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What Causes High BP After Treating Sudden Sensorineural Hearing Loss?
Question: I suffered SSHL in my right year three years back. I was having Telmisartan (Targit 40) once a day for my high BP and Febuxostat for Uric acid then. The hearing loss triggered within three days of starting on Febuxostat, though both list have hearing loss as rare side effect. I stopped having both drugs for the nexr few years but now my BP is high and I need to have a drug prescribed. What can be your suggestion? I am 85kg, 49 years old, male, XXXXXXX I have clocked BP as high as 187/98. Pls help. I am meeting my GP on Saturday. A homeopathic doc has suggested having Raulvofia Serpentina. Will I start on Targit 40 meanwhile? To my knowledge I am not diabetic and do not have kidney problems.
Brief Answer:
You should start with anti hypertensive medication
Detailed Answer:
Hello, I am Dr Mody and I would be addressing your concern.
Yes sensorineural hearing loss is documented side effect of both the drugs, however it's very very rare and in my 1000 plus patients whom I have started telmisartan haven't seen any. However.
1) febustat is a relatively new drug, so I wouldn't start it again considering it will still take some years to completely know the side effect profile
2) you can start telmisartan but considering many other drugs which are as good available for controlling blood pressure we may consider using them rather than telmisartan
3) I wouldn't venture into homeopathic medication considering that your body has not reacted well to medication, the compound you have suggested, side effect profile is completely unknown.
I may consider
Tab cilacar M (10/50) in morning and plain cilacar 10 at night
It doesn't contain telmisartan and related group. Safe with minimal side effects.
This is a light dose and we may need to change according to the pressure reading
You may discuss the same with your GP.
Regards Dr Priyank Mody, Cardiologist, XXXXXXX
You should start with anti hypertensive medication
Detailed Answer:
Hello, I am Dr Mody and I would be addressing your concern.
Yes sensorineural hearing loss is documented side effect of both the drugs, however it's very very rare and in my 1000 plus patients whom I have started telmisartan haven't seen any. However.
1) febustat is a relatively new drug, so I wouldn't start it again considering it will still take some years to completely know the side effect profile
2) you can start telmisartan but considering many other drugs which are as good available for controlling blood pressure we may consider using them rather than telmisartan
3) I wouldn't venture into homeopathic medication considering that your body has not reacted well to medication, the compound you have suggested, side effect profile is completely unknown.
I may consider
Tab cilacar M (10/50) in morning and plain cilacar 10 at night
It doesn't contain telmisartan and related group. Safe with minimal side effects.
This is a light dose and we may need to change according to the pressure reading
You may discuss the same with your GP.
Regards Dr Priyank Mody, Cardiologist, XXXXXXX
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thank you. I will shift to cilacar till I meet my GP on Saturday a I am not too comfortable mentally with the old prescription. I am having some problem finding Cilacar M(10/50). I think there is a combination available of 10/40. Will I buy that or will I have plain Cilacar 10 twice? Hope this suits me and my doc continues with the same as I har its not good to keep changing BP medications.
Brief Answer:
Start with cilacar and may add concor afterwards according to BP
Detailed Answer:
Cilacar 10/40 has 40 mg telmisartan only so don't buy that.
Now telmisartan is of group of antihypertensive Called ARB, similarly there is a group of antihypertensive called Ace inhibitors. Togather they are the most popular anti hypertensive and widely used, as I wanted to avoid that in you decided to go with other group which are safe with whatsoever no side effects.
Also the next common group diuretics has a side effect on hearing, so I have refrained from the same.
Considering you have no asthma / lung problem. The best would be
Cilacar 20 mg at night and tab concor 5 mg in morning.
This combination will not only help reducing the blood pressure, but will protect your heart brain and kidney from long term effect s of hypertension which should be the primary aim.
I am just sceptical about drug causing sensorineural hearing loss because if it's medication than it should have been in both ears and not one, anyway s it best to be safe considering you are young.
You may discuss the same with your GP.
You may contact me directly through HCM
Ask a specialist /Dr. Priyank Mody
Regards
Start with cilacar and may add concor afterwards according to BP
Detailed Answer:
Cilacar 10/40 has 40 mg telmisartan only so don't buy that.
Now telmisartan is of group of antihypertensive Called ARB, similarly there is a group of antihypertensive called Ace inhibitors. Togather they are the most popular anti hypertensive and widely used, as I wanted to avoid that in you decided to go with other group which are safe with whatsoever no side effects.
Also the next common group diuretics has a side effect on hearing, so I have refrained from the same.
Considering you have no asthma / lung problem. The best would be
Cilacar 20 mg at night and tab concor 5 mg in morning.
This combination will not only help reducing the blood pressure, but will protect your heart brain and kidney from long term effect s of hypertension which should be the primary aim.
I am just sceptical about drug causing sensorineural hearing loss because if it's medication than it should have been in both ears and not one, anyway s it best to be safe considering you are young.
You may discuss the same with your GP.
You may contact me directly through HCM
Ask a specialist /Dr. Priyank Mody
Regards
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thanks. Will have two 10mg tabs at night. And Concor 5mg in the morning. Will update on what my GP advised.
Sorry... just found that Concor is a beta-blocker. Aren't all beta-blockers ototoxic to some extent?? Shall I start on that? Also regarding SSHL the literatures do say that it actually happens in one ear in most of the cases.....thankfully !!!
Sorry... just found that Concor is a beta-blocker. Aren't all beta-blockers ototoxic to some extent?? Shall I start on that? Also regarding SSHL the literatures do say that it actually happens in one ear in most of the cases.....thankfully !!!
Brief Answer:
Do go through the detailed answer.
Detailed Answer:
Happy to know you are aware of your condition.
Concor is cardiac specific beta blocker, ie. It acts only on beta 1 cells which are present on the heart only and so it doesn't have the peripheral side effects of previous beta blocker, also to be double sure there were isolated cases of oto toxicity, which was vestibular and not sensorineural.
As I said there will be no medication which will not have a single case reports. Also these reported cases are not sure that it happened because of the drug. It's just a coincidental finding.
2)for any medication is your blood, so if it has to cause nerve damage as it is supplying blood to both the ears, both will be affected to some extent the most commonly one ear is affected more than the other so complete loss occurs in one ear only (thankfully ) , however the tests should be able to pick up some action potential loss in other ear too, which was not in your case. Also this would reverse on stopping medication
As I said at your age we shouldn't take any risk. So I would not suggest you should continue the previous medication till we have other alternatives..
Hopefully that will resolve your anxiety.
Regards Dr Priyank Mody
Do go through the detailed answer.
Detailed Answer:
Happy to know you are aware of your condition.
Concor is cardiac specific beta blocker, ie. It acts only on beta 1 cells which are present on the heart only and so it doesn't have the peripheral side effects of previous beta blocker, also to be double sure there were isolated cases of oto toxicity, which was vestibular and not sensorineural.
As I said there will be no medication which will not have a single case reports. Also these reported cases are not sure that it happened because of the drug. It's just a coincidental finding.
2)for any medication is your blood, so if it has to cause nerve damage as it is supplying blood to both the ears, both will be affected to some extent the most commonly one ear is affected more than the other so complete loss occurs in one ear only (thankfully ) , however the tests should be able to pick up some action potential loss in other ear too, which was not in your case. Also this would reverse on stopping medication
As I said at your age we shouldn't take any risk. So I would not suggest you should continue the previous medication till we have other alternatives..
Hopefully that will resolve your anxiety.
Regards Dr Priyank Mody
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
Thank you. I have started with Cilacor 20mg from last night and m feeling better. Possibly the worry about Telmisartan had got me anxious. However the net seems rife on beta-blockers as a class being responsible for hearing loss etc including Bisopropol, like
https://healthunlocked.com/afassociation/posts/0000/bisoprolol-and-tinnitus
Is it not possible to contine BP management with calcium channel blockers only?? Even M (10/50) seems to have a beta-blocker.
Will be glad if you advise though possibly I have started bugging you !!!
https://healthunlocked.com/afassociation/posts/0000/bisoprolol-and-tinnitus
Is it not possible to contine BP management with calcium channel blockers only?? Even M (10/50) seems to have a beta-blocker.
Will be glad if you advise though possibly I have started bugging you !!!
Brief Answer:
Do go through the detailed answer
Detailed Answer:
No problem, i am happy to be challenged, it's helps you grow too.
Internet is full of info. Interpretation is important.
What you had forwarded is a blog, there is no scientific paper / proof for the same.
Yet, I am someone who will not disrespect a person because of my ego.
So I went through the link and many more you have sent in detail.
In there observations of over 60000 patients.
They found that in ppl who took bisoprolol the incidence of hearing loss (reversible) is 0.036 %. While incidence of ppl getting hearing loss when not on any medication or 0.004%, , hence bisoprolol caused hearing loss more frequently.
Now the incidence of heart event in inability patient of hypertension is 15 % every year. And bisoprolol protects 100% of its patients from having a heart event.
I am a clinician and I would think about the benefit to a patient against any risk.
I will give you an example how this data is compiled.
I am giving iron supplements /multivitamin to 1000 female patients between 40-50 years, and I'm 10 year followed up I found 3 patient had some new diabetes , whether it's due to multi vitamin I don't know. So I will say that multivitamin causes diabetis. So am I justified. It could have been just a natural phenomenon.
Lastly In my last answer only I had mentioned start on cilacar and if needed go to bisoprolol.
But the pressure reading you have mentioned is in stage 2 hypertension and you need a combination of drug to control (that's a observed notion).
Yes cilacar m has metoprolol which is a beta blocker.
Hoping this could help.
Do rate for ref of other patients.
You may directly axcess me next time for earlier response.
Regards Dr Priyank Mody
Do go through the detailed answer
Detailed Answer:
No problem, i am happy to be challenged, it's helps you grow too.
Internet is full of info. Interpretation is important.
What you had forwarded is a blog, there is no scientific paper / proof for the same.
Yet, I am someone who will not disrespect a person because of my ego.
So I went through the link and many more you have sent in detail.
In there observations of over 60000 patients.
They found that in ppl who took bisoprolol the incidence of hearing loss (reversible) is 0.036 %. While incidence of ppl getting hearing loss when not on any medication or 0.004%, , hence bisoprolol caused hearing loss more frequently.
Now the incidence of heart event in inability patient of hypertension is 15 % every year. And bisoprolol protects 100% of its patients from having a heart event.
I am a clinician and I would think about the benefit to a patient against any risk.
I will give you an example how this data is compiled.
I am giving iron supplements /multivitamin to 1000 female patients between 40-50 years, and I'm 10 year followed up I found 3 patient had some new diabetes , whether it's due to multi vitamin I don't know. So I will say that multivitamin causes diabetis. So am I justified. It could have been just a natural phenomenon.
Lastly In my last answer only I had mentioned start on cilacar and if needed go to bisoprolol.
But the pressure reading you have mentioned is in stage 2 hypertension and you need a combination of drug to control (that's a observed notion).
Yes cilacar m has metoprolol which is a beta blocker.
Hoping this could help.
Do rate for ref of other patients.
You may directly axcess me next time for earlier response.
Regards Dr Priyank Mody
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Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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