Can Metpure-XL be taken by a sinus bradycardia patient?

Question

Hello doctor,

I have been a high BP and sinus bradycardia (heart rate of 52 beats per minute) patient for the last four years. I used to take Metpure-XL 25 mg after breakfast based on my cardiologist's advice. For the last six months, I was having headache and confusion plus slightly increased urination. Last week, I visited another cardiologist who checked my BP. My BP was very high in the range of 175/105 mmHg. He asked me to start with Telma 40 mg and Metpure-XL 50 mg after breakfast. I did all types of blood tests. My uric acid is slightly elevated at 7.8 mg/dL and Vitamin D is deficient at 10 ng/mL. All the other tests like the lipid profile, renal tests, LFTs, sodium, potassium, and blood sugar are alright. My headache is gone after taking new medicines. However, I am feeling bloated most of the time. My questions are as follows. Is bloating a side effect of Telma 40 mg? Can you advise another medicine? Is Metpure-XL 50 mg advisable in sinus bradycardia (a heart rate of 52 beats per minute)? Please assist me with next course of action.

Answer 1

Hello,

Welcome to icliniq.com.

Firstly, it is better to avoid Metpure (Metoprolol) if the heart rate is on the lower side at least resting heart rate should be above 55 to 60 per minute. Also, we have other options available for blood pressure control. So, it is better to reduce the dose to 25 mg, and check if the heart rate remains below 60 then stop. If needed we can add Amlodipine 5 mg once a day if the blood pressure remains high. I suggest you have low salt diet and monitor blood pressure regularly thrice a day for one week then once or twice a week. If blood pressure is persistently more than 140/90 mmHg then we need to add medicines. Do Regular exercises like brisk walking, jogging according to your capacity for at least 30 minutes a day five days a week will help. Lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Weight loss will also help in both bloating and blood pressure control. Regarding bloating, Telmisartan can cause but not very common with it. In fact, dietary factors and lifestyle are more important in causing it. For this, you should avoid fatty, oily and spicy diet. You can have some walk after having food instead of taking rest. Have multiple small meals instead of heavy meals. Have regular sleep habits and avoid stress. Lots of green leafy vegetables, fruits. Avoid smoking and alcohol if any. I suggest you take tablet Pantodac DSR (Pantoprazole and Domperidone) 40 mg or Esomeprazole and Domperidone combination before breakfast once a day for a week and then if needed. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. Hope this helps you and you can get back if you have any doubts.

Answer 2

Hello,

Welcome back to icliniq.com.

Firstly, you need to decrease the dose of Metpure (Metoprolol) to 25 mg as we cannot stop it suddenly. If the heart rate is still below 60 then we will stop completely. So, I suggest you the following. Consult your specialist doctor, discuss with him or her and with their consent take the following medicines. Take Telma CT (Telmisartan and Chlorthalidone) 40/12.5 mg once a day. It is better to have a combination of Telmisartan and Chlorthalidone, so from next time I suggest you buy this. Take Tablet Pantodac DSR (Domperidone and Pantoprazole) 40 mg before breakfast once a day for a week and Tablet Amlodipine 5 mg once a day in the morning only if the blood pressure is persistently more than 140/90 mmHg. So you let me know your blood pressure readings before starting this. All the best.

Answer 3

Hello,

Welcome back to icliniq.com.

You are welcome. All the best.

Can Metpure-XL be taken by a sinus bradycardia patient?

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