Q: I am a 48 years old hypertensive patient. My doctor has advised Espin 2.5 mg in the evening and Tenoclor 50 mg in the morning. Can I take Espin AT instead? If yes, at what time?

A:Espin is the brand name. It contains amlodipine. Tenoclor contains atenolol. The use of atenolol is not recommended any longer, particularly in sexually active male patients below the age of 55 years, because apart from causing erectile dysfunction, it can precipitate diabetes. There are globally accepted guidelines on the treatment of high blood pressure in (a) patients below 55 years and (b) patients above 55 years. In male patients under 55 years, the first line therapy should be enalapril (sold as Enam) 5-10 mg 1-2 times daily depending on response. Alternatively amlodipine (sold as Amlodac) 5 mg can be used. Two drugs are required only when one medicine is ineffective in its recommended dose. Please keep in mind more drugs mean more side effects.