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Does Ferrous Sulfate Interact With Nifedipine, Metoprolol And Diovan?

Posted on Wed, 15 Mar 2017

Question: Can you comment about any contraindications of my mothers drugs. Shes 92 years old. Has atrial fibriation ( controlled) . Has CHF and gets pitting edema in ankles and feet ...watches salt and takes occasional
20 mg of lasix....
Meds----are....she
Takes 45mg of ferrous sulfate. One per day for low ferritin level...
Hctz-25mg daily
Nifedipine--- 30 mg 2 times a day
Metoprolol--50 mg once a day
Diovan- 320 mg per day
Multaq-- 400 mg 2 times a day
Recently her htn has been worse. She complains of getting hot and hot feeling. Then bp is elevated!!!!!!
The only newer drug is the ferrous sulfate... Im concerned the iron is effecting her blood pressure . Does ferritin sulfate effect the effectiveness of her blood pressure meds???

Answered by Dr. Rishu Saxena (24 minutes later)

Brief Answer:
No ferritin sulphate has no effect on B.P medications.

Detailed Answer:
Hi
Thanks for choosing HealthcareMagic for your query!
As per your question iron and its derivatives have no effect on blood pressure and ferritin sulphate has no effect on blood pressure as such or blood pressure medicines she is on.
Though not asked yet as she is on a number of medication i would suggest you to ask your cardiologist to shift her on iron polypeptide 12 or 6mg per day dose.Iron polypeptides are much safer and well tolerated by patients as compared to other iron salts. Nifedipine should be replaced by amlodipine. Nifedipine causes severe dilation of veins leading to tachycardia which may precipitate a attack of angina in patient of CHF.
In case you have any other query feel free to ask.
Thanks

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Rishu Saxena (7 hours later)

Dr may i ask a follow up??? Mother is 92. She recently complaining of feeling hot , no fever, bp was 192/65/79... had a head ache. She took one clonidine and bp went down overnight to normal. Doctor prescribed regular methyldopa... described as an old blood pressure medication on top of her nifedipine, metoprolol, multaq ( for a fib) and diovan. What would be your comments on methyldopa?? Mom has one kidney ... creatinine is 1.5.

Answered by Dr. Rishu Saxena (1 hour later)

Brief Answer:
Follow the advice

Detailed Answer:
Hi,

Initially i would suggest you to discuss with your doctor to shift her from Nifedipine (reflex tachycardia can precipitate angina) to Amlodipine.

Secondly Methyl-dopa should not be given. Clonidine is a much better option considering her age. Clonidine is a centrally acting alpha-agonist and is a very safe drug much safer in elderly compared to methyl dopa.

Now a days, use of Methyl dopa is usually restricted to treat hypertension in pregnancy.
Please discuss these options with your cardiologist.
Thank you.

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Above answer was peer-reviewed by : Dr. Arnab Banerjee