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Suggest dosage for Norvasc, Spironolactone, Diltiazem and Lisinopril for a hypertensive person

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Cardiologist
Practicing since : 2001
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Question
Hi. I think I'm doubting my doctor. My blood pressure runs around 130/70. I have been taking 1x180mg Diltiziem ER and 40 mg Lisinopril HCl daily. I have a new doctor and new meds today. I'm supposed to stop the Diltiziem and Lisinopril HCl and take: 1x40 mg Lisinopril (w/o HCL), 1 x 5 mg Norvasc, 1x4 mg Doxazosin Mesylate, and 1x25 mg Spironolactone daily. This seems like it is too much. Can I have you opinion please?
Sat, 9 Jun 2018 in Hypertension and Heart Disease
 
 
Answered by Dr. Ilir Sharka 36 minutes later
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome on HCM!

I passed carefully through your question and would explain that the new therapy is no too much (you are going to take 4 drugs instead of three).

There is no risk of low blood pressure with the new therapy.

Spironolactone is useful in increasing potassium levels and has a weak anti-hypertensive effect.

But you should know that switching from Diltiazem to Norvasc may lead to an increased heart rate.

In such case a beta blocker may be necessary to control better your heart rate

Anyway, if your blood lab tests are normal and you have a normal heart rate and a good compliance with your actual therapy, there is no need to make such changes.

You should discuss with your doctor about this issues.

Hope to have been helpful!

Best wishes,

Dr. Iliri



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