Patient's Query
Hello doctor,
I had also consulted with you before. I am a 65-year-old widowed woman with one daughter. I am hypertensive and put on non-diabetics.
First, I used to take three medications: Olmezest (Olmesartan medoxomil) CH 20 milligrams, Rozavel (Rosuvastatin) 5 milligrams, and Nexpro RD (Esomeprazole and Domperidone) 40 milligrams. Taking these three medications, my blood pressure remained normal at 126/84 mmHg.
Then, one day, I took a painkiller, and my blood pressure became very high, along with vertigo. So, I consulted with a local doctor, and all these medications were changed. Now, I was taking Cilacar 10 milligrams for blood pressure, Rozavel 5 milligrams, Esoz 40 milligrams, and Levogen for hemoglobin.
I have been taking these tablets for the last 12 days. After taking these medications, my blood pressure used to remain at 143/86 mmHg. Today, suddenly at 8 PM, my blood pressure rose to 174/98 mmHg. After this, I took another dose of Cilacar 10 milligrams, but my blood pressure was not coming down.
I have had this blood pressure problem for a long time. First, I used to take Olmezest 20 milligrams, and my blood pressure remained quite normal. But this blood pressure medicine was changed, as my sodium and potassium levels were imbalanced after taking a painkiller.
Kindly help.
Thank you.
Hello,
Welcome to icliniq.com.
I read your query and can understand your concern.
You can discuss with your treating doctor regarding the increase in the dose of Cilacar (Cilnidipine and Telmisartan) to 10 milligrams twice daily instead of once daily. If it can control the BP (blood pressure), then you can continue with the same.
If Cilacar is not helping, then you can shift back to Olmezest CH 20 milligrams (Olmesartan medoxomil and Chlorthalidone). However, it is better to confirm that the kidney function test (urea, creatinine, sodium, and potassium) is normal before restarting it. Sometimes, the medicine may take time to act, so you can wait for BP to come down after Cilacar if it is not rising above 180 mmHg systolic.
Also, make sure you are taking painkillers (NSAIDs), as they can precipitate high BP. Also, avoid a high salt diet, and have plenty of green vegetables and fruits.
I hope this answers your query.
Please let me know if I can assist you further.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
Another thing I did not tell you is that last night, after posting my query to you, I called up my local doctor, who prescribed me Cilacar 10 milligrams. I narrated my whole incident, and he prescribed me another BP medicine, Benitowa 4 milligrams.
Last night, I again took Benitowa 4 milligrams to lower my BP. After taking this medicine, I started having frequent urination at an interval of 30 minutes. In this way, since last night, I have urinated nearly 15 times.
After this, today in the morning, I measured my BP, and it came down to 145/86 mmHg, and my pulse rate was 88 beats per minute. After this, urination became normal.
Now, I am not urinating so frequently. So my question to you is,
Kindly assist.
Thanks.
Hello,
Welcome back to icliniq.com.
I do understand your concern.
Thanks for asking again.
Cilnidipine and Benitowa (Benidipine) have a similar mechanism of action, so you can either take Cilnidipine or Benitowa, but not both of these. You can continue with Benitowa if it is controlling your blood pressure. Frequent urination will likely settle. Repeat kidney function tests (urea, creatinine, sodium, and potassium) will be enough, and other tests need not be undergone.
I hope this answers your query.
Please let me know if I can assist you further.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
I have been taking Benitowa 4 milligrams for the last two days, but I have been suffering from constipation since yesterday. The urination problem is not there now. My urine is normal now.
Currently, I am taking Benitowa 4 milligrams, Rozavel 5 milligrams, Esoz D, and Livogen-XT tablets. I had a constipation problem with Esoz D before, also when I used to take Cilacar 10 milligrams. This constipation has enhanced more after changing to Benitowa 4 milligrams.
Sometime back, when I used to take Olmezest CH 20 milligrams, I was prescribed Nexpro RD 40 milligrams, and at that time, this constipation problem was not there, but there was extreme weakness with Olmezest CH 20 milligrams. But after this painkiller issue of mine, all the medications have been changed, and now there is no weakness, but there is constipation.
Kindly help.
Thanks.
Hello,
Welcome back to icliniq.com.
I do understand your concern.
Thanks for asking again.
As of now, you can continue with Benitowa 4 milligrams (Benidipine) itself, and we should wait for a few days before changing it. You can take syrup Cremaffin plus (Sodium picosulfate, liquid paraffin, and milk of magnesia) one to two teaspoons at bedtime, depending on the requirement. You can start with one teaspoon at bedtime and may increase it if it is not effective.
I hope this answers your query.
Please let me know if I can assist you further.
Thank you.
Patient's Query
Hello doctor,
Thanks again.
I am consulting with you after quite a long time. As you know, I am hypertensive but non-diabetic. Regularly, I take the following 4 medications: Rozavel 5 mg, Benitowa 4 mg, Esoz 40 mg, and Livogen-XT.
My recent problem is that, since yesterday, while brushing my teeth, when I was cleaning my tongue and applying pressure, I had a nosebleed. I had a bleed today, also while brushing my teeth and cleaning my tongue.
Then today, in the afternoon, I checked my BP, and it was a bit high, 147/91 mmHg, and my pulse rate was 88 BPM. My BP generally stays in the range of 130/85 mmHg every day. I am quite scared now regarding my nosebleed.
I had my last medical test done four months ago. Is it something to worry about?
Kindly advise.
Thank you.
Hello,
Welcome back to icliniq.com.
I understand your concern.
I have gone through your reports (attachments are hidden to protect the patient's identity). They are fine except for ESR (erythrocyte sedimentation rate), which was elevated. You should get it repeated and also ask for the CRP (C-reactive protein) level, which can tell us if there is any inflammation going on in the body.
Regarding your nosebleed, most of the time, the causes are not worrisome. However, it is better to get it checked by an ENT (ear, nose, and throat) doctor. This much elevated blood pressure is unlikely to cause a nosebleed. However, you should monitor blood pressure regularly, and if most of the readings are above 140 mmHg systolic, then you need to take Benitowa 8 mg. Avoid fingering or putting any object in the nose if you used to do it.
Hope this answers your query.
Please let me know if I can assist you further.
Thank you.
Patient's Query
Hello doctor,
Thanks again. As you know, I am a hypertensive but non-diabetic woman. My age now is 65 years. Every day, I am taking the following medications: Benitowa 4 mg for BP, Rozavel 5 mg, Esoz 40, and Livogen-XT.
My BP generally stays in the range of 135/85 mmHg. A few days ago, as I had told you while brushing, I had a bleed but did not go to the ENT doctor. At that time, my BP was 150/95 mmHg. For two days, I had a nosebleed, but after that, my BP came down to normal. This happened at the start of this month.
After this, I did not have a nosebleed. But yesterday, suddenly, in the evening, my BP rose to 160/100 mmHg. So, after taking Benitowa 4 mg, I took one dose of Cilacar 10 mg. Today in the morning, my BP was the same. So, I took one dose of Olmezest CH 40 mg to lower my BP. Today, in the evening, my BP came down to 140/91 mg. So, I did not take Benitowa 4 mg. At 12 AM night, my BP again began to rise to 149/99 mmHg. Immediately, after this, I took Benitowa 4 mg. I will wait throughout the night and see what happens in the morning.
After retirement, I am going through stress and tension regarding my unmarried daughter. I do not know whether these fluctuations in BP are occurring for that or not. I am really scared regarding this fluctuation in BP.
Kindly assist.
Thank you.
Hello,
Welcome back to icliniq.com.
I read your queries and can understand your concern.
Fluctuations in blood pressure are quite usual and may occur due to various reasons like lack of physical activity, reduced temperature (cold weather), intake of painkillers, stress, and so on. It is unlikely to be related to Livogen intake.
Also, a peak reading of 160 mmHg systolic is not a very high BP reading. You can continue with Benitowa 4 mg twice daily, as once daily is unlikely to help you. If Benitowa 4 mg twice daily does not help, then we will need to add another antihypertensive for the time being, like the CH component of your previous medicine (Chlorthalidone 12.5 mg).
An alternative option is to shift to Olmezest CH 40 mg altogether and stop all other medicines, provided there is no kidney dysfunction (which was normal during the last check-up). Olmezest CH 40 alone is a good and potent antihypertensive. It takes a few days to act fully.
You should get yourself examined by an ENT (ear, nose, and throat) or any other local doctor for nose bleeding.
Hope this addresses your concern.
Please let me know if I can assist you further.
Thank you.
Patient's Query
Hello doctor,
Thank you once again for your reply.
I regularly take the following medications: Olmesartan Medoxomil + Chlorthalidone, Rosuvastatin, Esomeprazole, Clonazepam, and iron, folic acid, and zinc tablets. My blood pressure has now become normal. Last night, it was 121/76 mmHg, with a pulse rate of 77 BPM.
I have been taking Clonazepam 0.25mg for the past two months, and since last week, I have been experiencing stomach aches and gas after taking the medication. My appetite has also reduced. I do not feel hungry at night, and most days, I skip dinner. My urine and stool are normal, and there is no constipation.
Kindly help.
Thank you.
Hello,
Welcome back to icliniq.com.
I read your query.
Firstly, the finding of concentric hypertrophy is likely due to blood pressure and is not worrisome. The only action we need to take is to keep blood pressure under control, and it is not a cause for concern.
Secondly, abdominal pain and gas are likely side effects of iron tablets, which are quite common in general. Therefore, it is recommended to take iron supplements after meals if taken before. If this adjustment does not alleviate the symptoms, it may be advisable to discuss it with the treating doctor, and if not necessary, consider stopping it for a few days. Thirdly, instead of plain Esomeprazole, a combination of Domperidone and Esomeprazole may be taken for a few days.
Minimizing the consumption of oily, spicy, and heavy meals is recommended, and regular walks for 15 to 20 minutes after each meal can be beneficial. Additionally, it is advisable to undergo an abdominal examination by a local doctor and an ultrasound of the abdomen, especially if recommended by the local doctor and if other measures are not proving helpful.
I hope I have cleared your doubts.
Any further queries are welcome.
Thank you.
Patient's Query
Hello doctor,
As you know, I am hypertensive but non diabetic. I regularly take the following medications: Olmezest CH 20, Rozavel 5, LIVOGEN XT, ESOZ D 40, and ZAPIZ 0.25. My blood pressure after taking Olmezest CH 20 was 125/78. But you know, for the last five days, my BP has been a bit high. Yesterday at 10.30 pm, before dinner, my BP was 149/91 and pulse rate 73. It has been like this for five days.
Kindly assist.
Thank you.
Hello,
Welcome back to icliniq.com.
Yes, the rise in blood pressure may be due to winter and lack of physical activities, rather misty doi. Once the temperature goes up and you resume your physical activities, it may come back to normal. It is not worrisome to have a few of these much elevated readings. However, if these readings continue like this, then you may need an adjustment in the dose of antihypertensives.
Currently, for a short term, you may just watch for the blood pressure (BP) readings for a week, and if it stays elevated, then another antihypertensive agent like Cilnidipine 5 mg once daily should be added. You should resume your physical activities like walking or brisk walking according to your capacity. Zapiz may be taken according to need. If you need it, then it can be continued on a long-term basis, or else you can stop it if you are falling asleep without it. Rozavel may be continued for a lifetime, as it has multiple other benefits besides lowering cholesterol.
Repeat echocardiogram (ECG) is not required now, unless you develop any new symptoms like worsening breathlessness or chest pain on exertion. However, you may repeat the ECG after one year. Routine blood tests may be performed after one year of the last blood test.
I hope this answers your query.
Please let me know if I can assist you further.
Thank you.
Patient's Query
Hello doctor,
My BP has now become nearly normal with the onset of Winter now. My BP yesterday at 8 pm was 125/75, and pulse rate 75. But you know, for the last few months, I have been facing a health issue to which I have not been paying much attention.
It is that while I sleep and I snore, my daughter has noticed that my snoring is loud, and it seems as if I have breathing trouble. My snoring is not smooth; it is obstructive, as my daughter narrated to me. I do not feel any shortness of breath while sleeping. This has been happening for the last few years; I have loud and obstructive snoring at night.
I regularly take the following medications: Olmezest CH 20, Rozavel 5, Esoz D 40, Livogen-XT, and Zapiz 0.25 (at night since the last three months).
My daughter says that the sound of the snoring is not smooth; it gets obstructed several times, like hiccups.
I hope this answers your query.
Please let me know if I can assist you further.
Thank you.
Hello,
How much do you weigh and your height? Your symptoms are suggestive of obstructive sleep apnea. This is primarily due to being overweight; however, sometimes it may be due to thyroid or tonsils.
You will need to consult the pulmonologist (lung specialist) for the same. A pulmonologist confirms the diagnosis by subjecting you to a sleep study. A pulmonologist may refer you to an ENT (ear, nose, and throat) specialist for throat evaluation. If you are overweight, then a healthy lifestyle and weight loss may be helpful.
If the disease is found to be severe on a sleep study, then the doctor also advises CPAP (continuous positive airway pressure) therapy. Also, you can see whether your snoring is worse on one side or when lying flat, and avoid the position where it is worse.
I hope this answers your query.
Please let me know if I can assist you further.
Thank you.
Patient's Query
Hello doctor,
My weight has now increased as I have retired and am most of the time at home. My weight, I measured yesterday in the afternoon before lunch, and it was 156.528 pounds, and my height is 5 feet.
I have not consulted with ENT yet for my snoring problem, but I will do so soon. My daily routine has also been hampered after retirement. Now I take breakfast, lunch, and dinner very late. You know since last two days, a very strange thing has been happening with me. My BP has become quite low. Today, since morning, I have been feeling very weak. About one hour ago, I measured my blood pressure with an Omron Digital BP machine, and it was 111/72 and pulse rate 70.
I have not taken my BP medicine yet, as I am very scared that my BP will fall more. I take Olmezest CH 20 daily for BP, along with my other medications like Rozavel 5, Esoz D 40, Livogen XT, and Zapiz 0.25 at night.
I have a gas and constipation problem when I take boiled eggs. Yesterday, late at night, about 3 am, I went to the latrine twice and even had a stomachache. The medicine Livogen XT, after taking it, I seldom have stomachaches, so now I am taking Livogen XT on alternate days.
Kindly advise regarding my BP medication. I cannot switch to other BP medications as only Olmezest CH 20 suits me and keeps my BP normal. I have tried lots of BP medications before, like Cilacar 10, Benitowa 5, Asomex 5, and Olmezest 40. But only Olmezest CH 20 has helped in keeping my BP normal.
Kindly advise.
Thank you.
Hello,
Sorry for the late reply.
You first need to regularize your schedule of eating and other habits, which may be helpful. You also should consider some yoga, meditation, and daily physical activities like walking or brisk walking for 30 minutes in your daily schedule.
As winter is weaning off, blood pressure may go down. If blood pressure is persistently low, then you may need to consult the local doctor for examination, a detailed discussion, and an ECG.
Systolic blood pressure of 111 is not very low, and the strategy to withhold olmezest CH and regular BP monitoring is fine. You can continue to monitor the blood pressure and restart taking olmezest CH once it crosses 130 systolic.
If BP falls drastically, then you can have an ORS solution, rather than eggs. Levogen XT is known to cause gastritis and other gastric side effects. You can try it after meals to reduce gastritis, if you are having it before meals, or else you can have it alternate daily as well.
I hope this answers your query.
Please let me know if I can assist you further.
Thank you.
Patient's Query
Hello doctor,
Thankyou for your reply.
Another issue with my health happening over the last few days is the change in my blood sugar levels. I check my PP sugar level 2 hours after lunch in my Omron One Touch glucometer at home. I do this once a week, two hours after lunch.
About two weeks ago, I checked my PP sugar, and it was 120. Then, suddenly, yesterday, when I checked PP sugar, it was 135. I am really worried, doctor. It is not that I eat lots of sweets. I eat one sweet in a gap of two days. I do not even take sugar in my tea. In the food, we use artificial sweeteners instead of normal sugar. Now I am mostly at home and feel almost full. So when I do late lunch and do not feel hungry at night, I eat a croissant or maybe a cream roll. This does not happen every day. I take four medicines every day, which are: Olmezest CH 20, Rozavel 5, LIVOGEN XT, ESOZ D 40, and Zapiz 0.25 at night for the last few months.
After retirement, my weight has also increased. My current weight is 156.528 pounds, and height is 5.0 foot. I do not feel hungry much. After lunch and taking all the medicines, I feel almost full, and on most of the days skip dinner. I take my B. P. medicine and ESOZ D 40 in the morning after breakfast and other medications after lunch. My BP today was fully normal. It was 121/78, and pulse rate 67.
Kindly advise.
Thank you.
Hello,
Welcome back to icliniq.com.
I read your query.
Your post-lunch blood sugar level of 135 is mildly elevated (higher normal range) and not much to worry about. You should check both fasting and post-lunch sugar reports once a week for two weeks, and then maybe around every two weeks.
The most important thing is to focus on regular physical activities, which will reduce sugar and also help with weight loss. These will help in reducing blood sugar further. As your physical activities have gone down, so has your requirement for food. Excessive sweets should be avoided; once in a while, intake is acceptable. Avoid late-night dinners, as they can promote weight gain.
Statin (Rozavel) may slightly increase blood sugar, especially in new patients; it is unlikely to be related to statin or other medicines.
I hope this answers your query.
Please let me know if I can assist you further.
Thank you.
Patient's Query
Hello doctor,
I am consulting with you after quite a long time. As you that I am hypertensive but non diabetic. I am now 65 years old and am taking the following medications regularly: Olmezest CH 20, Rozavel 5, Esoz D 40, andLivogen.
My recent problem is that about one week ago, my left eye began to become red. At first, I ignored it, and suddenly, on Monday morning, when I looked in the mirror, I saw that there was a blood clot over my left eye. I immediately measured my blood pressure, and it was normal at 127/77 and pulse rate 67 in the Omron BP machine. I became quite tense and immediately rushed to a local ophthalmology doctor.
With the advanced computerised machines, they examined my eyes and told me that it is a rupture of blood vessels in the eyes, and nothing to worry about. They even asked if my blood pressure was high or not, to which I said that no, it is ok. They gave me one eye drop, a tear drop to apply in the eyes.
Since Monday, I have been using this drop over my eyes, and the blood clot has spread throughout the eyes and has become lighter than before. Is this something to worry about?
My last blood tests were done one year ago. I did my last ECHO test in the month of March and am attaching the ECHO report here for your reference. Today, just a few minutes ago, my BP was 113/73 and pulse rate 66. My oxygen level in the pulse oximeter was 100. Do I need to perform any medical tests as of now?
Kindly advise.
Thank you.
Hello,
Welcome back to icliniq.com.
I have read your query and can understand your concern.
Most of the time, subconjunctival hemorrhage is benign and not worrisome. It heals on its own in nearly two weeks. It can occur after a sudden or severe sneeze or cough, heavy lifting, straining, vomiting, or even rubbing one's eyes too roughly.
As suggested by the ophthalmologist, you can wait and watch for it. I have gone through your echo report, and it is fine. There is nothing specific to be done for it from a cardiac point of view. However, in general, you can do your lipid profile testing, LFT (liver function test), PT/INR (prothrombin test/international normalized ratio), and CBC (complete blood count) test.
CBC and PT/INR tests will help to rule out other causes for bleeding, like low platelet count, coagulation problems, and so on. Also, in general, at your age, you can undergo CT CAG (if not undergone in the recent past) just to rule out the possibility of cardiac blockages. You can undergo this at any time in the future. Hope this helps you, and get back to me if you have any more doubts or more information to share.
I hope this answers your query.
Please let me know if I can assist you further.
Thank you.
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Answered byDr. Sagar Ramesh Makode
Medically reviewed byiCliniq medical review team
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