Q: I am a 44 years old male suffering from blood pressure and diabetes for the past eight years. I am taking these medicines - Triperide - 1, Riomet - 500, Telsar – H and Nebicard – 5 once in a day. Presently, my sugar level and blood pressure levels are under control. In the recent test, it is found that my HbA1c is 5.9 mm/dl, fasting blood sugar level is 101 mm/dl, Creatinine is 0.7 and my blood pressure is 130/90 mmHg. I am worried whether the above-mentioned medicines have any side effects as I am taking these drugs for the past four years. Do these medications have side effects?

A:In all you are taking seven medicines. Tripride is the brand name; it contains three medicines: metformin, glimepiride and pioglitazone. Riomet contains metformin. Thus you are consuming and getting over-dosed with metformin twice, in Tripride and Riomet. Telsar-H also contains two drugs namely telmisartan and hydrochlorothiazide. Nebicard contains nebivolol. It is never a good idea to consume 3-in-one products such as Tripride because the dose of individual medicines can not be tirtated/altered and side effects get added up. Nebivolol (Nebicard) should be avoided in diabetcs because it increases blood glucose levels and thus reduces the efficacy of medicines meant for diabetes. In England, for example, Nebicard is administered only if other medicines are not effective. In young sexually active male patients of high blood pressure, more so if they are suffering from diabetes, the drug of choice for hypertension is enalapril sold as Enam 5-10mg 1-2 times daily as per requirement which apart from reducing blood pressure helps protect kidney from ill effects of diabetes (with/without a diuretic such as metolazone sold as Metoz 2.5mg to be taken in the morning).