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Dr. Andrew Rynne

Family Physician

Exp 50 years

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I am on Labetalol 200 daily, Olmesartan 40 daily and

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Dr. Yogesh D

General & Family Physician

Practicing since :2009

Answered : 880 Questions

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Posted on Mon, 31 Dec 2018 in Internal Doctor Category
Question: I am on Labetalol 200 daily, Olmesartan 40 daily and clonidine 0.2 twice a day.. stopped Spironolactone in September after 15 years due to severe side effects, Chlorathiazide for 5 days last week and my sodium level has dropped to 119. my B/P is running between 140/72 and 170/90. any suggestions?
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Answered by Dr. Yogesh D 6 hours later
Brief Answer:
Very difficult to make recommendations due to so many medicines.

Detailed Answer:
Hello,

You are already on the best possible medicines for your high blood pressure.

Clonidine is the last drug used to bring down the blood pressure when all others are not making it come down adequately.

You have been given the best possible medicines and are in need of clonidine.

My suggestions would be to change Olmesartan to Telmisartan twice a day, continue clonidine, continue Labetalol, add a calcium channel blocker with chlorthiazide.

Your case is not very easy to manage owing to the fact that despite so many medicines, the blood pressure is not yet under good control.

This is mainly due to stress, and anxiety.

So, addition of an anxiolytic medicine is very likely to help you.

Please discuss with your cardiologist as well as your psychiatrist.

Hope this answers at least part of your query, if you need any clarifications, you most welcome to discuss with me.

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