A friend of mine was started on metoprolol for elevated bp at 25mg and did not reduce her BP enough so the dose was increased. She felt lousy, tired weak etc, legs and feet resumed swelling and her md reduced dose back to 25mg and added valsartan 80mg. Since then the Val dose was increased to 120 and then 160m because of poor tolerance ( worsening fatigue, tiredness, leg swelling, the drug dose was reduced back to120mg but she generally feels poorly, experiences muscle aches,fatigue, and the foot and leg swelling persist. She can not take diuretics 0r Calcium channel blockers bed of a hx of multiple kidney stones and prior leg swelling on these e drugs. Are all these problems due to Met ?…, Val?…or to side effects produced by drug interactions involving the 2 drugs?? I failed to mention that because of leg swelling, she has been evaluated and presumably their is nothing in her blood work that helps explain her refractory Hpertension and very poor tolerance for the prescribed dose.; their does not appear to be any liver, kidney or other systemic disease that can explain the side effects and the inability to tolerate higher doses of the prescribed meds. Would you please let me know your thoughts? I, as a general internist, feel that many of the symptoms can be explained by the drugs alone and even worse in combination. What would a prudent person do ?? chrisgrad @comcast. net.