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Does Eritelam And Toficalm Cause Uneasiness In Heart?

Posted on Fri, 14 Nov 2014

Question: Hi Doctor,

My mother (age:53) has been suffering from hypertension but it was normal as she was using 'Embita XR 25'. She has always been normal. Recently she started reporting heat flushes on the right side of her face which was going till her arms due to which her BP was rising quite high, and it started happening 2-3 times in a day. For this we took the medications from the doctors and went through all the possible tests, everything was normal, doctors couldnt conclude what could be reason as all the reports are normal. Some people we met said it could be because menopause. N
Now after a month she is much better and no such symptoms, during this time doctor has suggested her to take 'ERITEL AM', 'Toficalm 50mg', 'T.Tryptomer -25mg'. Since the time she is noticing her hear beat and its usually in the range of 95 to 100.
I suspect this could be because of all these medicines which she never took before the incident of heat rush. Do you think we can normalize or try reducing the dosages of above medicines.
Her major concern is to normalize her heart beat, how shall we do that. My mother likes to know if she can move back to "Embita XR 25' again. I would be really grateful if you can suggest anything

Regards
XXXX

Answered by Dr. Harshal Vora (2 hours later)

Brief Answer:
Yes she should start Embita xr at low dosage again

Detailed Answer:
Hello. Welcome to HCM.
I have read your question and understand your concerns.
The symptoms she is feeling is due to withdrawal of Embita xr tab which contains Metoprolol which usually lowers our heart rate and blood pressure. Sudden withdrawal of that tab will cause palpitations, uneasiness sensations.

My advice to you is -

1. Ask your doctor to start a low dose of Embita xr again with reduced dosage of Tab Elitel AM, because taking both tab will affect blood pressure. So reduced dosage of both tab can be tried. Gradually she will feel better and soon all symptoms will be gone.

2.Also please remember that from next time even if required don't stop Tab Embita xr suddenly but reduce the dosage first and then stop.

3. Continue other medicines like tab toficalm and tab tryptomer as both will reduce anxiety and depression. They have nothing to be related with palpitations.

4.Meanwhile if any further episode occurs of palpitations then just allow her to calm down and tell her to lie down. It will subcide by its own. Don't worry it's not dangerous.

I hope I have satisfied your queries. If you still have any questions you may ask any time. You are always welcomed by HCM.
Thank you.
Be healthy and your mother will get better soon.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Harshal Vora (14 hours later)

Hello Dr. Harshal,

Really appreciated your prompt reply. Its really so kind of you that to provide us with appropriate suggestion. You are absolutely correct.

I had made my mother read your post and she is very much satisfied, after reading she took the prescription to evaluate the drugs. To our XXXXXXX what we noticed is that her doctor had mentioned one drug named "Metoprolol-25mg" which we forgot to buy as it was not available on the drug store, and we had forgotten to buy it.
Your reply helped a great deal as it made us notice this drug which we have been missing for past 1 week, we are going to buy "Metoprolol-25mg" (as this could be a replacement for Embita xr) and let you know if it helped in normalizing my mothers heart rate.

Thanks
XXXX
XXXX

Answered by Dr. Harshal Vora (1 hour later)

Brief Answer:
Thanks a lot

Detailed Answer:
Thank you very much. You are always welcome from my side and from HCM

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Harshal Vora (31 hours later)

Hello Dr. Harshal,

We are really happy with your suggestions, as you are aware of the case my mother, she has also started taking "Metoprolol-25mg". Although she has been taking all the other medicines for past 3-4 weeks. She feels normal now with BP 110/80 and heartbeat 85-90

My mother insisted me to ask you when she can actually move back to her old Embita XR 25'. How many days do you think she should continue "Tab Elitel AM".

Also if you can suggest us the combination of dosages of "Metoprolol-25mg" and "Tab Elitel AM" together it would be great. I mean how much percentage of each she should take so that she gets back to only "Embita XR 25'.

Your suggestion would be highly appreciated.

Thanks
XXXX

Answered by Dr. Harshal Vora (15 minutes later)

Brief Answer:
Kindly read my detailed answer

Detailed Answer:
Hello welcome back again
.
Actually tab metoprolol and tab Embita xr are totally same tablets. If she wants then she can starts from Tommorow tab Embita xr instead of metopro xl

BOTH ARE SAME DRUGS WITH DIFFERENT COMPANIES ONLY.

Unfortunately there are no combinations available of all 3 drugs (metoprolol +telmisartan +amlodipine) and it's not recommended also.

So, my advice is just make a blood pressure chart of her with all this medicines and then if blood pressure is persistently low than her doctor can reduce dosage of sartel - AM tab. I think after a 15 days your doctor can reduce tab sartel-Am dosage.

Otherwise everything is normal at present.

I think I have given you satisfactory answer. If you feel the same then Kindly rate the answer.
Thank you.
Have a great life ahead.

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj