Dear Doctor,I am 62 yr pld and weighs 68 Kgm. I suffer from mildly raised Blood pressure and Cholestrol for which  I am currently on Metoprolol 25 mg-OD,Nicardia 10 mg-OD and Atorvastatin 5 mg-HS. My conditions are under control with these dosages.But a medical friend told me that the dosages are very low to make any significent effect ! Almost double dosages have been originally started by my  doctor, but reduced with my inputs and slight persuation from me ! What do you think,Doctor ? John

"normal" doses are really a thing of the past.  There is no "normal" anymore - the more we have learned about the medications and the biology of varied people the more we have come to understand that there are going to be patients who need much less than or much more than the "reference range" dose of a drug.

It doesnt matter what the rest of people need - if those dosages work well for you then keep them low as long as possible!

Metoprolol is very very commonly used at 25mg so your friend has the facts wrong on that one.

Atorvastatin is a good medication - you have to think about the dose in terms of what the dose of an alternative drug would be - weaker drugs like simvatatin and pravastatin and lovastatin would require doses 2-8 times as high.  You doctor is using a very low dose of a powerful medication instead of a big fat dose of a weaker medication.  i agree with that strategy because it reduces the amount of drugs that your body has to metabolise and dispose of - reducing the load on the liver.

Rule of thumb - if it is working nothing else matters regardless of what your friends say :)

Hope that helps

Dr J-


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Dr. Joshua Cappuccilli


I can answer most questions involving medication use, side effects, adverse effects, interactions and how drugs relate to specific disease states. No one can answer all questions; I will respond as such if I cannot provide an answer. I will provide resources / references for the information that I use to formulate the answer given.


I am a Doctor of Pharmacy currently practicing in Florida in a retail pharmacy.

California Phamacist Association American Pharmacy Assocaition

BA University of South Florida PharmD University of Florida APhA Medication Therapy Management certification

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