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Greetings. I Am Scheduled For An Outpatient Procedure To Remove
Question: Greetings. I am scheduled for an outpatient procedure to remove my nipple area because of the rare case of male Paget's Disease. My GP wanted to make sure that my BP was totally normal even with anxiety on the day of the procedure. Last week he prescribed 25mg Losartan, and in my visit today he decided to raise it to 100mg. What are the factors that cause BP not to respond to 25mg for slightly elevated numbers requiring an increase to 100mg, and how long is it necessary to continue that higher dose? Thank you.
Greetings. I am scheduled for an outpatient procedure to remove my nipple area because of the rare case of male Paget's Disease. My GP wanted to make sure that my BP was totally normal even with anxiety on the day of the procedure. Last week he prescribed 25mg Losartan, and in my visit today he decided to raise it to 100mg. What are the factors that cause BP not to respond to 25mg for slightly elevated numbers requiring an increase to 100mg, and how long is it necessary to continue that higher dose? Thank you.
My procedure is scheduled for August 27. Thank you.
My procedure is scheduled for August 27. Thank you.
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome to Ask a Doctor service!
I understand your concern and would explain that 25mg of Losartan is a really low dose.
So, it may not be able to maintain blood pressure values under control, especially if your mean blood pressure values are high.
You should know that the dose of the anti-hypertensive drugs depends on the patients blood pressure values. We can not make exact predictions, but we base our judgments about the anti-hypertensive drug and dose on the mean blood pressure values of the patient and his body weight, his commorbidities, his blood lab tests .
So, if this high dose lowers your blood pressure too much, it will be necessary to reduce the dose until your blood pressure values will be within the normal ranges.
If your blood pressure values are within the normal ranges, it will be necessary to continue on that dose for a long time. Arterial hypertension is a chronic disease, which needs to be treated for a long time (maybe all your life), if blood pressure values are not under control with natural ways (low salt and caffeine intake, weight loss, regular physical activity).
If blood pressure values remain high, they can cause irreversible changes to the heart and blood vessels, increasing the risk for stroke or myocardial infarction. That is why it is very important to try to maintain normal blood pressure values all the time.
Hope you will find this information helpful!
Kind regards,
Dr. Ilir Sharka, Cardiologist
I would explain as follows:
Detailed Answer:
Hello!
Welcome to Ask a Doctor service!
I understand your concern and would explain that 25mg of Losartan is a really low dose.
So, it may not be able to maintain blood pressure values under control, especially if your mean blood pressure values are high.
You should know that the dose of the anti-hypertensive drugs depends on the patients blood pressure values. We can not make exact predictions, but we base our judgments about the anti-hypertensive drug and dose on the mean blood pressure values of the patient and his body weight, his commorbidities, his blood lab tests .
So, if this high dose lowers your blood pressure too much, it will be necessary to reduce the dose until your blood pressure values will be within the normal ranges.
If your blood pressure values are within the normal ranges, it will be necessary to continue on that dose for a long time. Arterial hypertension is a chronic disease, which needs to be treated for a long time (maybe all your life), if blood pressure values are not under control with natural ways (low salt and caffeine intake, weight loss, regular physical activity).
If blood pressure values remain high, they can cause irreversible changes to the heart and blood vessels, increasing the risk for stroke or myocardial infarction. That is why it is very important to try to maintain normal blood pressure values all the time.
Hope you will find this information helpful!
Kind regards,
Dr. Ilir Sharka, Cardiologist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome to Ask a Doctor service!
I understand your concern and would explain that 25mg of Losartan is a really low dose.
So, it may not be able to maintain blood pressure values under control, especially if your mean blood pressure values are high.
You should know that the dose of the anti-hypertensive drugs depends on the patients blood pressure values. We can not make exact predictions, but we base our judgments about the anti-hypertensive drug and dose on the mean blood pressure values of the patient and his body weight, his commorbidities, his blood lab tests .
So, if this high dose lowers your blood pressure too much, it will be necessary to reduce the dose until your blood pressure values will be within the normal ranges.
If your blood pressure values are within the normal ranges, it will be necessary to continue on that dose for a long time. Arterial hypertension is a chronic disease, which needs to be treated for a long time (maybe all your life), if blood pressure values are not under control with natural ways (low salt and caffeine intake, weight loss, regular physical activity).
If blood pressure values remain high, they can cause irreversible changes to the heart and blood vessels, increasing the risk for stroke or myocardial infarction. That is why it is very important to try to maintain normal blood pressure values all the time.
Hope you will find this information helpful!
Kind regards,
Dr. Ilir Sharka, Cardiologist
I would explain as follows:
Detailed Answer:
Hello!
Welcome to Ask a Doctor service!
I understand your concern and would explain that 25mg of Losartan is a really low dose.
So, it may not be able to maintain blood pressure values under control, especially if your mean blood pressure values are high.
You should know that the dose of the anti-hypertensive drugs depends on the patients blood pressure values. We can not make exact predictions, but we base our judgments about the anti-hypertensive drug and dose on the mean blood pressure values of the patient and his body weight, his commorbidities, his blood lab tests .
So, if this high dose lowers your blood pressure too much, it will be necessary to reduce the dose until your blood pressure values will be within the normal ranges.
If your blood pressure values are within the normal ranges, it will be necessary to continue on that dose for a long time. Arterial hypertension is a chronic disease, which needs to be treated for a long time (maybe all your life), if blood pressure values are not under control with natural ways (low salt and caffeine intake, weight loss, regular physical activity).
If blood pressure values remain high, they can cause irreversible changes to the heart and blood vessels, increasing the risk for stroke or myocardial infarction. That is why it is very important to try to maintain normal blood pressure values all the time.
Hope you will find this information helpful!
Kind regards,
Dr. Ilir Sharka, Cardiologist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Dr. Sharka. So if 100 mg is keeping my numbers around 130-140 over 75-85 then there are no concerns for adverse effects? I have a supplement that I benefit from that has potassium. Is there a good alternative to Losartan that doesn't have potassium so I could use my supplement (each capsule has 300 mg potassium 300 mg magnesium) ??
Thank you Dr. Sharka. So if 100 mg is keeping my numbers around 130-140 over 75-85 then there are no concerns for adverse effects? I have a supplement that I benefit from that has potassium. Is there a good alternative to Losartan that doesn't have potassium so I could use my supplement (each capsule has 300 mg potassium 300 mg magnesium) ??
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello again!
Yes, if your blood pressure values are in these ranges, there is no reason to worry about.
Anyway, losartan does not contain potassium, but it can lead to high potassium levels.
For this reason, another alternative would be a calcium channel blocker ( amlodipine, lercanidipine) which do not affect potassium plasma levels.
You should discuss with your doctor on the above treatment options.
Hope you will find this information helpful!
Wishing all the best,
Dr.Iliri
I would explain as follows:
Detailed Answer:
Hello again!
Yes, if your blood pressure values are in these ranges, there is no reason to worry about.
Anyway, losartan does not contain potassium, but it can lead to high potassium levels.
For this reason, another alternative would be a calcium channel blocker ( amlodipine, lercanidipine) which do not affect potassium plasma levels.
You should discuss with your doctor on the above treatment options.
Hope you will find this information helpful!
Wishing all the best,
Dr.Iliri
Above answer was peer-reviewed by :
Dr. Raju A.T
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello again!
Yes, if your blood pressure values are in these ranges, there is no reason to worry about.
Anyway, losartan does not contain potassium, but it can lead to high potassium levels.
For this reason, another alternative would be a calcium channel blocker ( amlodipine, lercanidipine) which do not affect potassium plasma levels.
You should discuss with your doctor on the above treatment options.
Hope you will find this information helpful!
Wishing all the best,
Dr.Iliri
I would explain as follows:
Detailed Answer:
Hello again!
Yes, if your blood pressure values are in these ranges, there is no reason to worry about.
Anyway, losartan does not contain potassium, but it can lead to high potassium levels.
For this reason, another alternative would be a calcium channel blocker ( amlodipine, lercanidipine) which do not affect potassium plasma levels.
You should discuss with your doctor on the above treatment options.
Hope you will find this information helpful!
Wishing all the best,
Dr.Iliri
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank you, that is extremely interesting. Is there any difference in the effectiveness of maintaining my BP values with Norvasc or Lercanil as compared to Losartan?
The doctor seemed to insist on Losartan although I told him about my potassium supplement. I am not really so rigid about all of this, I just enjoy the effects of the potassium/magnesium product. Would there be a serious risk of taking it (300mg x 3 per day) while taking Losartan 100 mg in terms of leading to high potassium levels?
The doctor seemed to insist on Losartan although I told him about my potassium supplement. I am not really so rigid about all of this, I just enjoy the effects of the potassium/magnesium product. Would there be a serious risk of taking it (300mg x 3 per day) while taking Losartan 100 mg in terms of leading to high potassium levels?
Thank you, that is extremely interesting. Is there any difference in the effectiveness of maintaining my BP values with Norvasc or Lercanil as compared to Losartan?
The doctor seemed to insist on Losartan although I told him about my potassium supplement. I am not really so rigid about all of this, I just enjoy the effects of the potassium/magnesium product. Would there be a serious risk of taking it (300mg x 3 per day) while taking Losartan 100 mg in terms of leading to high potassium levels?
The doctor seemed to insist on Losartan although I told him about my potassium supplement. I am not really so rigid about all of this, I just enjoy the effects of the potassium/magnesium product. Would there be a serious risk of taking it (300mg x 3 per day) while taking Losartan 100 mg in terms of leading to high potassium levels?
Brief Answer:
Opinion as follows:
Detailed Answer:
Hello!
Let me explain that taking Losartan (in fact 100 mg is the maximal daily anti-hypertensive dose) and 900 mg daily potassium supplement would seriously increase the risk of elevated blood potassium level (hyperkalemia) with its potential dangerous effects.
I definitely would not recommend taking concomitantly such high daily doses.
Instead you may use Magnesium supplements (like Magnesium vitamin B6), that appear safe when on Losartan treatment.
Or, another alternative would be a different anti-hypertensive class drug (other than Losartan or RASi), like calcium channel blockers (I mentioned before). In such case potassium/magnesium supplements would be safe.
Let me know in case of any further questions.
Wishing you good health!
Regards,
Dr. Iliri
Opinion as follows:
Detailed Answer:
Hello!
Let me explain that taking Losartan (in fact 100 mg is the maximal daily anti-hypertensive dose) and 900 mg daily potassium supplement would seriously increase the risk of elevated blood potassium level (hyperkalemia) with its potential dangerous effects.
I definitely would not recommend taking concomitantly such high daily doses.
Instead you may use Magnesium supplements (like Magnesium vitamin B6), that appear safe when on Losartan treatment.
Or, another alternative would be a different anti-hypertensive class drug (other than Losartan or RASi), like calcium channel blockers (I mentioned before). In such case potassium/magnesium supplements would be safe.
Let me know in case of any further questions.
Wishing you good health!
Regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Opinion as follows:
Detailed Answer:
Hello!
Let me explain that taking Losartan (in fact 100 mg is the maximal daily anti-hypertensive dose) and 900 mg daily potassium supplement would seriously increase the risk of elevated blood potassium level (hyperkalemia) with its potential dangerous effects.
I definitely would not recommend taking concomitantly such high daily doses.
Instead you may use Magnesium supplements (like Magnesium vitamin B6), that appear safe when on Losartan treatment.
Or, another alternative would be a different anti-hypertensive class drug (other than Losartan or RASi), like calcium channel blockers (I mentioned before). In such case potassium/magnesium supplements would be safe.
Let me know in case of any further questions.
Wishing you good health!
Regards,
Dr. Iliri
Opinion as follows:
Detailed Answer:
Hello!
Let me explain that taking Losartan (in fact 100 mg is the maximal daily anti-hypertensive dose) and 900 mg daily potassium supplement would seriously increase the risk of elevated blood potassium level (hyperkalemia) with its potential dangerous effects.
I definitely would not recommend taking concomitantly such high daily doses.
Instead you may use Magnesium supplements (like Magnesium vitamin B6), that appear safe when on Losartan treatment.
Or, another alternative would be a different anti-hypertensive class drug (other than Losartan or RASi), like calcium channel blockers (I mentioned before). In such case potassium/magnesium supplements would be safe.
Let me know in case of any further questions.
Wishing you good health!
Regards,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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