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Can Losartan Be Taken In Place Of Cilacar?

Posted on Mon, 19 Oct 2015

Question: Hi,

This is a question for my Mom. My Mom has been taking Atenolol-50mg(morning) and Cilacar-5mg(night) for nearly 2-3 years. Is it advisable to stop and change over to only Cilacar-5mg twice a day? Or would it be advisable to replace Atenolol-50mg with Losartan-50mg?

Also is Losartan-50mg better and safer than Cilacar-5mg.

Thanks in advance.

Thanks,
XXXX

Answered by Dr. Priyank Mody (23 minutes later)

Brief Answer:
Atenolol / cilacar is a good combination if blood pressure well controlle

Detailed Answer:
Hello, I am Dr Mody and I would be addressing your concern.

Firstly I would wish to know why do you want to change the drug. It it having side effects or the blood pressure is not being controlled by the same.
Now going through multiple possibility.
You cannot suddenly shift from atenolol to any other drug as there is a chance of rebound hypertension, so if at all you wish to change it should be gradually done. Losartan is a good option.

Now atenolol, losartan and clinidipine all belong to different group of anti hypertensive, have different side effects and different mechanism of action , however I can reassure you that they are the best three classes of drug.
So to second query. No for twice clinidipine.

It's always better to use two drugs with different mechanism for added benefit and greater protection of heart, brain and kidney. Eg, atenolol will protect the heart against long term blood pressure, while clinidipine will decrease protein loss and hence protect the kidneys. So their benefits are supra additive..
Cilacar is one of the safest anti hypertensive and and hence replacing it with losartan is not justified..
Also do send me the present blood pressure, pulse and any side effects, so I can recommend the best combination.

Regards Dr Priyank Mody

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Priyank Mody (1 hour later)

Hello Dr Mody,

Thank you very much for the very detailed response.

My Mom's BP ranges from 128-147/ 82-94 and pulse ranges from 52-68. And I am concerned with the amount of variations in her BP and Pulse. Also with her Pulse this low. Not sure if this was a side effect of the BP Medication. other than this, Mom does not get much sleep on some nights. She is 64 years old.

Thanks,
XXXX

Answered by Dr. Priyank Mody (13 hours later)

Brief Answer:
May consider change of atenolol to bisoprolol

Detailed Answer:
Hello XXXXXXX
I do understand your concern.
One misunderstanding I would like to , is about pulse. Ideal pulse rate is between 50-60 at rest, even if tomorrow you hit the gym by 6 months your pulse rate will go low, it's a sign of healthy heart, it means that the heart is able to compensate for all workload without having to work hard.
Now for your Mother, it atenolol which is decreasing the pulse rate
So now coming to the question.
Atenolol has a shorter half life ie, 8 hours, so the variation. It means you give atenolol in morning and by 8 hours it's effect starts weaning while the next cilacar is after 12 hours leading to variation in BP. However when atenolol is given for long time this variation in minimum
Also we have to understand that pulse and blood pressure are vitals of body it means it will change every other minute according to the need of the body, rather if it doesn't change than there is a problem, it means our heart is .
So my suggestion for my patients in such a situation would be.
Tab bisoprolol 5 mg in morning instead of atenolol 50, which is the same drug and better side effect profile (atenolol causes some sleep disturbance) and cilacar at night (it is very mild dose).
Hoping I could help.
Do rate for others ref.
Regards Dr Priyank Mody

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Above answer was peer-reviewed by : Dr. Sonia Raina