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Suggest Treatment For Insomnia

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Posted on Wed, 6 May 2015
Question: I am a 76 year old woman. I take Diovan HCT and Toprol XL. I probably should be taking it every day (1 of each) but I've been taking it sporadically. When I take the Diovan HCT, my blood pressure is good the next day, but the pulse is too high. When I take the Toprol XL, it brings the pulse down to normal, but the blood pressure goes up. Do you think it would be okay to take a lower dose of each one and take both of them every day? I have insomnia problems, so what would be the best time to take the meds so they won't cause more insomnia?
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Answered by Dr. Panagiotis Zografakis (1 hour later)
Brief Answer:
I would suggest taking both

Detailed Answer:
Hello,

diovan HCT contains valsartan and hydrochlorthiazide. Toprol XL contains metoprolol. Diovan HCT is a potent antihypertensive drug. That's why you've seen this difference in efficacy between the two drugs. Toprol XL is also an antihypertensive drug but a much less potent one. It is very efficient in reduced the pulse rate though.

Unless your doctor has specified different targets for you, then a good target for your heart rate is about 60 beats per minute and for the blood pressure between 130 and 140 (systolic) and 70-85 (diastolic).

In patients like you, I suggest keeping the potent drug (diovan HCT) and taking the less potent one (Toprol XL) in a dose that fits the circumstances. If your blood pressure after taking diovan is less than 130 then I suggest taking only half (or a quarter only) dose of toprol. Take it at the morning to avoid sleeping disturbances. Diovan has to be taken at the morning also, because of the diuretic - taking it at night would make you visit the toilet all night!

Contact me again, if you'd like further details.

Kind Regards!
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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Answered by
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Dr. Panagiotis Zografakis

Internal Medicine Specialist

Practicing since :1999

Answered : 3809 Questions

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Suggest Treatment For Insomnia

Brief Answer: I would suggest taking both Detailed Answer: Hello, diovan HCT contains valsartan and hydrochlorthiazide. Toprol XL contains metoprolol. Diovan HCT is a potent antihypertensive drug. That's why you've seen this difference in efficacy between the two drugs. Toprol XL is also an antihypertensive drug but a much less potent one. It is very efficient in reduced the pulse rate though. Unless your doctor has specified different targets for you, then a good target for your heart rate is about 60 beats per minute and for the blood pressure between 130 and 140 (systolic) and 70-85 (diastolic). In patients like you, I suggest keeping the potent drug (diovan HCT) and taking the less potent one (Toprol XL) in a dose that fits the circumstances. If your blood pressure after taking diovan is less than 130 then I suggest taking only half (or a quarter only) dose of toprol. Take it at the morning to avoid sleeping disturbances. Diovan has to be taken at the morning also, because of the diuretic - taking it at night would make you visit the toilet all night! Contact me again, if you'd like further details. Kind Regards!