Brief Answer:
Adverse Drug Reaction

Detailed Answer:
Dear XXXXXXX

Let me clarify your problem in two parts:

1. Due to Adverse Drug Reaction of actiblokipr (metoprolol), this causes insomnia and sleep disturbance and because of taking etizolam,sleeping disturbances can occur.
2. Again rebound hypertension.
3. XXXXXXX XXXXXXX vati is good option but has its own side effects and interaction.

kindly let me know if you want to continue further with the said drug (divya XXXXXXX vati)

Dr. Munish Sood

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Brief Answer:
Interactions and Curability.

Detailed Answer:
Dear XXXXXXX
Thanks for reverting back.
1.     Since you are on the said medicine since Dec 2012, so under no condition you should discontinue medicine on your own, consult with your Attending Physician regarding the possible side effects you are experiencing and any change in Dosage or other medicine free from said effects.
2.     In Insomnia, etizolam is given in a dose of 1-2 mg, and since dose prescribed was 0.5 mg it might not have given that therapeutic benefits for which it is indicated.
3.     You can continue with Actiblok IPR and gradually decrease the dose and shift to Ayurveda Medicine i.e. you can continue to take it as usual (8 a.m. in morning) and start taking “divya XXXXXXX vati” at night and because it contains herbs which have effect both on the heart as well as on the brain therefore it is suitable as both anti hypertensive as well as for proper sleep. [gradually reduce the dose of that medicine along with the intake of 'Mukta Vati'. Thereafter, you may stop taking that medicine.
4.     As you said you are pre hypertensive then take ‘mukta vati’ before breakfast and dinner (1 tablet), and will be more effective if it is chewed first and then water is taken.
5.      If you have to take it for longer period of time, even then there is no harm,will cure associated insomnia as well as uneasiness.
6. Mode of Administration:
i.     Take XXXXXXX vati with warm water, in my experience with patients in my Clinic ½ tablet in morning is good enough.
ii.     Avoid salt and salt XXXXXXX diet like: chutney, sauce, pickles, pop corn, namkeen, namkeen biscuits, papad, cheese, wafers, salted biscuits, salted peanuts/cashew nuts, salted butter milk.
iii.     Low fat diet: avoid saturated oils, deep fried foods, and unskimmed milk.
iv.     Increase fibre intake i.e. leafy vegetables, pulses and legumes, use skimmed or double toned low fat milk.
PS: use of “mukta vati” is related with nasal congestion and increase sensitivity to cold, if you experience the same, talk with your health care provider or revert back for prophylaxis of the same.

Dr. Munish Sood

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Brief Answer:
Side effects and Address

Detailed Answer:
Dear
Thanks for your prompt reply and concerns

1.Taking XXXXXXX vati cause two side effect(s): as noted by many patients:
. Due to presence of ‘sarpagandha’ in XXXXXXX vati, it causes nasal congestion which can be minimized by taking the drug with XXXXXXX warm water, or take the medicine (1 hour before food)
. likewise some have reported cold sensitivity problem; for this problem take ‘mukta vati’ before food and ‘medha vati’ or ‘brahmi vati’ after food.(dose should be the same).
2. You can visit Dr. XXXXXXX Vardhan,
DR KRANTHI'S INSTITUTE OF AYURVEDIC SCIENCES & RESEARCH, THE KERALA AYURVEDIC CARE, SPECIALITY PANCHAKARMA CENTRE,
3-6-101/1, ST NO: 19, BASHEERBAGH

Dr. Munish Sood

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Brief Answer:
Good Wishes

Detailed Answer:

Thanks for your replies given to my Consultation.

Best of Luck

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