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Question: my age-48m Hypertenstion since 10 years at present iam using telmisartan 40mg morning, after break fast and Amlip-2.5mg, night after Dinner& Rozavel 5mg, my weight 69ks, hight 5.10ft , my BP yesterday 170/80 my Gen.MD Doctor prescribed Telma AM- 1 tab daily in the morning Dear Doctor what i have to go by
Brief Answer:
TELMA AM contains same telmisartan 40 mg and 5 mg amlodipine
Detailed Answer:
Hello Mr XXXXXXX , I am Dr. Mody and I would be addressing your concern.
I went through your query and reports .
I will enlist my observations.
1) Now you are not overweight by the stats you have sent me .
2) your lipid profile is perfectly ok and you may rather consider stopping Rosavel and continue lifestyle medications as it's has been sound that below 70 Ldl may just not be good
3) Now coming to your blood pressure problem.
As your blood pressure was high Inspite of being of 10 years on telmisartan and amlodipine, you needed an increase in dose of your antihypertensive medication .
TELMA AM contains two drugs in combination.
That is telmisartan 40 mg and amlodipine 5 mg , so effectively your doctor has increased 2.5 mg dose of amlodipine to the medication you were taking.
As you have started taking the medication, you may continue the same and keep a tab on the blood pressure, if still high we will make necessary changes. Otherwise it's a calculated change by your doctor and it's justified by all mean
4) you may consider taking vitamin D supplements
D rise XXXXXXX 60 k once a week in 200 ml of water or milk at night for 6 weeks atleast .
Hoping I could clear your doubts.
Let me know if any clarification needed.
Regards Dr Priyank Mody
TELMA AM contains same telmisartan 40 mg and 5 mg amlodipine
Detailed Answer:
Hello Mr XXXXXXX , I am Dr. Mody and I would be addressing your concern.
I went through your query and reports .
I will enlist my observations.
1) Now you are not overweight by the stats you have sent me .
2) your lipid profile is perfectly ok and you may rather consider stopping Rosavel and continue lifestyle medications as it's has been sound that below 70 Ldl may just not be good
3) Now coming to your blood pressure problem.
As your blood pressure was high Inspite of being of 10 years on telmisartan and amlodipine, you needed an increase in dose of your antihypertensive medication .
TELMA AM contains two drugs in combination.
That is telmisartan 40 mg and amlodipine 5 mg , so effectively your doctor has increased 2.5 mg dose of amlodipine to the medication you were taking.
As you have started taking the medication, you may continue the same and keep a tab on the blood pressure, if still high we will make necessary changes. Otherwise it's a calculated change by your doctor and it's justified by all mean
4) you may consider taking vitamin D supplements
D rise XXXXXXX 60 k once a week in 200 ml of water or milk at night for 6 weeks atleast .
Hoping I could clear your doubts.
Let me know if any clarification needed.
Regards Dr Priyank Mody
Above answer was peer-reviewed by :
Dr. Deepak
Dear,
Dr. XXXXXXX Mody
Previously iam using
1, Telmi sartan 40mg = 1 - 0 - 0
amlip 2.5mg = 0 - 0 - 1
or
2, telma am = 1 - 0 - 0
or
3, Telmi sartan 40mg = 1 - 0 - 0
amlip 5mg = 0 - 0 - 1
outoff above 2 & 3 shell i use single dose or in a separate combination
Thanking you Sir
Dr. XXXXXXX Mody
Previously iam using
1, Telmi sartan 40mg = 1 - 0 - 0
amlip 2.5mg = 0 - 0 - 1
or
2, telma am = 1 - 0 - 0
or
3, Telmi sartan 40mg = 1 - 0 - 0
amlip 5mg = 0 - 0 - 1
outoff above 2 & 3 shell i use single dose or in a separate combination
Thanking you Sir
Brief Answer:
2 is similar in efficacy to option 3 , and you can choose as per ur conveni
Detailed Answer:
Hello Sir .
The action of telmisartan and amlodipine would last for 24 hours even taken for a long time , so once daily dosage in enough , and also studies have proved combination therapy in hypertension to be more effective , so in view of reducing pill burden and better compliance.
TELMA AM combination once would be same as taking two medications at different times .
Lastly there would fair chance that your pressure might not get to 120 -130 / 80 -85 range ( ideal for you). So keep monitoring and by 2 weeks if the pressure is still high.
Than a better regime would be
Tab Telma CT (6.25) in morning and amlodipine (5mg) at night .
2 is similar in efficacy to option 3 , and you can choose as per ur conveni
Detailed Answer:
Hello Sir .
The action of telmisartan and amlodipine would last for 24 hours even taken for a long time , so once daily dosage in enough , and also studies have proved combination therapy in hypertension to be more effective , so in view of reducing pill burden and better compliance.
TELMA AM combination once would be same as taking two medications at different times .
Lastly there would fair chance that your pressure might not get to 120 -130 / 80 -85 range ( ideal for you). So keep monitoring and by 2 weeks if the pressure is still high.
Than a better regime would be
Tab Telma CT (6.25) in morning and amlodipine (5mg) at night .
Above answer was peer-reviewed by :
Dr. Naveen Kumar
XXXXXXX
18/02/2016.
Dear Doctor. XXXXXXX Mody,
I was very much satisfied with your answers I want to tell my medical detailed history
1, My Date of Birth 03-10-1968
2, my both of my parents have Hypertension.
3, my weight 69kgs, Height 5.10ft
4, I am Non-Diabetic
29-06-2007 I consult Gen.MD.Doctor my BP 186/88 checked 3 times periodically and advised
Tab - Norten - 10mg 1 – 0 – 1
17-07-2007 BP - 156/88
Tab - Norten - 10mg 1 – 0 –1
Tab - Lorvas 1 – 0- 0
14-08-2007 Bp - 146/80
Tab - Norten - 10mg 1 – 0 –1
Tab - Lorvas 1 – 0- 0
13-12-2007 BP - 140/80
Tab - Norten - 10mg 1 – 0 –1
Tab - Lorvas 1 – 0- 0
19-09-2008 BP 130/76
Tab - Norten - 10mg 1 – 0 –1
Tab - Lorvas 1 – 0- 0
13-03-2010 BP - 156/80
Tab - Tenoric - 25mg ½ - 0 -0
17-06-2011 BP - 160/80
Tab - Tenoric - 25mg 1 - 0 -0
02-07-2011 BP - 136/80, triglycerides - 221
Tab - Tenoric - 25mg 1 - 0 -0
Tab - Rozaval-F 0 – 0 -1
____________________________________________________________
12-09-2011 BP - 130/90, By consulting the Cardiologist Dr. he referred
Tab - Telmisartan - 20mg 1 – 0- 1
Tab - Rozaval-F 0 – 0 -1
19-01-2012 BP - 150/80
Tab - Telmisartan - 40mg 1 – 0- 0
Tab - Rosuvastatin 10mg 0 – 0 -1
28-12-2012 BP - 118/90
Tab - Telmisartan - 40mg 1 – 0- 0
Tab - Rosuvastatin 10mg 0 – 0 – 1
07-08-2013 BP - 150/80
Tab - Telmisartan - 40mg 1 – 0- 0
Tab - Rosuvastatin 5mg 0 – 0 – 1
____________________________________________________________
25-09-2014 BP - 160/70 (right hand) - 170/90(left hand)
Tab - Telmisartan - 40mg 1 – 0- 0
Tab - Rosuvastatin 5mg 0 – 0 – 1
Tab - Amlodine - 2.5mg 0- 0 – 1, given my
Cardiologist
08-07-2015 BP - 180/80
Tab - Telmisartan - 40mg 1 – 0- 0
Tab - Rosuvastatin 5mg 0 – 0 – 1
Tab - Amlodine - 2.5mg 0 - 0 – 1
15-02-16 BP - 176/80(left hand) - 166/80(right hand) according to
yours advise stopped Rozavel(LDL-56)
Tab - Telmisartan - 40mg 1 – 0- 0
Tab - Amlodine - 2.5mg 0- 0 – 1
Dear Doctor,
My main consulting you is after adding Amlodine referred by my Cardiologist from that time disturbance in sleep, BP is same, vitamin D only 23 at present I am using the above medicine only.
can you suggest me better medication waiting for your reply….
Thanking You Sir.
18/02/2016.
Dear Doctor. XXXXXXX Mody,
I was very much satisfied with your answers I want to tell my medical detailed history
1, My Date of Birth 03-10-1968
2, my both of my parents have Hypertension.
3, my weight 69kgs, Height 5.10ft
4, I am Non-Diabetic
29-06-2007 I consult Gen.MD.Doctor my BP 186/88 checked 3 times periodically and advised
Tab - Norten - 10mg 1 – 0 – 1
17-07-2007 BP - 156/88
Tab - Norten - 10mg 1 – 0 –1
Tab - Lorvas 1 – 0- 0
14-08-2007 Bp - 146/80
Tab - Norten - 10mg 1 – 0 –1
Tab - Lorvas 1 – 0- 0
13-12-2007 BP - 140/80
Tab - Norten - 10mg 1 – 0 –1
Tab - Lorvas 1 – 0- 0
19-09-2008 BP 130/76
Tab - Norten - 10mg 1 – 0 –1
Tab - Lorvas 1 – 0- 0
13-03-2010 BP - 156/80
Tab - Tenoric - 25mg ½ - 0 -0
17-06-2011 BP - 160/80
Tab - Tenoric - 25mg 1 - 0 -0
02-07-2011 BP - 136/80, triglycerides - 221
Tab - Tenoric - 25mg 1 - 0 -0
Tab - Rozaval-F 0 – 0 -1
____________________________________________________________
12-09-2011 BP - 130/90, By consulting the Cardiologist Dr. he referred
Tab - Telmisartan - 20mg 1 – 0- 1
Tab - Rozaval-F 0 – 0 -1
19-01-2012 BP - 150/80
Tab - Telmisartan - 40mg 1 – 0- 0
Tab - Rosuvastatin 10mg 0 – 0 -1
28-12-2012 BP - 118/90
Tab - Telmisartan - 40mg 1 – 0- 0
Tab - Rosuvastatin 10mg 0 – 0 – 1
07-08-2013 BP - 150/80
Tab - Telmisartan - 40mg 1 – 0- 0
Tab - Rosuvastatin 5mg 0 – 0 – 1
____________________________________________________________
25-09-2014 BP - 160/70 (right hand) - 170/90(left hand)
Tab - Telmisartan - 40mg 1 – 0- 0
Tab - Rosuvastatin 5mg 0 – 0 – 1
Tab - Amlodine - 2.5mg 0- 0 – 1, given my
Cardiologist
08-07-2015 BP - 180/80
Tab - Telmisartan - 40mg 1 – 0- 0
Tab - Rosuvastatin 5mg 0 – 0 – 1
Tab - Amlodine - 2.5mg 0 - 0 – 1
15-02-16 BP - 176/80(left hand) - 166/80(right hand) according to
yours advise stopped Rozavel(LDL-56)
Tab - Telmisartan - 40mg 1 – 0- 0
Tab - Amlodine - 2.5mg 0- 0 – 1
Dear Doctor,
My main consulting you is after adding Amlodine referred by my Cardiologist from that time disturbance in sleep, BP is same, vitamin D only 23 at present I am using the above medicine only.
can you suggest me better medication waiting for your reply….
Thanking You Sir.
Brief Answer:
Telma CT ( 40 +6.25) 1-0-0 and Tablet concor cor 5 mg 0-0-1
Detailed Answer:
Hello , I did go through the history you have provided in detail .
I won't comment on the previous regime as that's not me .
Now amlodipine is known to cause sleep disturbance . And generally if the patient has the same it should be avoided.
You may discuss the same with your cardiologist.
Now TELMA AM contains amlodipine and so that combination would not be ideal for you .
After considering everything .
Tab telma CT 1- 0- 0 in the morning and concor cor 5 mg at night .
Why do I suggest this
1) amlodipine causing insomnia is a class effect. It means that any drug group will cause the same .
Now considering that you are young we should start medications which will not just control your pressure but also protect your heart , brain , kidneys from long term side effect of hypertension.
Telmisartan is an effective medication to protect your kidney and XXXXXXX , and concor ( bisoprolol) and telmisartan will protect the heart .
Sir as you have been on the anti hypertensive for long term changing may cause acute fluctuations which will settle in a week . Take pressure after 3 days of starting the medication .
As this is not the best medium to monitor the medication, I would request you to discuss it with your MD doctor and make changes under his supervision.
Vitamin d should be supplemented . D rise XXXXXXX 60 k in a glass of warm water every weekend for 6 weeks
Do rate for others reference
Regards Dr Priyank Mody
Telma CT ( 40 +6.25) 1-0-0 and Tablet concor cor 5 mg 0-0-1
Detailed Answer:
Hello , I did go through the history you have provided in detail .
I won't comment on the previous regime as that's not me .
Now amlodipine is known to cause sleep disturbance . And generally if the patient has the same it should be avoided.
You may discuss the same with your cardiologist.
Now TELMA AM contains amlodipine and so that combination would not be ideal for you .
After considering everything .
Tab telma CT 1- 0- 0 in the morning and concor cor 5 mg at night .
Why do I suggest this
1) amlodipine causing insomnia is a class effect. It means that any drug group will cause the same .
Now considering that you are young we should start medications which will not just control your pressure but also protect your heart , brain , kidneys from long term side effect of hypertension.
Telmisartan is an effective medication to protect your kidney and XXXXXXX , and concor ( bisoprolol) and telmisartan will protect the heart .
Sir as you have been on the anti hypertensive for long term changing may cause acute fluctuations which will settle in a week . Take pressure after 3 days of starting the medication .
As this is not the best medium to monitor the medication, I would request you to discuss it with your MD doctor and make changes under his supervision.
Vitamin d should be supplemented . D rise XXXXXXX 60 k in a glass of warm water every weekend for 6 weeks
Do rate for others reference
Regards Dr Priyank Mody
Above answer was peer-reviewed by :
Dr. Deepak
DEAR DOCTOR XXXXXXX MODY EXCELENT ANSWERS GIVEN BY YOU
1 Next how to follow up you Mody Doctor ?
2 For hyper tension medication which doctor you prefer either a general physician or a Cardiologist ?
waiting for your reply….
Thanking You Sir.
1 Next how to follow up you Mody Doctor ?
2 For hyper tension medication which doctor you prefer either a general physician or a Cardiologist ?
waiting for your reply….
Thanking You Sir.
Brief Answer:
Do go through the detailed answer
Detailed Answer:
Hello Sir ,
1) You can follow up with me directly using the same online forum of health care magic by sending me an direct question , if you happen to come to XXXXXXX you can meet me at Lilavati hospital in Bandra
2) A good physician is well versed with hypertension and so a close follow up with him should be ok
3) Why i suggest telma CT , telma causes increase in potassium which is nullified by Chlorthalidone , so it's a good combination as the side effects get nullified.
However just add uric acid and electrolytes in the next investigation list to monitor any side effects of the drugs . Once in three months is ok
4) For concor, keep a tab on the pulse .
5) Because you were for so long on rosavel, the lipids will increase . How if Ldl is less than 130 , there is no scientific reason to justify it's use.
6)lastly .
A treadmill stress test every 2 yrs and urine micro albumin every 1 year and eye examination once in 3 years is ideal to see the effect of hypertension on body.
Hoping I could help .
Let me know ever if any help required.
Wishing you a healthy lifestyle.
Regards Dr Priyank Mody
Do go through the detailed answer
Detailed Answer:
Hello Sir ,
1) You can follow up with me directly using the same online forum of health care magic by sending me an direct question , if you happen to come to XXXXXXX you can meet me at Lilavati hospital in Bandra
2) A good physician is well versed with hypertension and so a close follow up with him should be ok
3) Why i suggest telma CT , telma causes increase in potassium which is nullified by Chlorthalidone , so it's a good combination as the side effects get nullified.
However just add uric acid and electrolytes in the next investigation list to monitor any side effects of the drugs . Once in three months is ok
4) For concor, keep a tab on the pulse .
5) Because you were for so long on rosavel, the lipids will increase . How if Ldl is less than 130 , there is no scientific reason to justify it's use.
6)lastly .
A treadmill stress test every 2 yrs and urine micro albumin every 1 year and eye examination once in 3 years is ideal to see the effect of hypertension on body.
Hoping I could help .
Let me know ever if any help required.
Wishing you a healthy lifestyle.
Regards Dr Priyank Mody
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Naveen Kumar
Answered by
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