Q: I am suffering from high blood pressure (130-145 mmHg/85-100 mmHg). I was prescribed Nebistar 5 mg (5 months), which was later reduced to 2.5 mg (3 months) and later totally withdrawn. Now after one month of not taking the medicine, I have again having high BP. My lipids are normal and KFT test was also normal. I request you to kindly advise me, which medicine and with what potency should I take - Nebivolol or Enalapril? I heard there are a large number of side effects of Nebivolol like impotency. Can I switch to Enalapril 5.0 mg once daily?

A:Nebistar (nebivolol) belongs to beta-blocker group of drugs and is no longer recommended for use as first line therapy in controlling blood pressure due to its adverse effect on blood lipids. It should be particularly avoided in young, sexually active males because of the risk of impotence. The first line, drug of choice in young patients (below the age of 55 years) is enalapril (sold under trade names of BQL, Enam etc). Initially 5 mg single dose is generally adequate.