Age: 63 years
FBS: 100 mg/dL
PPBS: 109 mg/dL
Total Cholesterol : 254 mg/dL
LDL: 174 mg/dL
Triglycerides : 114 mg/dL
HDL: 57 mg/dL
SGPT: 52 U/L
Uric Acid: 6.3 mg/dL
Urea: 21 mg/dL
Creatinine: 1.09 mg/dL
Na⁺: 132 mmol/L
K⁺: 3.7 mmol/L
Urine ACR: 46.77 mcg/mg Creat
Average BP over the last 7 days: 156/86 mmHg
My father has never taken any BP or cholesterol medication before. He previously had herpes zoster followed by post-herpetic neuralgia and is still taking Gabantin 300 mg and Symbal 20 mg.
Considering his current condition and these ongoing medicines, is it safe and appropriately to start Telista 80 mg and Razel EZ 10 mg?
Since this is his first BP medication, is starting directly with Telista 80 mg appropriate, or would a lower dose be preferable?
Answers (10)
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Telmisartan 80 as the very first dose in a 63-year-old is a bit aggressive; I would start 40 mg and step up in 2-4 weeks if BP stays above 140/90. His urine ACR of 46 shows early kidney involvement, so telmisartan is exactly the right drug class here, just at a sensible dose. LDL 174 with hypertension and albuminuria does justify a statin, so rosuvastatin 10 mg is reasonable. Gabantin and Symbal do not clash with either, though BP may dip more when combined with duloxetine, so watch for giddiness on standing.
Next Steps
Start with the 40 mg strength, log home BP twice daily for 2 weeks, and repeat creatinine, potassium and urine ACR after 2-3 weeks of starting it. If he gets chest pain, sudden breathlessness or one-sided weakness, that is an emergency, not a dose question. Send me his BP diary on an online consult and I will titrate the dose for you.
Starting with a low dose is better as dose can be increased as per the response.
For lipids, a single medicine can be taken Rosuvastatin 10mg one after dinner, along with diet restrictions.
Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
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