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Suggest treatment for headaches, neck and shoulder pain and high BP

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Posted on Tue, 12 May 2015
Question: Iam a 66-year-old female with a genetic disorder and a cyp450 methylation problem and am havin66g difficulty with BP medications. I had a stress test that was normal however I'm having great difficulty in finding a blood pressure medication that suits me well without major side effects. I'm currently on 100 mg of like losortan potassium, 5mgs of bystolic and 25 mgs of hctz. I started with 25 mg of Losortan potassium then 50 mg and now 100 mg of which none change my blood pressure readings My.cardiologist poop poos all my symptoms and says don't read the side effects. The symptoms have been so severe that I am getting horrible leg pain, tension headaches and back neck spasmsconstantly . I'm tired but also have insomnia and nausea. I stopped Losortan for approximate a week I felt better but I still had tremendous neck and shoulder pain. My BP readings are between 145/74-54 to 168/75-54. With or with out the losortan .I'm beside myself because I'm scheduled for surgery and I'm afraid with BP not properly controlled.What options might you suggest so I can discuss this with my PCP.
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Answered by Dr. Ilir Sharka (1 hour later)
Brief Answer:
You can try more safer alternatives for your high BP management.

Detailed Answer:

Hello!

Thank you for asking on HCM!

I understand your concern, and would like to explain you that, as you are having those disturbing side effects, I recommend to stop immediately Losartan, and try another more safe profiled alternative.

From the other part, Losartan as well as Irbesartan are highly metabolized by CYP450 pathway, and this is another reason why you shouldn't use them.

You can use instead one of the following Valsartan, Eprosartan, Candesartan that are not metabolized by CYP450 system.

Hydrochlorothiazide has no significant interaction with the cytochrome P450 system, so you can safely continue its use.

Bisoprolol is partially metabolized by the liver, so you can continue using it very cautiously.

You can discuss with your doctor about these topics, and decide another more safe alternative to Losartan.

Hope to have been helpful to you.

If you have any additional uncertainties, feel free to ask me whenever you need.

Greetings! Dr. Iliri

Above answer was peer-reviewed by : Dr. Pradeep Vitta
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 8351 Questions

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Suggest treatment for headaches, neck and shoulder pain and high BP

Brief Answer: You can try more safer alternatives for your high BP management. Detailed Answer: Hello! Thank you for asking on HCM! I understand your concern, and would like to explain you that, as you are having those disturbing side effects, I recommend to stop immediately Losartan, and try another more safe profiled alternative. From the other part, Losartan as well as Irbesartan are highly metabolized by CYP450 pathway, and this is another reason why you shouldn't use them. You can use instead one of the following Valsartan, Eprosartan, Candesartan that are not metabolized by CYP450 system. Hydrochlorothiazide has no significant interaction with the cytochrome P450 system, so you can safely continue its use. Bisoprolol is partially metabolized by the liver, so you can continue using it very cautiously. You can discuss with your doctor about these topics, and decide another more safe alternative to Losartan. Hope to have been helpful to you. If you have any additional uncertainties, feel free to ask me whenever you need. Greetings! Dr. Iliri