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Can You Suggest Whether To Stop Cold Turkey Or Gradually Anti-hypertensive Therapy?

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Posted on Mon, 16 Jan 2023
Question: I went to a "new" doctor in May 2018. I had a plethora of blood tests, all came back okay! Blood pressure was "high" doctor said during the visit. 140/101. I personally was elated at that number it was MUCH lower than it had ever been in previous visits to doctors and hospitals and I was excited at the progress! This being a new doctor I explained the history. The doctor listened but, then said I needed meds to control it. Only ever saw this gentleman once and he seemed unaffected by my history and progress as explained? The doctor only took my blood pressure "once" on that visit. It bothered me some to start taking these meds ( Losarton Potassium 50 mg.) no other doctors had prescribed it- even when the pressure was higher? However, I trusted this doctor at his word, and thought maybe I should try it? I began taking the Losartan in Mid May, it is now the first week of August. I have had one refill. The side effects have been horrible to include; Chest pains, coughing, heart palpitations, anxiety, mood swings, bad dreams, diarrhea, brain fog, dizzy, and back pain. These side effects were not "all at once" but, slowly progressed so, it was difficult at first to figure out what was wrong? One day was exceptionally bad and so I began researching online and was shocked to see the plethora of folks who were experiencing the same side effects while taking Losartan. I want to stop taking it and I want to go back to the natural methods I was using for controlling it - that were working which included removing salt from my diet, as well as any processed foods, sweets, cutting out caffeine, sugar and changing diet and exercise as well as vitamins and supplements! It was slow progress but, I was making it! I called the doctor and his assistant ( over the phone ) told me I could stop taking it. I asked repeatedly if it was "safe" to do this and she said my blood pressure could go back up, but that I could stop taking it -- the "choice" was up to me. I asked again, "I understand I have that choice- what I am asking you is if it is safe to do so?" The assistant repeated what the doctor said - I could stop taking it. However, everything you read online tells you to "taper off" and it makes me nervous - what is the right thing to do? Is is safe to simply stop this? I have a blood pressure reader at home to monitor but, am still very uncertain what to do. I have "one" full pill left before another refill is needed- so, in order to taper I would need to get another prescription- which of course I would do if necessary- but, that would require another visit to the doctor as well- and I would do that as well if it was necessary- however, it bears mentioning it may be more than a week for me to get that appointment so I truly am "stuck" and don't know what to do?
doctor
Answered by Dr. Ilir Sharka (1 hour later)
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello,

Regarding your concern, I would explain that it depends on your blood pressure values whether to stop cold turkey or gradually anti-hypertensive therapy.

If your blood pressure values are too low, stopping cold turkey anti-hypertensive therapy may be needed.

But, as your blood pressure values have dropped gradually due to your lifestyle modifications, a gradual reduce in the dose of Losartan is necessary, in order to avoid possible rebound hypertension.

Another option, considering the fact that you do not tolerate well Losartan, would be to switch to another drug like calcium channel blockers (amlodipine, lercanidipine) and then try to reduce gradually the dose of the drug, depending on your blood pressure values.

Thanks.
     
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ilir Sharka (30 minutes later)
Brief Answer:
My opinion as follows:

Detailed Answer:
Hello again!

What is the exact dose of Losartan that you are taking now? I would also like to know your mean blood pressure values during the day actually?

The main problem is your diastolic blood pressure values which is quite high. I agree with you that stopping abruptly Losartan may lead to blood pressure spike.

For this reason, I recommen dto gradually reduce the dose (first try half of the dose) and closely monitor your blood pressure values, in order to avoid blood pressure spikes.

Hope to have been helpful!

Wishing good health,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (4 minutes later)
I'm a little confused by your answer. Allow me to explain further. First, my blood pressure dropped "some" while on Losartan. But, not regularly. Meaning, it fluctuates constantly. The reduced blood pressure ( at the office ) was due to the lifestyle change before I started taking Losartan.

I have taken the Losartan now for two months and am asking it if is safe to "abruptly" stop taking it or if I should taper off? Again, I already spoke to my doctor and he said it was okay to stop taking it- but, there are so many conflicting answers I don't know who or what to believe?
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Follow up: Dr. Ilir Sharka (17 minutes later)
I am taking 50mg of Losarton right now. My reading ( taken just now ) was 164/98

Below is my question.

1. If I take "half" of the pill now and then continue to do that- how long will I have to do this before I can stop altogether?

doctor
Answered by Dr. Ilir Sharka (8 hours later)
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello again!

Thank you for the additional information!

Your blood pressure values are still high and stopping losartan abruptly or gradually would lead to uncontrolled high blood pressure.

For this reason, as you do not tolerate this drug, I would recommend switching abruptly to another antihypertensive drug, like lercanidipine.

You can stop taking 50mg of losartan abruptly and start that day 5mg of lercanidipine.

This way you will avoid blood pressure spikes.

A close monitoring of blood pressure values is necessary during these days.

Further increase in the dose of lercanidipine may be needed depending on your blood pressure values.

You should discuss with your doctor on the above issues.

Hope you will find this answer helpful!

Wishing good health,

Dr.Iliri
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9541 Questions

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Can You Suggest Whether To Stop Cold Turkey Or Gradually Anti-hypertensive Therapy?

Brief Answer: I would recommend as follows: Detailed Answer: Hello, Regarding your concern, I would explain that it depends on your blood pressure values whether to stop cold turkey or gradually anti-hypertensive therapy. If your blood pressure values are too low, stopping cold turkey anti-hypertensive therapy may be needed. But, as your blood pressure values have dropped gradually due to your lifestyle modifications, a gradual reduce in the dose of Losartan is necessary, in order to avoid possible rebound hypertension. Another option, considering the fact that you do not tolerate well Losartan, would be to switch to another drug like calcium channel blockers (amlodipine, lercanidipine) and then try to reduce gradually the dose of the drug, depending on your blood pressure values. Thanks.