Patient's Query
Hello doctor,
I have been taking Dilzem CD 120 (Diltiazem) for the past four years for hypertension and tachycardia. My heart rate was normal, but my blood pressure (BP) was not reducing. I took 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 (Telmisartan) 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.
I doubt whether I should continue Dilzem because I feel it is a high dose and does not have many benefits for BP, even though it is effective for heart rate. Should I increase the quantity of Telma and start taking Telma 40 and maybe take only one Dilzem capsule? I will consult my cardiologist, but I am worried and want some suggestions.
Kindly advise.
Hello,
Welcome to icliniq.com.
I understand your concern.
Diltiazem is generally prescribed for controlling heart rate and certain cardiac rhythm abnormalities, along with its effect on blood pressure. If there is no history of rhythm abnormality, medications such as angiotensin receptor blockers like Telmisartan or thiazide diuretics are usually preferred for better blood pressure control.
However, there may be a specific reason your cardiologist prescribed Diltiazem based on your clinical condition. Therefore, any change in dose or medication should be done only after proper evaluation.
I hope this helps you.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
Four years back, I was taking Tryptomer 10 mg (Amitriptyline) 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 (Telmisartan) for one week for my blood pressure.
So I thought maybe the high heart rate was due to Telmisartan, and the cardiologist gave Dilzem (Diltiazem) so that it helps both blood pressure and heart rate. Now with Diltiazem, my heart rate is under control. At that time I did not know that Amitriptyline could cause a high heart rate, and now I have stopped Amitriptyline. Now I am confused about whether to increase the dose of Telmisartan.
Kindly help.
Hello,
Welcome back to icliniq.com.
I understand your concern.
If your BP (blood pressure) is not controlled on Diltiazem, then it is better to add another drug like Telmisartan 40 milligrams. 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, Telmisartan can be added for its control, but for Diltiazem, consult your cardiologist.
I hope this has helped you.
Thank you.
Patient's Query
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.
Patient's Query
Hello doctor,
Thank you.
Hello,
Welcome back to icliniq.com.
You are welcome.
Patient's Query
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?
Kindly advise.
Hello,
Welcome back to icliniq.com.
I understand your concern.
Telmisartan works better at night. Take one tablet of 40 milligrams at night, do not split it.
I hope this helps you.
Thank you.
Patient's Query
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?
Kindly advise.
Hello,
Welcome back to icliniq.com.
I understand your concern.
If blood pressure is controlled on 20 milligrams, then no need to increase the dose. Take this in the morning and Diltiazem in the evening.
I hope this helps you.
Thank you.
Patient's Query
Hello doctor,
My BP was 124/88 mm Hg yesterday and this morning. This 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.
Kindly advise.
Hello,
Welcome back to icliniq.com.
I understand your concern.
I would advise you to continue with Telmisartan 20 milligrams for at least two weeks. If the 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:
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 remains high.
I hope this has helped you.
Thank you.
Patient's Query
Hello doctor,
Suggestions were of good help.
Thank you.
Hello,
Welcome back to icliniq.com.
You are welcome.
Patient's Query
Hello doctor,
Thank you again for your time.
I have been taking one Dilzem CD 120 capsule in the morning and one Telma 40 at night for 10 days. Now my blood pressure is normal, but sometimes it 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 two days.
This 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?
Kindly advise.
Hello,
Welcome back to icliniq.com.
I understand your concern.
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.
I hope this helps you.
Thank you.
Patient's Query
Hello doctor,
It is usually around the 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.
Kindly advise.
Hello,
Welcome back to icliniq.com.
I understand your concern.
Yes, if your blood pressure falls to 90/60 mmHg or lower, reducing Telmisartan from 40 mg to 20 mg is a reasonable approach, especially since your cardiologist has already suggested this adjustment.
Diltiazem should not be stopped abruptly, as doing so may cause a rebound increase in heart rate and worsen your symptoms.
Continue monitoring your blood pressure regularly. If you develop symptoms such as dizziness, fainting, severe weakness, or persistent low blood pressure, contact your treating physician promptly for further evaluation.
I hope this helps you.
Thank you.
Patient's Query
Hello doctor,
I have irritable bowel syndrome, and some days I have more bowel movements. A doctor has given me a tablet, Colospa 135, earlier. 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?
Kindly advise.
Hello,
Welcome back to icliniq.com.
I understand your concern.
Yes, you can take Mebeverine. It may decrease your 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.
I hope this helps you.
Thank you.
Patient's Query
Hello doctor,
My issue is that I have been having frequent bowel movements since yesterday afternoon. Because I have already been diagnosed with irritable bowel syndrome, I did not go to the 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.
Kindly advise.
Hello,
Welcome back to icliniq.com.
I understand your concern.
If you do not have any stomach discomfort, then there is no need for Mebeverine. Continue the Saccharomyces boulardii sachet, and if you still have frequent loose stools, then you can take an Imodium tablet 2 milligrams only once or twice a day. Avoid a high-fiber diet and milk products, and do not skip meals.
I hope this helps you.
Thank you.
Patient's Query
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 five bowel movements five times. Can it be a COVID symptom? And if I get symptoms like throat pain, can I take Azithromycin 500 for three days?
Kindly advise.
Hello,
Welcome back to icliniq.com.
I understand your concern.
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 Povidone-iodine gargles and drink warm water only.
I hope this helps you.
Thank you.
Patient's Query
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.
I understand your concern.
You may take a capsule of Vizylac twice daily, which is a probiotic for seven 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.
I hope this helps you.
Thank you.
Patient's Query
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.
Also, he is taking Tendia 500 mg for diabetes, and Flodart Plus for prostate issues. After three 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.
Kindly advise.
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.
I hope this helps you.
Thank you.
Patient's Query
Hello doctor,
Now, headache is the main symptom. Till now, there is no cough, but there is a small irritation when clearing the throat, which he has had for a long time. Should any cough syrup be given? Also, are any vitamins to be given?
Kindly advise.
Hello,
Welcome back to icliniq.com.
I understand your concern.
No need for cough syrup, but you can give him lozenges ( a combination drug). He can also take a multivitamin (Zincovit) twice daily. Give him warm water only.
I hope this helps you.
Thank you.
Patient's Query
Hello doctor,
This is for mothers who have tested positive for COVID-19. She has cold symptoms and mild cough, and throat irritation. She has been 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.
Kindly advise.
Hello,
Welcome back to icliniq.com.
I understand your concern.
Yes, she may take it twice daily if she has a mild cough, but stop it if the cough frequency and intensity decrease.
I hope this helps you.
Thank you.
Patient's Query
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 my 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.
Kindly advise.
Hello,
Welcome back to icliniq.com.
I understand your concern.
Yes, you may take Cetirizine; it will not affect your heart rate. For dryness, you can use soft Paraffin cream or coconut oil. Get a complete blood count (CBC) and liver function tests to rule out any allergy or liver dysfunction.
I hope this helps you.
Thank you.
Patient's Query
Hello doctor,
I started having a sore throat last 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 a 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.
Kindly advise.
Hello,
Welcome back to icliniq.com.
I understand your concern.
Since you are taking HCQ, Dilzem, and Azithromycin is not recommended because they may interact with the two drugs and may cause cardiac complications. Use home remedies for sore throat, saltwater gargles, and drink hot water in sips. Please do not take Azithromycin or Clarithromycin type of medicines.
I hope this helps you.
Thank you.
Patient's Query
Hello doctor,
I have taken Azithromycin many times. 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?
Kindly advise.
Hello,
Welcome back to icliniq.com.
I understand your concern.
You may take Doxycycline after consulting a doctor.
I hope this helps you.
Thank you.
Patient's Query
Hello Doctor,
This is the fifth day of my COVID-19 infection. For the last two days, I have had a mild fever for a short time. Today, I do not have a fever, but I am experiencing fatigue. Since I was feeling more tired than usual, I checked my blood pressure, and it was 97/72 mmHg.
I am currently taking Diltiazem 120 mg in the morning and Telmisartan 40 mg at night.
My question is whether I should continue taking Telmisartan 40 mg or reduce it to Telmisartan 20 mg. Since my blood pressure today is 97/72 mmHg and I currently have COVID-19, I am worried that my blood pressure may drop even further.
My cardiologist has suggested trying Telmisartan 20 mg. I would like to know your opinion.
Kindly advise.
Hello,
Welcome back to icliniq.com.
I understand your concern.
Yes, I would also suggest you lower the dose to 20 milligrams. And if you are feeling weak, you may take oral rehydration solution (ORS) for three to four 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.
I hope this helps you.
Thank you.
Patient's Query
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?
Kindly advise.
Hello,
Welcome back to icliniq.com.
I understand your concern.
Yes, you can break it into half. You can dissolve one sachet of ORS (oral rehydration solution) in 34 fluid ounces of water and take it throughout the day, then repeat it the next day.
I hope this helps you.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
My physician has prescribed a Becosule capsule as I was having leg muscle pain. Some years back, I had a severe allergy or side effects from a capsule called Dobical, which is calcium dobeselate. But I have had no issues with B-complex capsules. But a worry about an allergy, as Becosules also contain some calcium components. Is it safe to take Becosules?
Kindly advise.
Hello,
Welcome to back icliniq.com.
I understand your concern.
I do not think you have an allergy to calcium; it is more likely that Dobesilate was responsible for the allergic episode. So you may take Becosule.
I hope this helps you.
Thankyou.
Patient's Query
Hello doctor.
I have another query. Which is a safe painkiller other than Dolo? I do get pain in the pelvic area and groin area before and after periods sometimes. Last year did an ultrasound scan, and they said there was a possibility of adenomyosis. Also, because of irritable bowel syndrome, constipation, and gas, I keep getting stomach pains which come and go. So is there a pain killer which I can take? I am allergic to penicillin and Dobical. Have not taken any painkillers other than paracetamol.
Kindly advise.
Hello,
Welcome to back icliniq.com.
You may take a tablet of Meftal spas (Dicyclomine and Mefenamic acid) during your periods, which would relieve your pain and the same can be taken for irritable bowel syndrome.
Thank you.
Patient's Query
Hello doctor,
I have some skin issues with boils, hives, and sometimes itching. I did blood tests, and everything is normal. RFT, LFT, and blood count are all normal. Earlier, five months back, the same thing occurred, and the dermatologist gave me Atarax 10, and with one Atarax itself, it got better.
Now, for two weeks, I am getting hives that quickly go away when applying Fucibet ointment but keep coming in different areas of the skin. I am taking Dilzem CD 120 and Telma 40 for BP and OXCQ 200 for lupus. My query is whether I can take Atarax 10 along with these.
Kindly advise.
Hello,
Welcome to back icliniq.com.
I understand your concern.
Atarax may interact with HCQS, which may affect cardiac rhythm. Dilzem and Telma may cause further lowering of your BP. These interactions are possible but are not very common. If you need to take any anti-allergic better to take Levocetirizine. This is safe with the other drugs that you are taking.
I hope this helps you.
Thank you.
Patient's Query
Hello doctor,
I have Okacet 10 tablet with me. Is that fine? Can I split it and take it as 5 mg per day? How long should I take it? Can I take it along with Hydroxychloroquine?
Kindly advise.
Hello,
Welcome back to icliniq.com.
I understand your concern.
Yes, you can take 5 mg or 10 mg depending on your symptoms. Take it for four to five days until your symptoms subside, then take it whenever required. Yes, you may take it with HCQS.
I hope this helps you.
Thank you.
Patient's Query
Hello doctor,
I took Levocetirizine 5 mg for five days and then stopped, but on the second day again I started getting hives, and my body was also itching. So again, for two more days I took Levocetirizine 5 mg. For a total of seven days, I took the tablet. Yesterday I felt a rapid heart rate at night. Can it be due to Levocetirizine?
While on the tablet, I have no skin issues. The dermatologist asked me to take Levocetirizine 5 mg on alternate days for two more weeks. But I am worried about the heart rate issues. Should I stop Levocetirizine or reduce the dose? My other medicines are Dilzem CD 120, Telma 40, and OXCQ 200.
Kindly advise.
Hello,
Welcome back to icliniq.com.
I understand your concern.
Yes, Levocetirizine sometimes may increase heart rate, but that is very rare. Since you already have this history of tachycardia, that might have been precipitated by this drug. Take Levocetirizine whenever required; do not take it daily. Is there any precipitating factor for your hives? Do you have any allergy to any food products or moisturizing creams, or any cosmetic product?
I hope this helps you.
Thank you.
Patient's Query
Hello doctor,
I do not have any history of food allergies. The only allergy I had was to penicillin and a Dobical capsule. But my skin is sensitive and dry, and I apply Cetaphil moisturizer daily for that. Six months back, I got these hives, and for two weeks they kept coming, and I had one Atarax tablet.
Skin rashes went away, and then, after six months, they occurred, and I applied Fucibet for two weeks. Now, after taking Levocetirizine 5 mg no hives at all. My lupus is under control, according to my rheumatologist, because anti-ds DNA is also negative this time.
I used a new sunscreen called Sunbann Soft two weeks back, and coincidentally the hives started from then on. Can it be that which caused it? But I did not have hives on my face. Can you suggest a sunscreen with SPF 50 for sensitive skin?
Kindly advise.
Hello,
Welcome back to icliniq.com.
I understand your concern.
Yes, sunscreen might be a reason for an allergic reaction. Certain allergens include benzophenones (especially benzophenone-3, or oxybenzone), dibenzoyl methanes, and cinnamates. Look for these ingredients in your cosmetic products. You may use UV doux SPF 50 sunscreen; this does not contain allergens.
I hope this helps you.
Thank you.
Patient's Query
Hello doctor,
Thank you for your prompt reply.
I am having loose stools and an ache in the upper stomach and back, which I feel are gas issues. Yesterday I had food from outside, but no one else at home has issues, so it does not look like food poisoning. Nowadays I do not drink milk due to irritable bowel syndrome, and yesterday I had a soup which was too creamy, and I am guessing it caused the problem.
Also, I feel like I have gastritis as I already have gas issues. Had loose stools four times. I took an Econorm sachet in the morning and had a glass of lime tea. Also took Pantocid. The pain is not continuous but comes in between.
Earlier once doctor has given me a Colospa 135 tablet for irritable bowel. Should I take that? Will it help with loose stools and gas? I am also taking medicines for blood pressure like Dilzem CD 120 and Telma 40.
Kindly advise.
Hello,
Welcome back to icliniq.com.
Given your past history of IBS, this could be triggered by oily, fatty foods, painkillers, and dairy products, so it is likely triggered by outside food. If you experience spasmodic pain, you can take Colospa (Mebeverine). For loose motions, take Lopamide (Loperamide) 2 mg every 12 hours for two days and stop once the motions are no longer loose. You may continue Econorm sachet twice daily for the next five days.
Patient's Query
Hi doctor,
Thank you for your response.
Now, the motion has become normal after Econorm and lime tea. But occasionally, pain in the upper abdomen and back comes and goes, and I feel like it is gastric pain because I already have gastritis issues because of other medicines, Hydroxychloroquine and Dilzem.
Thank you.
Hi,
Welcome back to icliniq.com.
Continue Colospa for three days.
You can take Sucrafil (Sucralfate) for three to five days, two tablespoons, and eight hourly. This will subside in a few days.
Thank you.
Patient's Query
Hi doctor,
Thank you for the reply.
I have a query related to a pain in the urethra. I need to say a bit of history of pain.
One year back, I had pain on the sides of the urethra but no urinary infection. I had no pain while urinating, but I had pain for three months. I consulted the neurologist, gynecologist, and everyone and did a blood test, urine tests and scan, but everything was normal. Doctors said they did not find anything wrong. I took Dolo for three months, and the pain suddenly disappeared after three months. After three months today, I started getting the same pain on one side of my urethra. It is as if a needle is pricked; the pain is continuously there for 4 hours.
I had a Dolo, but no use. I am confused and need help deciding whether to wait and see or go to the hospital. I have constipation now. Can this be because of constipation? Is there a painkiller safe to use for this pain for now?
I am allergic to penicillin. The other medicines I am taking include:
One doctor told me this can be a neuro pain as I also have mild fibromyalgia. Can you please help with some suggestions?
Hi,
Welcome back to icliniq.com.
Fibromyalgia does not cause pain, specifically in the urethra. But yes, it is related to increased urinary frequency and pain during urination.
Do you also have the above symptoms of burning urination?
Due to constipation also, urethral constriction may happen, leading to pain. I would advise you to take syrup Lactulose 30 ML for hard stools. Needle prick-type pain may also point towards inflammation or mucosal injury of the urethra. Take a capsule of Pyridium 200 mg thrice daily for two days, then tell me if this gives some relief.
Thank you.
Patient's Query
Hi doctor,
Thank you for your response.
I do not have any burning or pain during urination. But other times, the pain comes. Now, the pain is a little reduced. I had only one Dolo yesterday. But this time, the new problem is that I frequently have the urge to urinate. Every one or two hours, I am emptying my bladder. After opening, I again have the desire but try to hold for 1.5 hours. This is since yesterday afternoon. My date of period is nearing. Can that be a reason?Urine routine and other tests have been conducted. I will inform you once the results are available.
Is Pyridium safe with tachycardia? Because I am taking Dilzem CD 120, and my heart rate is 95. BP is 138/86 mmHg.
Thank you.
Hi,
Welcome back to icliniq.com.
Yes, Pyridium is safe with other drugs.
Can you hold urine, or does it leak out before you reach the toilet?
Thank you.
Patient's Query
Hi doctor,
Thank you for your response.
No, there was no leakage issue. That pain and the urgency to urinate also went away in 24 hours. So, I did not take any medicine other than Dolo. But after a five-day gap, the same pain again came yesterday evening and has been there for 16 hours. It is not precisely on the urethra. The pain is on the left side of the urethra. I had Dolo, but the pain was still there.
I did a full urine routine and blood tests, and everything came utterly normal. Last time, my rheumatologist and neurologist advised me to take Tryptomer 10 mg as they suspected it was nerve pain. But I am worried about the side effects.
I was taking Tryptomer for two years, and that is how I got tachycardia, I guess. So I stopped it. I want your suggestions on taking Tryptomer 10 mg or any other safe medicine for nerve pain. Or should I do any further tests? No pain while urinating.
Thank you.
Hi,
Welcome back to icliniq.com.
For nerve pain, you may take Pregabalin 75 mg once or Gabapentin 300 mg once at night if you have side effects from Tryptomer. This would not elevate your heart rate and would help with your pain. I hope you had it checked by a gynecologist to rule out any reproductive organ-related disease.
Thank you.
Patient's Query
Hi doctor,
Thank you for your response.
I do not have any side effects from Tryptomer. But I am guessing that maybe my increased heart rate is due to that. Yes, I consulted a gynecologist last time I got this urethra pain. She said there was nothing to worry about, maybe estrogen levels getting low as I am 41. I was advised to apply estrogen cream and see. I am able to tolerate the pain, but the pain has been there continuously for 24 hours.
Is Tryptomer safe to take with my BP medicines Telma 40 and Dilzem cd 120? Will it decrease BP or increase heart rate or palpitations? If I get a conviction from a doctor about Tryptomer, I am ready to take it.
Hi,
Welcome back to icliniq.com.
Pregabalin or Gabapentin is a better choice here because Tryptomer (Amlodipine and Telmisartan) and Diltiazem may interact with each other, not that it would lower your BP, but yes, the metabolism of Tryptomer may slow down, which may increase its blood level and would cause undue side effects. Take only 100 mg of Gabapentin if you do not feel much pain. It would be better than Tryptomer.
I hope this helps.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
I have a query related to my blood pressure. I have been taking one Dilzem CD 120 capsule in the morning and one Telma 40 capsule at night for the past six months. Previously, my blood pressure was high. Now, it is consistently around 120/70, sometimes 110/80. My heart rate is currently 86 beats per minute. I am concerned that my blood pressure might drop too low if I continue with the same dosage. I consulted a cardiologist, and she advised me to maintain the same dose and follow up after four months. I would appreciate your suggestions. My latest blood pressure reading is 120/70.
Hello,
Welcome back to icliniq.com.
The target blood pressure that we need to maintain should be less than 130/85 mmHg. If, at this dosage, your blood pressure is under control and you are not experiencing dizziness, it is better to continue with the same dose. If your blood pressure drops too low and you experience symptoms, that is an indication to reduce the dosage. Therefore, my suggestion would be to continue with the same dose.
I hope this helps you.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
Today morning it is 95/68 mmHg in my home blood pressure machine. That is a digital one, so not very accurate, but it still seems to be low. Heart rate is 91. I am continuing with the same dose now. Is it possible to reduce the Dilzem dose from 120 to 90? And how often should I check my bp in a manual machine?
Kindly advise.
Hello,
Welcome back to icliniq.com.
I understand your concern.
You may check your BP twice a day, once in the morning fasting and then in the evening two hours after a meal for the next few days. Do not check it every day. You may lower down your night dose of Telma 40 (Telmisartan) to Telma 20. Do not reduce the Diltiazem dose for now.
I hope this helps you.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
My blood pressure has suddenly been a bit high for the past three days. Despite taking Dilzem CD 120 and Telma 40, it has been elevated, ranging from 150/100 mmHg to 150/90 mmHg, and the recent reading shows 130/100 mmHg. I am currently menstruating and experiencing slight throat irritation. Could these factors be contributing to the increase in my blood pressure?
Currently, I am taking Dilzem CD 120 in the morning and Telma 40 at night. Should I add an extra dose or continue with the same medication and wait? A few days ago, my blood pressure was very normal, around 110/80, and suddenly it has spiked even after taking my medications, which is concerning. I have recently undergone fasting cholesterol and sugar tests, and everything is normal. My kidney function and other blood tests were done two months ago and were normal. Do I need to undergo any additional tests?
Kindly advise.
Hello,
Welcome back to icliniq.com.
I understand your concern.
Yes, sometimes it has been observed that blood pressure may rise during periods. But in my opinion, you should wait until your period ends. This should resolve on its own. Just check whether your salt intake has increased recently, directly or indirectly.
I hope this helps you.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
My salt intake is not excessive, but I do eat bread every day because I need to eat every three hours due to gas issues. I am not exercising regularly, but I will start. My intake of vegetables and fruits is very low. Could that be a contributing factor?
Also, because of my high blood pressure today, I already took half of a Telma 40 tablet in the afternoon. So now, I just have to take the other half, right? And continue with the same dosage of one Dilzem 120 capsule in the morning and one Telma 40 capsule at night?
Kindly advise.
Hello,
Welcome back to icliniq.com.
I understand your concern
Start exercising daily. Increase your intake of fruits daily, especially beetroot, pomegranate, and apple juice. You may also consider drinking hibiscus tea, as it has shown very good results in lowering blood pressure. Continue with the same dosage of antihypertensive drugs.
I hope this helps you.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
I have a fluid blister on my finger. Initially, it was itching a bit, and then suddenly a blister formed. Now, there is no itching. I applied Neosporin ointment. Should I wait for a few days? I have had urticaria before, but not this type of fluid blister. I am attaching a picture of the blister here.
Kindly advise.
Hello,
Welcome back to icliniq.com.
I understand your concern.
I have looked at your blister (attachment removed to protect the patient’s identity). I do not see any redness around it. It is likely an insect bite that led to itching and blister formation, or exposure to some chemical you may be allergic to. Do not burst it; it will heal on its own. Do not apply cream or any petroleum jelly to cover it.
I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
I have a doubt related to irritable bowel syndrome. It gets triggered frequently, and I have more bowel movements and sometimes loose stools. I am taking Econorm sachet frequently nowadays, as it helps with this. Is it safe to use Econorm frequently?
Kindly advise.
Hello,
Welcome back to icliniq.com.
I understand your concern.
Yes, you may use Econorm; it is good for your IBS. Just check your diet to see if you have consumed any IBS-triggering foods recently. You may also take tablet Rifaximin 400 mg thrice a day for seven days to stabilize the current situation. Keep taking Saccharomyces boulardii daily for two weeks.
I hope this has helped you.
Thank you.
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