Question to GP Maarten: High blood pressure and medication?
Maarten Vasbinder lives in Isaan. His profession is general practitioner, a profession that he mainly practiced in Spain. On Thailandblog he answers questions from readers who live in Thailand.
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Dear Martin,
Blood pressure remains a problem… after the debacle of the Exforge HCT 10mg / 160mg / 12,5mg which gave me the much too low blood pressure of around 80/60, I went back on my old meds.
The blood pressure seemed to go well at first with around 145/80, but in the past week it became higher again to at least 165/90. I measure it every two or three days.
Out of bed a little later this morning, 09.30 am and downstairs before coffee, a blood pressure of 195/105 pulse remains good, below 70. I'm going to worry about that now.
So I use Metoprolol 50mg in the morning and Enaril 20mg in the evening again. I have since lost 3 kg.
What do you recommend, increase the Enaril or use the Exforge again but in half a dose, or another alternative.
As always, I really value your opinion.
Yours faithfully,
J.
*****
Dear J,
My preliminary advice is to buy amlodipine 5mg. 1 tablet in the evening. Then take the Enaril after lunch. You can possibly increase the amlodipine to 10 mg after a week. If you get big legs, let me know.
Exforge has the disadvantage that you cannot increase or decrease the different drugs separately.
The advantage is only for the industry that can patent such a combination and thereby increase the price.
Sincerely,
Maarten
Do you have a question for Maarten and do you live in Thailand? Send this to the editor: www.thailandblog.nl/contact/ It is important that you provide the correct information (see list at the top of the page).