Expert: Dr. Ravindra Bhaskar Ghooi - 10/27/2009

Question
Sir, I am 53 Indian male taking atenolol 100 losartan 100 HCTZ 25 and Amlodepine 10 mg. I take the medicines for more than 5 years. I am currently transferred to new place where in regular health check up, internist suggested following changes :

1. Metoprolol 100 in place of Tenormin 100 mg
2. Telmisartan 80 mg in place of losartan 100 mg
2. Indapamide 1.5 SR in place of HCTz 25 mg

My query is whether suggested changes is necessary at all because it increases financial burden.

I spoke to my relative cousin brother who is a GP He told me that I can continue with the existing drugs or he prescribed Following:

Tenormin 100 Amlodpeine 10 Enalalpril 20. HCT.25 mg. He says enalapril is a proven drug gor years and equally effective. I want to ask U whether Enalapril and Losartan similar and what is the rough dose equivalence of Losartan 100 to Enalalpril. Am I going to loose the benefit of losartan if I start enalalpril. I shall be obliged to receive your guidance though my question is bit long. Regards

Answer
Hi Jagdish,
My first reaction is why make any changes if your BP is well controlled?
The drugs advised by your cousin are also good. I would generally replace Losartan 100 with enalapril 10 mg. Especially since you are also adding amlodipine. Both losartan and enalaprl act through the same system, though at different points. You will not lose any benefit by switching over to enalapril, however some people do not tolerate enalapril, if that happens with you I would suggest you revert to losartan.
Frankly I think if yo are doing well on your present therapy you should not make any changes at all.
Ravi Ghooi