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Tapering Losarten/ARB?

Posted , 3 users are following.

Siberian
Siberian

About one month ago I tried to transition off Losartan 50 mg to Hydroclorothyziade 12.5 mg, unsuccessfully.  My blood pressure spiked to >170/110 with repeated spikes for more than a week.  As a result, I quit caffeine, sodium, sugar and lost nearly 18 lbs (in one month).  Unfortunately, Losartan 50 mg now gets my blood pressure too low.  I’ve split my dose to 25 mg twice daily, but ~2 hours after I take a 25 mg dose my blood pressure is around 100/70.  Although if I skip/delay a dose it can go as high as 140+/90+.  Is there a way to safely taper any ARB without experiencing a rebound effect?  I’ve had numerous tests, and all indications are that I am healthy (other than high blood pressure).  I have been on Losartan 50 mg for about a year, and I am allergic to Lisinoprol, which I took for one month before losartan.  I am sedentary and overweight, but prior to taking blood pressure medication I was very active and my blood pressure was always below 140/90 (averaging ~135/85).  Any advice or perspective would be welcome.

0 likes, 9 replies

9 Replies

  • annie78444
    annie78444 Siberian

    Posted

    i dont understand your query - Losartan Potassium (are you on this?)  comes in various strengths - why have you got to take 50 mg? splitting the dose is fine, many do this, but you are still on 50mg. you could try 25pd or 12.5pd etc, discuss with doctor?
    • Siberian
      Siberian annie78444

      Posted

      I am trying to get down to just a daily 25 mg dose, but any phasing back sends my blood pressure up to the >140/90 range (after a day or so).  I think it is because of the rebound effect of cutting back on an ARB.  If I take the 25 mg twice daily, my blood pressure stays low (~100/70), and I don’t feel energetic.

    • Siberian
      Siberian annie78444

      Posted

      Also, Annie - thank you for the reply.  I should add that I cannot find Losartan 12.5 mg, I do believe it is available outside the United States.
    • annie78444
      annie78444 Siberian

      Posted

      Hi, if you are healthy, i cant imagine that a few days or even a week or so of 140/90 as you adjust to the lower dose will do you harm, in uk that would be considered not too bad a reading anyway unless you were in a higher risk group,  Your reading at the moment seems not too healthy anyway at less than 100/70, if it is affecting your energy and ability to move.  you do not say your age or whether you are male or female, as that is quite a low pulse pressure.  Re dosage, the 2.0mg Candesartan cilexetil is, i think, equivalent to the 12.5mg losartan potassium. 
    • Siberian
      Siberian annie78444

      Posted

      I did ask my doctor to see if another ARB would be an option, but he would prefer I try Losartan 25 mg combined with Amlodopine 2.5 mg (I have not tried the Amlodopine). I’m concerned that would bring my blood pressure even lower.  I tried to scale back the Losartan by 12.5 mg tonight and within two hours of the reduced dose I was up to 145/94. 
    • annie78444
      annie78444 Siberian

      Posted

      That does not sound too bad - do you sit quietly to do your readings, and discard your first one?  and then do two more and record them?  This is the rule here now.  it may be that things are done differently where you are, and the blood pressure numbers you want may be very different there .  best to ask yr doctor. 
    • Siberian
      Siberian annie78444

      Posted

      I do sit for a few minutes and try to relax when taking my readings.  I guess the “big” swing in resting blood pressure from ~100/70 to ~140/90  is what bothers me the most, and it is usually accompanied by anxiety.  I feel best at 120-130/80.   Also, I am male, age 45.
  • ErnieSC
    ErnieSC Siberian

    Posted

    Siberian,

    ?Reading between the Lines, I suspect there are several reasons for your erratic BP Readings.  1st off, You've probably become sedentary because your current BP Med makes you lethargic and you don't feel like exercising.  You said your BP Reading had become too low.  Although I'm personally unfamiliar with Losartan, all BP Meds I am familiar with are COATED and hence are somewhat Slow Release.  When you Break one, it almost immediately enters the Blood Stream, drops your BP but then climbs back in a couple+ Hrs.  Occasionally when mine spikes, I intentionally Break one.  Get your MD to give you the 1/2 dose, get back to exercising, lose more weight and I'm willing to bet you'll be OK!  Keep us Posted and Good Luck!   Ernie

    • Siberian
      Siberian ErnieSC

      Posted

      Ernie, thanks for the reply.  I am taking two 25 mg tablets twice daily.  My other tablets were scored in the center and the pharmacist did tell me they could be cut in half.  
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