Internal Medicine Questions Internist

Blood pressure?

I went to the doctor about five days ago and he prescribed 5 mg more of lisinopril and still take 25 mg Spironolactone, a total of 10 mg of lisinopril. I took this for two days and had to call the doctor back because I was extremely lightheaded and had a headache so he told me to stop taking 5 mg and only take 5 mg and 25 mg of Spironolactone. Then after this, I have been experiencing low blood pressure during the day and high blood pressure at night and in the morning. My question is what should I do? My blood pressure during the day is 109/60 and at night is now going up to 144/80 and in the morning it’s even higher like 155/90. I never had this happen before until he gave me 5 mg more than take away the 5 mg of lisinopril. I take both medications in the morning. I have a history of high blood pressure. I have a follow-up appointment Friday but my concern is should I do something sooner?

Male | 46 years old
Complaint duration: 5days
Medications: Lisinopril 5mg and spironolactone 25mg
Conditions: High blood pressure

4 Answers

You likely do not have to do anything sooner. The blood pressure at 155/90 although is high is not extremely high. Sometimes the blood pressures can go 200/100 or higher! Talk to your doctor and if there seems to be a regular pattern of your blood pressure readings, you may consider taking the blood pressure medications at different times of the day.
Spironolactone and lisinopril is an unusual combination of drugs for blood pressure. Moreover spironolactone is usually taken more than once daily. You did not say how often you take it. If you're taking it only once a day, that may explain why your blood pressure is high in the morning (I assume) before you take your morning dose. Ask your doctor to review your medication combination.
Blood pressure is dynamic and it will change throughout the day
controlling it with medication is sometimes hit or miss primary care doctors manage this blood pressure in an outpatient setting all the time document your blood pressures at home and bring that data into your doctor so that he can adjust add subtract medication as needed
Take Linopril twice a day and stop Spironolactone