As you may know, on May 27, 2011 I hosted a live on-line blood pressure chat. As promised, I want to answer some of the questions on the blog, because I know some of you weren’t able to attend. Plus, these important questions and answers certainly bear repeating.
Reader Question: I am on 5 mg of Nadolol and 1.25 mg of Amlodipine and I want to reduce the dosage as my blood pressure is now stable (120/80 for last 9 months). Do I reduce the dosage daily or can it be taken every other day at same dosage? These meds are supported by fish oil supplements, exercise, and a high plant and fruit diet.
My Answer: Good for you for holding steady at 120/80 for 9 months! Anyone considering tapering off of a prescription blood pressure medication must do so under the supervision of a doctor. So it is imperative that you work with your doctor as you move forward. You can discuss with your doctor the following strategies I’ve found helpful in the past:
1. I get my patients down to a low dose of the prescription drug.
2. I make sure my patients are exercising, keeping their weight down, maintaining lifestyle changes to lower blood pressure, are faithful to a sensible nutritional supplement regime, and can track their blood pressures daily at home for me.
3. I give them a blood pressure log to keep, with parameters on when they need to call me.
4. I schedule office visits every two weeks to track their progress carefully while they taper.
5. I halve the dose of medication for two weeks, and then check their blood pressure.
6. I halve the dose again for the second two weeks if the blood pressure is stable, then I check them again, and so on.
7. Should the blood pressure creep up, we may have to go back to the Rx dose that works and hold it there for a while longer.
Some folks may need low dose medication even when they do everything right. Most are successful if they adhere to the plan long term. I hope you are one of them! If you stick to a good lifestyle-oriented preventive program, you’re more likely to succeed.
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