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Blood pressure medicine
71 yrs, hypertension. BP usually remains in 145/87 range. Is on betablocker carvedilol 3.125 twice a day. It does go normal in 130 120 after med n sometimes remain in 140 n 150 too. Has early cirrhosis.
Sometimes it does go to 150/90, 160/90 with headache before meds. Heart rate mostly in 70s , 80s.
My question is when BP is high and there is still time to take the routine bp meds, can it be taken early when BP is high?
Before taking meds if BP remains in 150 or 160 is it advised to add other bp medicine or increase current dose?
Have'nt got a proper expert answer for this yet. Seeking good experienced suggestion particularly for BP around 160/90 n dosage or additional med.
Answers (31)
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Do not alter the medicines without consulting your doctor.
You've received very helpful responses, in addition to those, I suggest starting a diary for BP charting - maintain a record of the date, time, and BP. Show this to your doctor during your next visit. It will help them determine whether to alter the medicines.
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Dear
You cannot change carvedilol timings
Add amlodipine 5 mg 1 at night
Next Steps
Measure BP every 2-3 days
Health Tips
Decrease fast food salt increase potassium containing fruits like banana orange
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1) follow low salt diet
2) do relaxing things like meditation, Yoga , healthy exercises etc
3) avoid stress
4) do such routine measures , if with this also your bp remains higher than 140/90 mm hg on regular basis . Then can consider for the additione of medicine.
5) which medicine would be best for her ?
- considering Cirrhosis , if renal function is good then diuretics are good choice.
- or we can also add ACE inhibitors or ARB according to her clinical conditions.
- CCB may not be good choice in view of Hypoproteinemia and high chance for pedal edema.
Thanks .
I hope my suggestions were helpful .
Kindly connect for detailed talk .
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The patient needs further evaluation
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Unless proper examination and evaluation of basic blood parameters of all the system .
Need through out clinical examination.
Then only medicine and proper suggestion can be retrieved.
There might be other factors too .
Need to correlate and
For while take medicine as usual dose.
Kindly connect so will do needful accordingly.
Next Steps
serum sodium and potassium levels
renal parameters
2d echo
and pft
Health Tips
low salt diet
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Continue BP medicine and avoid taking before due time and avoid extra dose of same
Can add diuretic if edema and other symptoms are there
Kindly consult physician near you
Next Steps
to meet physician and follow up with BP readings for at least week
Health Tips
do not add or take medicines before due
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She should not take the medicine earlier than when it is due. She should be put on an additional medicine which should be scheduled in such a manner that there is an adequate gap between the two medicines.
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Her current BP is not controlled by coverdilol alone .She may need additional diuretic and an ARB/CCB to have an an optimal BP for her age,but under the supervision of her physician as she has other medical issues.
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Hi .. Continue Carvedilol . As you Pt has early cirrhosis. Just look for edema .. one of the complications of cirrhosis. If he has edema better to add low dose Diuretic it will take care of raise BP as well as edema too. Contact on Practo for detail management with all available reports.
Thank you.
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If b.p rises only occasionally, nothing has to be done. If it rises daily or very frequently or you have symptoms, dose can be increased. Another medicine is added, if someone is on full dose of antihypertensive med. Then another is added.
Share details of your treatment, then I can help you further.
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Usually the BP medications should be taken at a fixed timing.
In this case I suppose the Hypertension is inadequatly treated as there is persistent rise of BP.
Patient is also early cirrhosis so his Carvedilol must have been started keeping in view portal hypertension and not Systemic Hypertension.
Need some more history and need detail lab work
Next Steps
Consult for detailed history taking and evaluation
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Need few more details
Kindly connect
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Hello,
For treatment please pay and consult at practo or pay and consult at GPay.
My GPay number is same as my mobile number . My GPay number is +91959508739nine.
Take a glass of milk daily.
Thanks.
Dr Praful Mahamuni,
Family Doctor,
MBBS .
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A treating doctor can add antihypertensive medicine its not good to go with open platform.
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Thanks for your detailed question. With BP readings fluctuating between 130–160 mmHg and a known history of early cirrhosis, it's good that close monitoring is already in place. Carvedilol is often preferred in such cases due to its hepatic and cardiac profile.
Next Steps
If BP rises significantly before the usual dose, do not double dose or shift timing without a physician’s advice. Timing adjustments or split dosing may be considered only after proper evaluation.
Cirrhosis can affect how the body handles medications, so caution is required before increasing or adding any drug.
Monitoring morning BP and patterns can help guide future dose adjustments by your doctor.
Health Tips
Keep a BP diary (morning/evening readings) for a week and note associated symptoms like headache or dizziness. This will help during your follow-up consultation.
⚠️ Word of Caution:
Avoid self-adjusting BP meds, especially in liver conditions. Some drugs may worsen hepatic function or lead to drops in BP that affect brain or kidney perfusion.
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Dr. Manoj Kumar
General Physician
10 yrs exp
Dehradun
Need few more details
Kindly consult
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Dr. Vamshi Krishna Koppula
General Physician
5 yrs exp
Karimnagar
Kindly consult
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Dr. Nazia Begum M.G
General Physician
15 yrs exp
Belgaum
Consult online will guide you
U need to change medication
Need proper history and evaluation for further treatment
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Dr. Sachin Bhiwaji Sanap
General Practitioner
7 yrs exp
Hingoli
need more information
kindly consult
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Dr. Zaheer Ahmad
General Physician
10 yrs exp
Bareilly
The all bp value mentioned in history is normal according to her age...
In view of edema a small dose of diuretic should be added along with the same previous treatment
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Dr. Manjeet Singh Sandhu
General Physician
38 yrs exp
Faridkot
Hello Mam
If you have high BP it is good to take BP medication everyday.
When you are taking medication regularly for a few weeks and then start monitoring blood pressure twice a day for 7 day with automatic blood pressure machine.
If your blood pressure comes high in 7 day record then we can add more medication.
Also need to check cholesterol, diabetes, thyroid and kidney function along with Lytes.
Urine test also
An ECG is also needed.
Take fruit vegetables
Low fat and salt
Exercise
We can review in 40 days.
If you feel differently you can contact before.
Dr Sandhu
Alberta Canada
Assoc physician Internal Medicine
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Dr. Sunil Nagar
General Physician
18 yrs exp
Rewa
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Dr. Thresia Pereira
General Physician
37 yrs exp
Mumbai
Consult available now
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Dr. Ravi Kumar Nadella
General Physician
18 yrs exp
Hyderabad
Just bland diet helps
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Dr. Anuj Mothsra
General Physician
6 yrs exp
Jhunjhunu
Can help you, kindly consult and provide detailed history for proper diagnosis and further management
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Dr. Neha Raut
General Physician
9 yrs exp
Pune
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Dr. Marini Vanitha
General Physician
12 yrs exp
Kakinada
Reduce salt in diet.
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Dr. Chaithra H
General Physician
5 yrs exp
Bangalore
Take antihypertensives.
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