Q. Can an alteration in the dose of Dilzem and Telma control BP and tachycardia?
Hello doctor,
I am taking Dilzem CD 120 for the past four years for hypertension and tachycardia. My heart rate was normal but my BP was not reducing. I was taking Dilzem CD 120 in the morning and Dilzem-SR 90 at night. But my BP went high up to 160/100 mmHg. So I started taking Dilzem CD 120 capsules twice a day. Still, my BP was not reducing and I started taking Telma 20 in the afternoon for the past two weeks. Now my average BP is 130/90 mmHg. Some days my diastolic pressure is 93 or 95, while other days it becomes low up to 86. It keeps fluctuating. My doubt is whether I should continue Dilzem because I feel it is a high dose and it is not of many benefits for BP even though it is effective for heart rate. Should I increase the dose of Telma and start taking Telma 40 and maybe take only one Dilzem capsule? I will consult my cardiologist but as I am worried and I want some suggestions.
Kindly help.
Hello,
Welcome to icliniq.com.
Thank you for your query.
I understand your concern regarding your high BP (blood pressure) and heart rate. First of all, Diltiazem prescribed for BP and heart rate is quite unusual unless your heart rate rhythm is irregular or some abnormal rhythm is present. Please mention if you have a history of that. If there is no such history, then other ARB (angiotensin receptor blocker) drugs like Telma (Telmisartan) or thiazides can be prescribed for BP and for your heart rate, there are other substitutes in place of Diltiazem. But still, you should consult your cardiologist as he might have prescribed this drug to you considering what was best for you at that time.
I hope this has helped you.
Thank you.
Hello doctor,
Thank you for the reply.
Four years back I was taking Tryptomer 10 mg once daily for migraine-type headaches. So I think maybe because of that I got a high heart rate once and at that time I was on Telma for one week for my BP. So I thought maybe the high heart rate is due to Telma and the cardiologist gave Dilzem so that it helps both BP and heart rate. Now with Dilzem, my heart rate is under control. At that time I did not know that Tryptomer can cause high heart rate and now I stopped Tryptomer. Now I am confused about whether to increase the dose of Telma.
Kindly help.
Hello,
Welcome back to icliniq.com.
If your BP (blood pressure) is not controlled on Diltiazem then it is better to add another drug like Telma (Telmisartan) 40 mg. But stopping or reducing the dose of Diltiazem has to be done carefully as reducing its dose may cause a reflex increase in heart rate. As far as BP is concerned Telma (Telmisartan) can be added for its control but for Diltiazem consult your cardiologist.
I hope this has helped you.
Thank you.
Hello doctor,
Thank you for the reply.
My latest BP reading is 120/86 mmHg on the home BP apparatus which is a digital machine. So my query is if I reduce my Dilzem dose to just one Dilzem CD 120 capsule at night and if I take one Telma 20 in the morning do you think my BP will remain under control? My cardiologist asked me to try it like that but I am looking for suggestions.
Kindly help.
Hello,
Welcome back to icliniq.com.
Yes, you can continue that, but monitor your heart rate for a few days. If it remains within the range of less than 90 then you can surely continue with that.
I hope this has helped you.
Thank you.
Hello doctor,
Thank you.
Hello doctor,
Can I take one Telma 20 in the morning and one Telma 20 at night instead of taking Telma 40 at once? Is it the same effect?
Thank you.
Hello,
Welcome back to icliniq.com.
Telma works better at night, take one tablet of 40 mg at night, do not split it.
Thank you.
Hello doctor,
I get a lot of gas issues due to medicines. Telma 20 also gives heartburn. So I thought Telma 40 at once would be difficult. That is why I asked about splitting it. Also, I am taking Dilzem CD at night. BP is now 125/88 mmHg. Is Telma 40 needed or is Telma 20 enough?
Thank you.
Hello,
Welcome back to icliniq.com.
If blood pressure is controlled on 20mg, then no need to increase the dose. Take this in the morning and Dilzem (Diltiazem) in the evening.
Thank you.
Hello doctor,
My BP was 124/88 mm Hg yesterday and also today morning. Today evening it is 124/95 mmHg. So this fluctuation is something to worry about? I am confused about whether to continue Telma 20 or to increase to Telma 40. Because some days diastolic pressure is in the normal range and some days it is not.
Thank you.
Hello,
Welcome back to icliniq.com.
I would advise you to continue with Telma (Telmisartan) 20 mg for at least two weeks. If still average diastolic blood pressure (average of three different readings measured on three different days) comes out to be above 90, then a dose increment can be considered. I suggest you follow a few instructions mentioned below:
1. Increase intake of fresh fruits and vegetables.
2. Walk or exercise daily for at least 30 to 45 minutes.
3. Reduce your salt intake.
4. Reduce tea and caffeine intake.
Do not worry, your BP (blood pressure) is very well controlled. Diastolic will also come down if you do some lifestyle changes. The dose can be increased if it still remains high.
I hope this has helped you.
Thank you.
Hello doctor,
Thank you. Suggestions were of good help.
Hello doctor,
I have been taking one Dilzem CD 120 capsule morning and one Telma 40 at night for 10 days. Now my blood pressure is normal but sometimes goes as low as 101/75 mmHg. Should I continue the same dose or should I reduce the dose? I can see my cardiologist only after 2 days. Today morning's BP was 126/83 mmHg. Now evening reading 101/75 mmHg. So I am worried whether it will go too low but also if I reduce the dose then will it again become high like before. Hoping to get some suggestions.
Thank you.
Hello,
Welcome back to icliniq.com.
Hope you are doing great. According to me, your BP is well controlled, 100/75 mmHg is not a problem unless you are feeling dizzy on that BP.n It should not go below 90/60 mmHg. So you do not have to reduce your dose. I would advise you to continue the same dose. If you feel dizzy or your BP goes below 90 /60 mmHg, then only dose reduction can be considered.
Thank you.
Hello doctor,
It is usually around 112/80 mmHg range since this dose started. So if it goes till 90/60 mmHg then should I reduce Telma 40 to Telma 20? Or should I stop Dilzem and take only Telma 40 once at night? My heart rate is now 84.
Thank you.
Hello,
Welcome back to icliniq.com.
Yes if it goes till 90/60 mmHg, then reduce Telma to 20 mg. Dilzem should not be stopped abruptly, it may cause a rebound increase in heart rate.
Thank you.
Hello doctor,
I have irritable bowel syndrome and some days I have more bowel movements. A doctor has given me earlier a tablet Colospa 135. Now that I am taking Telma 40 for BP, I wanted to ask if it is normal to take Colospa 135. Can I take Colospa in the afternoon? Will it affect heart rate?
Thank you.
Hello,
Welcome back to icliniq.com.
Yes, you can take Colospa, it may decrease heart rate, and that too rarely, but do not increase it for sure. If you have been prescribed it once then you can take it in the afternoon.
Thank you.
Hello doctor,
My issue is that I am having feeling bowel movements frequently since yesterday afternoon. Because I have already been diagnosed with irritable bowel syndrome I did not go to hospital. Another doctor also gave me an Econorm sachet to take if I have issues. So which is better Colospa tablet or Econorm? I have no stomach pain or discomfort. But due to medicines especially HCQS, I have gas issues.
Thank you.
Hello,
Welcome back to icliniq.com.
If you do not have any stomach discomfort then, there is no need for Colospa. Continue Econorm sachet, and if you still have frequent loose stools then you can take Imodium tablet 2 mg only once or twice a day. Avoid high-fiber diet and milk products and do not skip meals.
Thank you.
Hello doctor,
My sister and father tested positive for COVID. As I do not yet have any symptoms I did not test. But I am having more bowel movements as mentioned yesterday. It is not loose stools but yesterday I had a bowel movement 5 times. Can it be a COVID symptom? And if I get symptoms like throat pain can I take Azithromycin 500 for 3 days?
Thank you.
Hello,
Welcome back to icliniq.com.
Yes, it may be a symptom of COVID-19, because the new strain is causing loose stools and stomach problems. If you feel a sore throat, do not take Azithromycin, as it may further cause stomach discomfort. Do Betadine gargles and drink warm water only.
Thank you.
Hello doctor,
My motion is not really loose but I am always feeling like having a bowel movement. Yesterday I had lime tea after which it got better. But today again I feel the same. So if it is due to COVID it will resolve in a few days may be, right? Also if it is due to my irritable bowel syndrome, do you have any suggestions for managing it?
Thank you.
Hello,
Welcome back to icliniq.com.
You may take a capsule of Vizylac twice daily, which is a probiotic for 7 days. Irritable bowel syndrome does not happen without abdominal discomfort, because abdominal cramps should be the first symptom. Most likely it is due to COVID. Just avoid milk products and a fiber diet for now.
Thank you.
Hello doctor,
I am asking a query for my father. He tested COVID positive and symptoms started today early morning. Mild fever and headache. The fever goes away after taking Dolo. Till now no cough and no sore throat.
He has done angioplasty 1.5 years back and since he is on the following medicines.
1. Clopilet A 75mg.
2. Coralan 5mg.
3. Prolomet XL 12.5 mg.
4. Storvas 20 mg.
5. Tazloc 20 mg.
Also, he is taking Tendia 500 mg for diabetes, and Flodart Plus for prostate issues. After 3 days he started taking Rasalect 0.5 mg as he had shivering arms and the neurologist diagnosed it as starting of Parkinson's disease. So I would like to get some suggestions about whether he should be taking the antiviral or should he just wait and take just Dolo.
Thank you.
Hello,
Welcome back to icliniq.com.
I understand your concern regarding your father's health. I would advise you not to give him any antiviral, you can give him Dolo for fever or headache and other home remedies. Keep watching his blood sugar, blood pressure, and oxygen level. The anti-viral drug may interact with his heart medications, I would not recommend it.
Thank you.
Hello doctor,
Now headache is the main symptom. Till now there is no cough but there is a small irritation of clearing the throat which already he has since a long time. Should any cough syrup be given? Also, are any vitamins to be given?
Thank you.
Hello doctor,
No need for cough syrup, but you can give him lozenges. He can also take Zincovit twice daily can be given. And give him warm water only.
Thank you.
Hello doctor,
This is for mothers who have tested COVID positive. She has cold symptoms and mild cough and throat irritation. She is also taking medicines for hypertension for a long time and a tiny dose of cholesterol tablets. My query is whether she can take Zedex cough syrup.
Thank you.
Hello,
Welcome back to icliniq.com.
Yes, she may take it twice daily if she has a mild cough but stop it if cough frequency and intensity reduce.
Thank you.
Hello doctor,
I have another query about myself.
Is it normal to take Okacet 10 mg for itching? I have mild itching and I just guess it is because of dry skin issues as I have dry skin issues. So should I take Okacet or Atarax? Will it affect heart rate? Also, should I do any blood tests for this itching? There are no rashes. It is just mild itching here and there on my body but I am worried that it will become more.
Thank you.
Hello,
Welcome back to icliniq.com.
Yes, you may take Okacet, it would not affect your heart rate. For dryness, you can use Parasoft (soft paraffin) cream or coconut oil. Get a CBC and liver functions to rule out any allergy or liver dysfunction.
Thank you.
Hello doctor,
I started having a sore throat yesterday night. As everyone else in the family is COVID-positive I guess it is COVID. I will do an antigen test. My query is whether I should take Azithromycin for sore throat. If so please suggest the dosage, 500 mg or 250 mg, and for how many days. My other medicines are Dilzem CD 120, Telma 40, and OXCQ 200.
Thank you.
Hello,
Welcome back to icliniq.com.
Since you are taking HCQ, Dilzem, and Azithromycin is not recommended because they may interact with the two drugs and may cause cardiac complications. Do home remedies for sore throat, salt water gargles, and drink hot water in sips. Please do not take Azithromycin or Clarithromycin type of medicines.
Thank you.
Hello doctor,
I have earlier taken Azithromycin many times. And I am allergic to Penicillin. So if next time I need any antibiotics for dental treatment or anything, which is a safe antibiotic that I can take with Dilzem?
Thank you.
Hello,
Welcome back to icliniq.com.
You may take Doxycycline after consulting a doctor.
Thank you.
Hello doctor,
This is the 5th day of my COVID. Last two days I had a mild fever for some time. Today no fever but there is fatigue and I was feeling more fatigued and checked bp. Bp was 97/72 mmHg. I am already taking Dilzem 120 morning and Telma 40 at night. My query is whether I should take Telma 40 or Telma 20. Because today's BP reading is as low as 97 and also I have COVID and I am a little worried that my BP will get too low. My cardiologist suggested trying Telma 20. I would like to get your suggestions.
Thank you.
Hello,
Welcome back to icliniq.com.
Yes, I would also suggest you lower the dose to 20 mg. And if you are feeling weak, you may take Electrol ORS for 3 to 4 days, because post-COVID weakness may last for weeks. And that will maintain your BP also. Monitor your BP in the morning, if you feel dizzy or your BP is low then you may skip Telma for a few days and continue ORS for a few days.
Thank you.
Hello doctor,
Can I break Telma 40 into half and take it? Or should I buy the Telma 20 tablets? Also, how many times I should take ORS a day?
Thank you.
Hello doctor,
Yes, you can break it into half. You can dissolve one sachet of ORS in one liter of water and take it throughout the day, then repeat it the next day.
Thank you.
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