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What are good medicines for high blood pressure?

Wednesday, 13 August 2003
Answered by: Chandra M. Gulhati
Editor,
MIMS,
New Delhi
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Q. I was taking Amlong 5mg along with 25mg of Atenolol. Now, I am advised to take Losar 50mg with 25mg of Atenolol. Is Losar is a better drug than Amlong?

A.  The general clinical practice of treating hypertension is to control blood pressure with one medicine up to its full dose. Then if response is not adequate to add second medicine. Since you have not given adequate information about your case, it is not possible to advise you whether or not amlodipine 5mg and atenolol 25mg was appropriate or not. Assuming that medication was appropriate and if your blood pressure was under control, there would have been no need to change the medication. On the other hand if the blood pressure was not under control, then one would need to either increase the dose of two drugs being taken previously or change to a new treatment. All drugs are equally good. It would be incorrect to say that losartan is better or worse than amlodipine. It all depends on which drug(s) keep your blood pressure under control. As per new evidence that has emerged from a very large clinical trail in New York, the second drug should invariably be a diuretic - the drug that increases urine production. Furthermore there is a diuretic called indapamide (sold as Indicontin Continus by ModiMundipharma) with dual action i.e. it increases the urine production and also separately reduce BP. Apart from scientific reasons, diuretics help to remove excess salt from the body and the patient is not required to drastically reduce salt intake. Due to so many spurious and substandard drugs in the market, prescribers and patients should ensure that the brands being used are from reputed manufacturers such as Aten (Cadila Healthcare) of atenolol, Amlodac (Zydus Alidac) of amlodipine, Losacar (Zydus Medica) or Lozitan (Wockhardt) of losartan just to give some examples.

A.  The general clinical practice of treating hypertension is to control blood pressure with one medicine up to its full dose. Then if response is not adequate to add second medicine. Since you have not given adequate information about your case, it is not possible to advise you whether or not amlodipine 5mg and atenolol 25mg was appropriate or not. Assuming that medication was appropriate and if your blood pressure was under control, there would have been no need to change the medication. On the other hand if the blood pressure was not under control, then one would need to either increase the dose of two drugs being taken previously or change to a new treatment. All drugs are equally good. It would be incorrect to say that losartan is better or worse than amlodipine. It all depends on which drug(s) keep your blood pressure under control. As per new evidence that has emerged from a very large clinical trail in New York, the second drug should invariably be a diuretic - the drug that increases urine production. Furthermore there is a diuretic called indapamide (sold as Indicontin Continus by ModiMundipharma) with dual action i.e. it increases the urine production and also separately reduce BP. Apart from scientific reasons, diuretics help to remove excess salt from the body and the patient is not required to drastically reduce salt intake. Due to so many spurious and substandard drugs in the market, prescribers and patients should ensure that the brands being used are from reputed manufacturers such as Aten (Cadila Healthcare) of atenolol, Amlodac (Zydus Alidac) of amlodipine, Losacar (Zydus Medica) or Lozitan (Wockhardt) of losartan just to give some examples.

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