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You are here: Experts > Health/Fitness > Pharmacology > Pharmacy > Atenolol or metoprolol
Expert: Dr Alan Galbraith
Date: 3/12/2008
Subject: Atenolol or metoprolol
Question
QUESTION: Respected Sir,
I shall never forget the timely response and guidance your goodself has provided to me whenever I was confused. Sir, I am male-50 years Indian Gujarati hypertensive with tachycardia am on Tenormin-100 Losartan 100 HCTZ 25 Amlodipine 10 mg. I have been on the medications since 1989. My family history is positive for HBP but negative gor IHD.
Of late I have been observing, my internist who started my medications for bp is now asking me very time to switch to Metorpolol 100 in place of Tenormin 100 other medications as it is. My bp is very ideal but is it necessary to switch over from tenormin 100 to metoprolol 100. He insists for it. The aid internist has been my family doctor. I need your guidance.
ANSWER: Dear Harsvadan
I can see no reason from what you tell me why you should switch betablockers if your BP is under control. However, metoprolol may under certain circumstances be better than atenolol in controlling the tachycardia. I would think your internist would have a sound reason for the switch which is not obvious from your history. I would confront him politely and ask why he wants to change the betablocker. You can then get back to me if you want further advice.
I will be on holiday as from 16th march for two weeks.
Regards
Alan Galbraith
---------- FOLLOW-UP ----------
QUESTION: Man many thanks for prompt answer. As suggested I spoke to the internist for insistance to switch over to metoprolol. He saya after the artice published in the Lancet magazine, they all internist and the cardiologist all over India prefer the molecule because of the potential of metoprolol in saving at the time of stroke. I do not understand what he wanted to convey. I suggest you sir spare some time to address the query and advise wheteher indicated change is if at all necessary.
Secondly, My internist also suggested to take Lozol 1.50 ( Indapamide) in stead of the HCTZ though on inquiry with the chemist the price of both HCTZ 25 and Lozol, Lozol is more costlier thatn the HCT which I m taking. He says Indapamide is of less diurteic and more of antiHBP with SR
Answer
Dear Harsvadan
I do not fully agree with your internist on any of these points. in my opinion if your BP is stabilised on atenolol, HCT and amlodipine, I see no reason for change. The paper in The Lancet was a review of many findings and it does say that metoprolol may be better in hypertension and may be better in reducing strokes. However this is still not gospel and the paper cannot be considered the definitive answer to hypertension treatment. In fact it would be better if your internist changed to an ACE inhibitor which are unarguably better. However they may not be best in treating your tachycardia. Obviously I am not in a position to say definitively what you should be taking. Re the indapamide, again I agree with it being less of a diuretic but HCT if tolerated by you, I see no reason to change. It is still an excellent diuretic to help control BP.
Regards
Dr Alan Galbraith
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