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Suggest Treatment For Withdrawal Symptoms Of Clonidine
Question: ATTENTION DR SHARKA..........here I am back again, glad to advise that I was able follow your instructions in changing from clonidine to doxazosine and also changed from lisinipril and amlodipine to your recommended methyldopa, I started at 2 mg doxazosine 2 times per day and 250 mg methyldopa, remained on 160/12.5 valsartan and 2.5 minoxidil. the first day after starting doxazone I stood up early am in my conference room, passed out , fell flat in the floor, thank heaven, no damage except pride....I think the pressures are still adjusting, I have been on the new program about 10 days now, my morning stage 2 systolic up to 190 in the early a m , my problem now is my heart rate is always 90 up t0 104 all the time and on my old medications it was usually in the mid 50 s and never over 65........new type problem for me. what do you suggest coach???? if you need more info let me know......... XXXXXXX XXXX thanks
Brief Answer:
I would recommend follows:
Detailed Answer:
Hello XXXX!
I am glad to hear from you again on HCM!
I am sorry to hear about the morning episode of fainting.
It is true that stopping clonidine may lead to increased heart rate. That is why, I would recommend adding a betablocker to your actual therapy.
Carvedilol could be a good treatment choice in this regard. I would recommend starting at a low dose of 3.125mg (half a tablet of 6.25mg) twice daily and increase the dose gradually after 2 weeks to 6.25mg twice daily, based on your heart rate values. It is important starting in low doses and increasing very slowly in order to avoid possible adverse effects (such as bradycardia, fatigue, tiredness, etc.).
This drug is also helpful in lowering your blood pressure besides your heart rate.
What is your actual dose of methyldopa? Are you taking it 250mg three times daily?
You may need to increase the dose with another tablet during the evening (one tablet in the morning, one at lunch and two tablets in the evening) if your blood pressure is still high, in order to have a better control of blood pressure values during night and early morning.
Hope you will find this answer helpful!
I remain at your disposal for further questions whenever you need to ask me!
Kind regards,
Dr. Iliri
I would recommend follows:
Detailed Answer:
Hello XXXX!
I am glad to hear from you again on HCM!
I am sorry to hear about the morning episode of fainting.
It is true that stopping clonidine may lead to increased heart rate. That is why, I would recommend adding a betablocker to your actual therapy.
Carvedilol could be a good treatment choice in this regard. I would recommend starting at a low dose of 3.125mg (half a tablet of 6.25mg) twice daily and increase the dose gradually after 2 weeks to 6.25mg twice daily, based on your heart rate values. It is important starting in low doses and increasing very slowly in order to avoid possible adverse effects (such as bradycardia, fatigue, tiredness, etc.).
This drug is also helpful in lowering your blood pressure besides your heart rate.
What is your actual dose of methyldopa? Are you taking it 250mg three times daily?
You may need to increase the dose with another tablet during the evening (one tablet in the morning, one at lunch and two tablets in the evening) if your blood pressure is still high, in order to have a better control of blood pressure values during night and early morning.
Hope you will find this answer helpful!
I remain at your disposal for further questions whenever you need to ask me!
Kind regards,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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