Brief Answer:
follow up

Detailed Answer:
Dear XXXXXXX

Thanks for reverting back with your follow up and health concerns
1.Since both the drugs [additive + Adverse drug effect] will be causing some bradycardia and low blood pressure thus could be concern of feeling low on energy, and cause of mild headache [ especially with actiblok], let the body gradually adapt to reduced cardiac output for alleviation of the symptoms.
2.After stopping actiblok, make sure you take magnesium supplementation to maintain cardiovascular tone. [green vegetables,nuts and legumes, chocolates and fruits such as bananas, grapes and oranges.
3.Tapering period of 2 weeks is better than abrupt discontinuation and since planning to stop by coming week hopefully the desired period would be achieved.
4.Headache from eyeball to back of head can be due to over exertion, reading/working in dim light, eye problem [ophthalmologist opinion required], maximum sitting in front of screen, too little sleep or disturbed sleep schedule can also cause the same.
5.Continuing with dose as described will eventually see off from nasal blockage problem.
6.If blood pressure remains in the desired range then dose of ‘mukta vati’ can be reduced to ½ tablet twice a week and then ½ tablet once a week, and slowly medicine intake can be stopped BUT drugs are only part of a complete program of treatment for hypertension which also includes diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely if you are being treated for hypertension.


Dr. Munish Sood
Consultant & Physician
Naimittika Clinic.

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Brief Answer:
Patient Information

Detailed Answer:
Dear XXXXXXX

Thanks for reverting back with your concern

1. Since you were pre hypertensive at first place [as mentioned earlier], thus gradually lowering the drug over 1 to 2 weeks is preferable but should be carefully monitored [preferably by your attending doctor] .

PS
Do not stop taking metoprolol without first talking to your doctor. [because it is a common notion that "A patient developing a new complaint while on treatment, attribute it to the drugs rather than to the disease".

Dr. Munish Sood
Naimittika

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Brief Answer:
Patient Information

Detailed Answer:
Dear XXXXXXX
1. main concern of telling the fact is that your Attending doctor must be taken into consideration about your tapering of metoprolol dose [so that he is proactive in advance about any Adverse effect [if at all].
2. taking till 4/11/13 and be back the next day, it is good that during this time period [in between towns] you will be on the tapering dose of the medicine.
3. usually [as described earlier] tapering period of 2 weeks is better than abrupt discontinuation, so in nut shell drug can be stopped after gradual tapering [which you are already doing], but only thing is that your Doctor there should have knowledge about the same so that he may assist you further.

PS
. if you are taking it on alternate days basis, thus is usually sufficient to stop the drug after 4/11/13 but supplement with magnesium as described earlier.

Dr. Munish Sood
Naimittika

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