Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Dosage For Envas
Question: One of my patient is on T. Metoprolol XL 25mg OD (essential hypertension) since last 4 years. His age is 32 years. Yesterday he contacted me for experiencing erectil dysfunction. Now I am planning him to put on ACE inhibitor. My questions are 1. How to taper Metoprolol XR 25mg? 2. What should be initial dose of Envas (ACE inhibitor) , 2.5/5/10mg? And 3. Timing for starting Envas i.e during tapering phase or after completely stopping Metoprolol? Thank you.
Brief Answer:
Please refer to the detailed answer below
Detailed Answer:
Hello
After going through the medical details provided by you i would like to tell you that its good to slowly tapper the dose of metoprolol and side by side adding ACE inhibitor in the lowest possible dose.
Reduce the dose of Metoprolol to 12.5mg od and along with this add 1.25 mg of ACE inhibitor. Tell the patient to monitor the BP regularly of 7 days and follow up after 7 days. if bp is maintaining fine you can stop beta blocker and add ace inhibitor to 2.5mg od preferably in the morning of during that time of the day when bp remains high in your patients case.
Tell the patient to follow up after 14 days with blood pressure charting during these 14 days.
I hope this information will be helpful.
Kind Regards
Dr Bhanu Partap
Please refer to the detailed answer below
Detailed Answer:
Hello
After going through the medical details provided by you i would like to tell you that its good to slowly tapper the dose of metoprolol and side by side adding ACE inhibitor in the lowest possible dose.
Reduce the dose of Metoprolol to 12.5mg od and along with this add 1.25 mg of ACE inhibitor. Tell the patient to monitor the BP regularly of 7 days and follow up after 7 days. if bp is maintaining fine you can stop beta blocker and add ace inhibitor to 2.5mg od preferably in the morning of during that time of the day when bp remains high in your patients case.
Tell the patient to follow up after 14 days with blood pressure charting during these 14 days.
I hope this information will be helpful.
Kind Regards
Dr Bhanu Partap
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
