Question: Dear Doctor ,
I am male 50 years old .Last about 8 years I have been hypertensive and have been taking following medicine
1.     Lotensyl 10 mg
2.     Nebicard 2.5 mg
3.     Metilda Forte ( Vit B12 + etc )
With this my BP has been under control .
About a year before I was diagnosed for diabetes ( border line ) –HBA1C was 6.4 I tried to control in with life style changes but I was not successful and last month when I all test done checked it had gone to 7.8 ( my fasting was 160 and PP 210 ) and last several months I also had disturbed sleep and I became used of Alperx 0.25 mg +5 mg Nitrest . I consulted to one MD doctor and he advised me as follows

1.     To discontinue Lotensyl 10 mg and start Teleact CT 40/12.5 mg of Ranbaxy
2.     Continue Nebicard 2.5 mg
3.     Citapin XR 1000 mg
4.     Crestor 10 mg 1 tab at night
5.     Nexito plus I tab before bed
6.     Nitrest 5 mg SOS ( But I have been taking it regularly as I do not get sleep with out this )
7.     To stop Metilda Forte ( Its Vit B12 etc )
8.     Bone Shine one XXXXXXX once in a month ( I had vid d deficiency but now its fine )
Questions :
1.     I have not discontinued lotesyl as combination of lotensyl and nebicard has been working very fine with me for my BP . I remember this combination suited me after lot of hit and trial and all other medicine were giving side effect .Please advise why I am being advised for change of this and switch over to TeleAct CT . Is it not advisable to use lotensyl for diabetics .
2.      I tried Crestor but it makes my stomach upset so I discontinued it .Suggest if there is some other alternate with no or least sife effect . Before this I tried Atorwin but that was also giving red flash on my f ace so I stopped it .
3.     Its more than a month starting Citapin 1000 mg but my fasting is 130 to 140 and PP around 180 .Does this medicine need change or I need to be continue for some more time .
4.     With Nexito plus + Nitrest 5 mg though I am able to sleep but I do not get sound sleep . Does it require some changes .
5.     Why he advised me to discontinue Metilda ? .Though my Vit B12 test showed ok but it was slightly higher than lower limit . I am told for diabetics its better to have this capsule regularly
Look forward to your advise on above to lead healthy life .

Regards

XXXX

Dear Doctor ,

Thnaks for prompt and detailed reply .Against your answers I have mentioned few more questions and seek your advise
Few more questions :
2...You can do two things.Either you switch it with SIMVASTATIN or pravastatin or you can reduce the dose of Crestor to 5 mg and add EZETIMIBE to it.

Q: Sugest me some brand which has combination of crestor 5 mg + EZEtTIMIBE

3...Your blood sugar levels are still slightly high.If I was your treating doctor,I would have added a GLIPTIN like SITAGLIPTIN or VILDAGLIPTIN to your treatment for a better sugar control.

Q Suggest me some brand which has combination of Metformin also .Its dose and timings

4...Carry on with your sleeping tablets.

When I travel to different time zone I again have sleeping problem .Suggest me some new medicine to add or I should increase dose of Nexito plus + Nitrest

5...In my opinion VIT B12 should be continued because you are on metformin,which depletes VIT B12 levels.

Q Should I continue with Metilda Forte or you advise some other good brand

6...keep taking VIT D and calcium. I have been taking Vid only For calcium please advise some good brand or combination of these two with right dose

Thnak s for all the help .
Last clarification :

Sleeping pill :( Nexito plus + Nitrest 5 mg ) .When I travel to different time zone ie US which additional pill will I require / or I need to increase dose of these medicines

ZANUVIA : How many days will it take to act on and when should I consult you again . What test should I get done for consuting you again

with best regards