doctor has advised it.

But now Since you are finding difficulty with the drug continue with Stamlo beta.

You need regular monitoring of your blood pressure twice weekly.

Also ECG monitoring for every 3 months is mandate as long term use of stamlobeta has proven rhythm disturbances of heart.

If your blood pressure is under control with stamlobeta you can continue the drug but with ECG monitoring.

If its uncontrolled you need to start Telma again.

Sudden discontinuation of Met xl 50 should not be done.So take Met xl 50 for 2weeks followed by 25 mg for 2 weeks.

NOTE:These drugs should be taken under strict medical supervision of your doctor.

Post your further queries if any,
Thank you.
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Prasanna Heijebu (14 hours later)
Thank you very much.
doctor
Answered by Dr. Prasanna Heijebu (13 hours later)
Brief Answer:
You are always welcome.

Detailed Answer:
You are always welcome.
Take care.
Thank you
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
Dr.
Dr. Prasanna Heijebu

General & Family Physician

Practicing since :2010

Answered : 1422 Questions

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Suggest Remedy For Palpitations When On Telmisartan

Brief Answer: Stop Stamlobeta Detailed Answer: Hi Sir. I understand your concern. Since you are in pre-diabetic stage and reported side effects with Stamlobeta,its use is not warranted in your case again. Also sudden withdrawal of Metolar XL is not advised. In order to maintain your blood pressure under 130/80 mm of Hg,I advise you to go for Tab Metolar XL 50 mg twice a day and Tab Telmisartan 40 mg once a day. Both these drugs together can produce excellent control of your blood pressure. Post your further queries if any. Thank you.