differences between metoprolol and lisinopril

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Hodd1969
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differences between metoprolol and lisinopril

hey everyone, can you please help me a little bit by sharing a bit of light on these 2 medications that I have mentioned in my title? the reason why I ask this is, of course, I am being prescribed them, both medications for high blood pressure. this happened just not so long ago and one of them, as said, is called Metoprolol (prescribed to take 50 mg of it) and the other one is called Lisinopril (prescribed to take 20 mg of it). as you can see, I am really interested in finding out what exactly are the differences between these 2 and I'm also very very interesting in finding out as to why would a doctor thought about prescribing me 2 different medications to take in the same time for the same diagnosis? I mean, of course I could ask this question directly my doctor, however it kinda seemed inappropriate, especially because it seemed that I am not in agreement with his opinion. I honestly can't say either I am or I am not in agreement with his opinion until I find out more and that's why I'm here. what is supposed to do one of them and what is supposed to do another one? which one is going to affect my blood pressure reading? both of them? or only onebad and the other is for another thing? if both then why simply not prescribing one with a higher dosage? because of side effect risks? someone already used one or both of them? what you can say from your personal experience? have you ever heard of someone else being prescribed both high blood pressure meds? do you think it is a good idea? as you can see I have a lot of questions which I would like to discuss here with you more experienced guys. I've got to find out which one of them is directly affecting my blood pressure reading as soon as possible. I am wondering if that's safe and of course I ask this because I'm wondering whether can I take only one of them? seems to be much safer to me.

 

have to say that my pain clinic is giving me a really bad headache and a hard time about not using my blood pressure medications… and yeah, if that's important to mention: my blood pressure, the last time when I checked it, was 126 over 89. is that AS bad? please help, I really don't know why they are tripping so so hard about it all. any help appreciated!

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Webster
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I honestly think that this is

I honestly think that this is going to be a really good question that you could search on web md site since there is just so so much information!  just think about it for a bit… everything is dislocated simply at your fingertips when you are having the internet available. just go there and search for it. that's it. silly… I don't think that there is a big problem to search at least general information about each one of them and read like 20 mins. kick are for tricks.

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123454321
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hello there, I really have no

hello there, I really have no idea about the other one since I haven't ever taken it myself, however I did have taken lisinopril as I have been on that medication for a while.. I just know that it is dilating/ relaxing the blood vessels and therefore it is reducing blood pressure. that's how lisinopril is a medication for high blood pressure, making it lower. however you have mentioned your pain clinic and to be honest, I really have no idea how this is related to your pain clinic, I mean, lisinopril isn't a pain killer and it doesn't touch your pain in any form.

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Hodd1969
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oh yeah Webster, just go

oh yeah Webster, just go ahead and call me out, I deserve it! I have been lazy just once! only this time, and I am already getting busted! ohhh jeeze LOL :D in fact, so you just know, I've always been doing my homework before posting such kind of stuff, I rarely ever take this approach to attain information… as I said, usually I am doing research firstly and just in case I am still coming up being empty handed then I am posting a thread with a question that I simply couldn't find. but this I was just a bit lazy and thought that somebody could tell me everything as it is. ooooh.

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Webster
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Hood1969, no offence… plus,

Hood1969, no offence… plus, if I knew the answer then I would already have told you instead of telling you that. I have no idea at all about any high blood pressure stuff so I doubt I can help you with that. instead, I was just trying to point you in the right direction where you can find everything you need yourself just in case nobody would respond. plus to that, a little bit of humor is always good for the soul. in the end I hope that you're going to find your answers and I hope you're gonna be alright!

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oh yeah the 'number guy' :D

oh yeah the 'number guy' :D had an excellent point about how lisinopril works. indeed, this medication is helping to increase the flexibility (in fact, distensibility) of your blood vessels. if you want to read more info about this one there is a really good study which was comparing the 2. the study is pretty old (1994) but I still think that it is worth reading. for finding it go on pubmed. com and search there for : ' Effect of lisinopril and metoprolol on arterial distensibility. ' you're going to be given the actual article.

 

you've got to know that there are at least a half of dozen classes of BP medications (which is a lot) and each one of them is having a different mechanism of action. having that said, I guess this is why your doctor put you on 2 meds for high blood pressure. even if they are indeed, ultimately, doing the same, the mechanism of action is different and I guess this is important to take in consideration. and yeah, they are different because from as much as I know - Metoprolol it is a beta blocker, and so this means that it is blocking the receptors for adrenaline (or at least what I think). however you need to know that there are at least 3 proposed modes of action. if you want to find out more about this one then go on rxlist site and search for Toprol XL. when you're there click on clinical pharmacology for that drug and read there. hope it would be helpful. however, as for the other drug Lisinopril then it is another class, it's an ACE inhibitor. Angiotensin II it is a peptide which is causing the blood vessels to constrict. it is a drug that is interfering with the enzyme that it is transforming angiotensin I to angiotensin II would be really helpful to prevent the constriction of the blood vessels! once again if you're interesting to find out more and to learn more then again go on rxlist site and search for prinivil (which is lisinopril) and also go on clinical pharmacology. there I think, you are going to find enough information.

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Mary Heaven
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oh well… even though it seems

oh well… even though it seems that I am the only one here who is responding and is on the exact same meds that you have been prescribed too - the 20 mg of the Lisinopril, I am also on a second medication that is given for high blood pressure which is called Amlodipine Besylate with a dosage of 5 mg. so well, initially I have been started on the Lisinopril for the first time, and both for the moderate to high blood pressure, as well, (my doctor PCP told me about this), for assisting in the protecting of my kidneys with my diabetes type 2. well, when my blood pressure has only came down to the level of the range of 120-130/ 80-90 level, exactly like you have said that your was, the doctor has added the second medication then.

 

and so, my blood pressure is now averaging anywhere around 105/ 70 with taking both medication (much better with only one) and to be honest, I really can tell you the difference in how it feels as well (not only the numbers themselves). I can't be sure but it seems to me that the previous poster here is right. we're being given 2 different medications for the same diagnosis because they have 2 different ways of achieving the results that we need to achieve. having that said, one is just completing another one. per example, you might be given one medication 50 mg and other one only 10 mg and you're still going to receive much more better results than if you're going to be given 100 mg of only one medication. that's because there isn't another medication which has another mechanism of action which can 'boost' the first one. and vice versa. again, I am not sure if that's the case, but this what it seems to be 'logical' to me.

 

also, in my opinion (though I am not an expert), your blood pressure it is really too high and that's why you've been given them, and it is not a good blood pressure even if it does not fall under the 50+ year old guideline of 140/ 90 level, however I think that it is your 89 reading which is the real cause of being worried. I do believe that the AMA has been discussing about considering treatment (the diet, regular exercise, medications) for anybody that is having their blood pressure of consistently more than 120/ 80. the guidelines issues in 2003 has created the pre hypertesive condition, something which your current blood pressure would just indicate and that's why you need help now on not passing through this borderline.

 

and yeah, I should mention that my blood pressure is always raising up when I am in any kind of pain that it is not able to be controlled or when I am having an anxiety or a panic attack. as the other member said, I don't see why your pain clinic would tell you to take your bp medications, and that is why I can guess that this is the reason that your pain clinic is concerned (at least this is the only thing that comes into my mind thinking about it). hope you're going to be alright!

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I just wanted also to add

I just wanted also to add here: I have ended up switching from Lisinopril to Benicar later and that's because of reasons as: the Lisinopril has done nothing in order to lower my blood pressure and the HCTZ simply has dehydrated me. a complete different story was with the Benicar as it has had no side effects for me (which is amazing) and my blood pressure it is consistently below the normal of 120/80. having that said, it was obvious that Benicar works much more better for me and so, no wonder why I have remained on it. just in case you're not going to find your meds to be useful, I suggest to talk about Benicar to your doctor!

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Webster, it's all cool, don't

Webster, it's all cool, don't worry, I'm all fine and no offense! that's all I took it as I have been a little bit joking around. no worries. in fact, I've gotta say that it is taking quite a lot to get me upset.

 

for the rest that you've replied and tried to help: thank you very much, as I have said it - I appreciate it a lot! and I've gotta say: I have taken 2 readings this morning. one of them read 93/51 and the other one read 108/56 (if that makes any difference, I am using the reli on brand electronic monitor which I have got from walmart). I'm not just hoping my best so I can get my blood pressure stabilized before I am going to have my next appointment! I hope it so much because they have threatened me with being terminated just in case I am coming back in there with my blood pressure being still high!

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guys look, for your future

guys look, for your future reference (for those who didn't know): Lisinopril it is an ACE inhibitor, Benicar it is a ARB and metoprolol as well as all of those other drugs with ol's out there are all beta blockers. it is true that they are all having different in mechanism of actions, that is why they are all classified differently even though all their aim is to reduce blood pressure. so:

 

beta blockers are slowing the heart rate and it is allowing better ventricular filling time as well as lower afterload.

 

the lisinopril is working by stopping the agiotensin 1 from being converted to angiotensin 2 which would then be transferred to kidneys and therefore would stimulate aldosterone release among some other actions as well.

 

also, Benicar and some other ARBS drug out there are allowing angiotesin 2 to be made unlike the way lisinopril works, however it is preventing them from binding and from forming aldosterone. this is where the Angiotensin 2 is coming into play in other ways too complex to be explained all here.

 

but anyway, if you're going to ask your doctor why he decided to give you a certain medication it is not going to mean/ seem that you do not agree with him and his professionalism. you do not agree with him only when… you don't agree with him. so you're free to ask questions and if you do have some (but I see you have a lot) then you ask all of them to your doctor and he would be the person who would explain it all best. whatever the case, I just want to say one more thing here and it is… you've got to remember that there are reasons for a doctor to choose between a certain antihypertensive and other one which means that if you're being put on one then there are explanations for that, and this decision is typically being based off what the probable cause for that is, either or not there is cardiac failure, your pulse rate, GFR calcs and others. good luck!

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that's a really amazing reply

that's a really amazing reply out there. as it has been said up there by someone else and as it was said in the previous amazing reply, I am just going to try to simplify it: the meds that you have been prescribed by your doctor are basically both meds which are working to decrease your blood pressure but in different ways. the reason for you being on both meds.

 

OP, to answer your question which nobody seemed to answer it: the lisinopril is going to be the medication that will have more of an effect on your actual blood pressure than metoprolol, however you still should know that both of them do it. and by saying this I just want to mention that you shouldn't stop either one without at least telling your doctor what you intend to do. anyway, the explanations behind it can be pretty much detailed and complex but whatever the case, please, just don't… one important thing is… are you using both of them exactly like you are being supposed to take them? trust me that playing around with high blood pressure medications can end up really bad and if I would be you - I would do exactly as my doctor says.

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what CaCe said up there is

what CaCe said up there is definitely correct, however I am just going to try to elaborate since I think that it must be really hard for somebody to understand when he/ she has no prior study/ knowledge of the subject or in depth reading. reading OP's post I had the feeling that he/ she has no prior knowledge about the subject and that's why I thought that we need to explain and elaborate here. now, lisinopril it is very often given as a first like prescription for blood pressure control or also sometimes a diuretic like for example hydrochlorothiazide. anyway, to explain more how it works… exactly as it has already been mentioned this above, the lisinopril is blocking the enzyme that it is blocking angiotensin I from turning into angiotensin II but it hasn't been explained what this mean… well, that means a decrease in the vascular constriction and a decrease in the vascular constriction is leading to a decrease resistance on the heart, but I guess that we all know that the more resistance then the higher is the blood pressure. Aldosterone (which has also been mentioned in posts above but has never been explained what's exactly - one other hormone in the kidneys) it is being stimulated by Angiotesin II and what it is exactly doing is to promote fluid retention. and that's why, increased fluid retention in the vascular system with an increase in the vasconstriction this ends in the high blood pressure and therefore, all of this means that there is the heart which has less resistance to pump against and the vascular system is being more compliant.

 

and so, the other one, Metoprolol, this is a common beta blocker (one of the most popular) and it is working in blood pressure in a few ways: the first thing, you've got to search for the cardiac output, this is just an simple equation that somebody would see in algebra (Cardiac Output (OC) equals Heart Rate x Blood pressure) and since I'm trying to make it as simple as possible I should say that it is binding to the various beta andrenergic receptors and since it is doing this, it is blocking the activity of the epinephrine (aka adrenaline) and it is having an effect on the heart therefore is putting kind of a limit on the heart rate and that's how it is decreasing the overall workload of the heart and so, therefore, in the end, is decreasing the blood pressure of the patient. pretty much that's why it is called a 'blocker'.

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hey CaCe, thank you very much

hey CaCe, thank you very much for your post and for expanding it, I guess we really needed it. however, there's just one correction that I've been thinking that I should make is that from as much as I know, CO is calculated as the following:

 

CO is equal of heart rate X the stroke volume! and here the stroke volume it is the volume of blood that is moved into the aorta in one pump. plus, I also know that it can be calculated as the following CO = (MAP - RAP)/ TPR and where RAP it is usually 0, MAP it is the Diastolic Pressure + 1/3 (Systolic - Diastolic Pressure) and TPR it is the resistance of the blood vessels (that is being affected by vasoconstriction, viscosity, etc.). and so, to make a summarization we can say that CO = MAP/ TPR = HR x SV.

 

and also, on diuretics, they are really great treatment in the cases of heart failure and for idiopathic hypertension. but yeah, one more thing here is that you must be worried about either or not are you using a potassium sparing or potassium wasting diuretic as you do not want your potassium levels to fluctuate because this might lead to other problems…

 

oh yeah, one more thing here that I nearly forgot to say is that the beta blockers are also having an effect on renin secretion and this should be taken in consideration as well.

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well, I just can say that I

well, I just can say that I am doing that combination right now… I am one of those persons who is simply not able to use any ARB like for example Benicar and I do know this because I have tried all of them! As for the Toprol XL I can say that it is a terrific selective beta blocker that it is giving me absolutely no horrible side effects. I can say that I was pretty much hesitant to go to 100 mg and that's because it does aggravate my asthma sporadically (yes, I suffer from asthma). and this is the reason why my doctor has added me 10 mg of Lisinopril instead and it works so well that I am currently planning to go to 20 mg. at least we've discussed about this with my doctor and he seem to agree with me, we're going to see. I just really really hope that I am not going to get those side effects that I am getting when I am using any drug of the ARB class. something tells me that it is not going to be like that, but I still am a bit afraid.

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hello brigittekey, honestly,

hello brigittekey, honestly, this regimen you're talking about sound to be really good, I doubt that you're going to get any problems with it as well.

 

but what you are experiencing is quite normal I would say and the explanation to that is that beta blockers are being well known to worsen asthma as the beta receptors are located in the lungs… typically though, the more selective the beta blocker is to B1, and it is much less likely (as much as I know) to influence the B2 receptors in the lungs. however, as much as I know there is always going to be some cross reactivity… and that's pretty much why the physicians are usually trying to avoid them in people who are suffering from asthma and even if they do prescribe them to asthmatics then with a grain of salt keeping an close eye on those people.

 

but yeah… if I may ask… what has happened to you with the ARBS? I mean, I would understand if you wouldn't want to talk about this, but what kind of side effects you have had? were they as bad? were the same side effects to all ARBS meds?

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Quote: and also, on

Quote: and also, on diuretics, they are really great treatment in the cases of heart failure and for idiopathic hypertension. but yeah, one more thing here is that you must be worried about either or not are you using a potassium sparing or potassium wasting diuretic as you do not want your potassium levels to fluctuate because this might lead to other problems…

 

just wanted to add something else here on this part… both a potassium sparing and a wasting diuretic is going to cause a change in your potassium level, and that's since sparing means that it is not excreting it (and this, what means? that it is retaining it) in the time wasting means that it is getting it out, excreting it (and that is why, we are losing it, obviously). just in case you are using a potassium wasting diuretic then you may be quite fine at lower doses (and still not for everyone), or you may need a potassium supplementation. you surely need it in case you already was having a potassium deficiency or if you're taking a higher dosage. but even if you DON'T have any potassium deficiency and you are not on a high dose of it then I would still recommend to look up for potassium supplements! plus to that, I should say that there are also some combos of potassium sparing and wasting diuretics which is given like that so in this way they are balancing each other out. that seem to be one very good idea if you ask me. whichever the case, please take care of you. and yeah, finally, the last thing… there are classes of medications that are having absolutely no effect on (and no connection with) potassium. I was talking only about the potassium sparing. hope this helps.