Hello doctor, I am a 60-year-old non-diabetic woman. I am married with a daughter. I had a hysterectomy operation. I am hypertensive and was on Asomex 2.5 mg for the last three years. But taking Asomex 2.5 mg, my BP level fluctuated and sometimes it even increased to about 170/90. I am unable to take Asomex 5 mg as it leads to swelling of my legs and frequent urination. I am on service so on telling my doctor he reduced the dosage to Asomex 2.5 mg. Two months back, I was having a little discomfort and even experiencing pain on the left side of my chest. On monitoring, my BP at my Omron digital BP machine my BP came out to be 180/102. So on the next day, I immediately consulted a general physician and he prescribed me two drugs. Olmezest CH 40 to be taken in the morning and Asomex 2.5 mg to be taken at night or Asomex 1.25 mg if the BP goes below 120/80. I started taking these two drugs from the next day and even regularly monitored my BP using Omron digital BP machine. After 20 days of regularly taking these drugs my BP came down to 123/78, so I took Olmezest CH 40 in the morning and Asomex 1.25 at night and continued this medication for one month. A week ago I was feeling quite weak and on monitoring my BP I saw my BP came down to 90/60. So, now I have stopped taking Olmezest CH40 for the last six days and now I am only taking Asomex 2.5 mg. Today in the morning my BP was 118/70 and my pulse level was 73. Is it safe to stop Olmezest CH 40 like this? What hypertensive drugs can I take and in what dose to stop my BP level fluctuating in this manner?
Hello. You may stop Olmezest if BP falls. You will likely need another antihypertensive along with Asomex 2.5 which is not enough for you and we will not be able to increase it due to side effects. Olmezest takes some time for its full action so when it achieves its full action, it leads to hypotension. So, you will likely need 20 mg of plain Olmezest instead of Olmezest CH 40 which contains two antihypertensives. So, in my opinion, you should continue to monitor your BP regularly, ideally thrice a day for one to two weeks till medicine dosage are optimized. And as soon BP starts rising above 135 to 140 systolic, you should start plain Olmezest 20 mg once a day in the morning. This will help in preventing the future episode of accelerated hypertension. Also, continue with a low salt diet, regular exercises. Hope this helps you and get back if you have any doubts.