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Are drug combinations effective in controlling BP?

Q: Because of the high blood pressure my mother started taking a drug called catapres as per doctors advice. After that she started loosing hair from the whole body starting from her eye brows. Thinking that its because of the drug, she started taking other drugs called stamlobeta. Now her hair has started becoming thinner. What might be the cause? She has undergone thyroid testing which is one of the possible cause. It would be of great help if you can provide guidance. She is 44 years old.

A:Catapres is the brand name of a medicine called clonidine. One of its side effects that can occur is loss of hair. Therefore the decision to discontinue Catapres was correct. Stamlo Beta is the brand name of a combination product that contains two drugs: amlodipine and atenolol. On the face of it, there appears to be no good reason to take this combination because (a) one should always try to control blood pressure, particularly in a relatively young person with just one medicine and add second medicine only if there is inadequate response to the highest recommended dose of the initial medicine and (b) combination products of this nature should be avoided since one cannot change the dose of one of the two medicines since they are in one tablet and (c) in the event of only one drug being adequate, the use of two drugs means that the side effects of the two get added. Before prescribing a combination product, it is worthwhile to try amlodipine alone (Brand name: Amlodac 5mg) once daily. In all probability, there would be adequate response. If the response is not adequate after using it for about 3 weeks, the dose can be increased to 10mg daily (i.e. Amlodac 10mg). Only when the response is not adequate should one consider adding the second medicine.

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