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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Should Metoprolol And Lisinopril Be Discontinued While Having Low BP?

I am a 77 yr old male with laryngeal cancer I have had 3 rounds of chemo using Gemzar and Carboplatin I also take 20mg Lisinopril and 25mg Metroprolol Succinate ER once daily. My blood pressure has been very low normal is in the mid 130's over 70-80 since starting chemo the highs have been 119 over 60 and most lately it has been 85 over 52 know can say difinitively whether I should continue or suspend the heart meds I am extreley tired and sleep most of the day and night.
Fri, 10 Nov 2017
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Ayurveda Specialist,  's  Response
**
Thanks, for contacting with your healtth concern

1. Metoprolol is a beta blocker use to treat high blood pressure apart fom anxiety, migraine, but comes with black box warning which says that one should not stop the drug suddenly since it may cause chest pain, rebound high blood pressure or evena heart attack so it is best to first consult your attending physician who will not stop but will gradually decrease the dose.

2. Lisinopril is an ACE inhibitor use to treat high blood pressure, heart failure and after heart attacks and dizziness, headache, low blood pressure are ADR [adverse drug reaction] of the drug, and discontinuing or suspending the medicine(s) will not help since stopping for few days will not help the medicine to be processed out of the body.

PS. It might be causing orthostatic hypotension.

3. Recent study has revealed that there is positive drug drug interaction between oral cancer drugs with:
- proton pump inhibitor's [PPIs]
- anti hypertensive medicine [particularly calcium channel blocker]
- steroids, some antibiotics and antifungal drugs

PS. So your attending physician or Cardiologist is in best position to take care of the symptoms and manage them accordingly.
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Should Metoprolol And Lisinopril Be Discontinued While Having Low BP?

** Thanks, for contacting with your healtth concern 1. Metoprolol is a beta blocker use to treat high blood pressure apart fom anxiety, migraine, but comes with black box warning which says that one should not stop the drug suddenly since it may cause chest pain, rebound high blood pressure or evena heart attack so it is best to first consult your attending physician who will not stop but will gradually decrease the dose. 2. Lisinopril is an ACE inhibitor use to treat high blood pressure, heart failure and after heart attacks and dizziness, headache, low blood pressure are ADR [adverse drug reaction] of the drug, and discontinuing or suspending the medicine(s) will not help since stopping for few days will not help the medicine to be processed out of the body. PS. It might be causing orthostatic hypotension. 3. Recent study has revealed that there is positive drug drug interaction between oral cancer drugs with: - proton pump inhibitor s [PPIs] - anti hypertensive medicine [particularly calcium channel blocker] - steroids, some antibiotics and antifungal drugs PS. So your attending physician or Cardiologist is in best position to take care of the symptoms and manage them accordingly.