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Can Lisinopril Or Losartan Be Taken Instead Of Metroprolol?

Posted on Tue, 10 Nov 2015

Question: What are the risks of moving from the old standard Metroprolol to such as Lisinopril or losartan? also have some kidney damage to one kidney due to radiation therapy - but has been stable for the past 5-6 years

Answered by Dr. Pavan Kumar Gupta (3 hours later)

Brief answer....switching from metoprolol to lisinopril or losartan should be done gradually.
Detailed answer...
Hello,
Thanks for the query.
I have read your query and understand your concern.
Following abrupt cessation of metoprolol or as a matter of fact any beta blocker,execration of angina symptoms can be seen and in few cases even myocardial infarction has also been noticed.
In lieu of this fact,this switching should be done gradually over a period of 2-4 weeks with tapering of doses as well as close monitoring by your doctor.
I hope it helps,however you are most welcome to revert to me for any further query.
Best of luck
Thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pavan Kumar Gupta (3 days later)

Dr. XXXXXXX Thank you for the prompt response to my initial question. As a follow up please comment on the following:

1. Is there any real benefit in switching from Metroprolol, which I have been taking for over 7 years "without any significant side effect" to one of the other mentioned - Lisinopril or Losartan ?

2. Can you confirm the new metrics for recommended treatment of elevated blood pressure - we have read that it is now 150/90 particularly in elder people ?

Thank you again for the response

Answered by Dr. Pavan Kumar Gupta (2 hours later)

Hello,
Really a good question.
Very frankly speaking not much of a benefit if you are not suffering from diabetes.
In fact the only reason for shifting from metoprolol to lisinopril or losartan is that these drugs are little bit more kidney protective,however this kidney protection is seen more in diabetics.
Since your other kidney has been damaged a bit by radiation,your doctor might be contemplating to switch the medicines just to provide a bit of security to the other kidney although metoprolol is not damaging to any kidney.
Ideally speaking just a marginal benefit. Not much.
As far as answer to 2nd query is concerned,the answer is yes.
The guide lines have changed recently and it says that in elderly people a BP of 150/90 is acceptable.
Thanks

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