Dear madam/ sir, welcome to HCM. At the outset I would like to warn you against using Depin under the tongue. It can unpredictably drop the BP drastically in some patients and lead to strokes and heart attacks. I rarely use clonidine
(arkamine) now a days since we have much better agents. When I need to stop ark amine, I do it very slowly over weeks rather than days. It is notorious to cause rebound hypertension
. Changing Metoprolol
(Metolar) to Labetolol (100mg TDS) might help in your case to counter act the rebound hypertension. If you have fluid retention (swelling of feet), a small dose of loop diuretic
(Lasix 20mg) might help controlling BP and the fluid retention as well. Moxonidine
(0.2mg BD) would be my next choice
if you are not having fluid retention. I would strongly recommend you to consult a friendly physician/ Nephrologist
to guide your management rather than self medicate (even if you are a doctor yourself). I hardly know your entire case details and hence would not encourage you to blindly follow my advice. The gist of what I want to tell you are 1) Stay clear of sublingual Depin. 2) Do not self medicate. 3) There are lot many other options to control BP, so dont panic and lose heart. If you BP is not getting controlled after appropriate advice from a nephrologist, you will need further investigations.