Why Was Metoprolol Removed From His Prescription?
 
                                    
                                    
                                          
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                                           Fri, 10 Feb 2023
                                           
                                        
                                        
                                        
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                                                Fri, 10 Feb 2023
                                                
                                            
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                                                Tue, 6 Aug 2024
                                                
                                                
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                                            Question : Good day doctor. My father-in-law is 83 years old with a history of high blood pressure and sometimes high heart rate. 3 months ago, he had very high blood pressure and felt dizzy. He visited hospital emergency and later discharged with no significant impact. His Rampiril changed to a higher dosage of 10mg after discharge. In addition, He used to take a higher dosage of Ramipril (10mg capsule). Later he suffered from periodic low blood pressure during the day so his cardiologist reduced Ramipril first to 5mg and later on to 2.5mg.  
However, he fell recently and the emergency cardiologist suspected that the fall was likely triggered by low blood pressure. As he recovered well, he was discharged from hospital. Emergency cardiologist suggested to reduce his medication so to alleviate high blood pressure. However, the new perscription shows Rmipril jumped up to 10mg instead of going down. but Metoprolol was removed.while Ramipril increased 4 times.
My question - why was Metoprolol removed from his perscription? does removing 2.5mg of Metoprolol justify the significant increase in Ramipril? I would appreciate if you could help me to understand the difference and similiarities between Metoprolol and Ramipril in terms of lowering blood pressure.
                            However, he fell recently and the emergency cardiologist suspected that the fall was likely triggered by low blood pressure. As he recovered well, he was discharged from hospital. Emergency cardiologist suggested to reduce his medication so to alleviate high blood pressure. However, the new perscription shows Rmipril jumped up to 10mg instead of going down. but Metoprolol was removed.while Ramipril increased 4 times.
My question - why was Metoprolol removed from his perscription? does removing 2.5mg of Metoprolol justify the significant increase in Ramipril? I would appreciate if you could help me to understand the difference and similiarities between Metoprolol and Ramipril in terms of lowering blood pressure.
                                    Brief Answer:
Kindly refer below
Detailed Answer:
Hello
Thanks for the detailed information. After going through the medical query I can understand your concern and I would like to tell you that Metoprolol belongs to beta blocker group which is mainly used to keep heart rate under control. Ramipril on the other hand belongs to ACE inhibitor group which causes blood vessels to relax thereby lowering blood pressure.
Now in your father-in-laws case there is a history of syncope (loss of consciousness) there by causing fall.
Probably the treating doctor might have assessed low heart rate as a cause of syncope that’s why they have stopped metoprolol.
Regards
                                    
                            Kindly refer below
Detailed Answer:
Hello
Thanks for the detailed information. After going through the medical query I can understand your concern and I would like to tell you that Metoprolol belongs to beta blocker group which is mainly used to keep heart rate under control. Ramipril on the other hand belongs to ACE inhibitor group which causes blood vessels to relax thereby lowering blood pressure.
Now in your father-in-laws case there is a history of syncope (loss of consciousness) there by causing fall.
Probably the treating doctor might have assessed low heart rate as a cause of syncope that’s why they have stopped metoprolol.
Regards
 Above answer was peer-reviewed by :
                              
                            
                                  
                                      Dr. Chakravarthy Mazumdar
                                  
                              
                                         
 
                                    
                                    
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