53 Y F is taking bisoprolol 2.5 mg once daily (Before sleep), Cetirizine 10 mg once daily , Cefixime 400 mg once daily along with Clindamycin 300 mg 3 times per day. Tamsulosin 0.4 mg is going to be added to this drug regimen. Which time you prefer to administrate Tamsulosin since Tamsulosin may interact with bisoprolol and lower blood pressure even more? I suggested to take both medications at different times during the day, Bisoprolol before sleep and Tamsulosin in the morning because I don't want to lower blood pressure too much during sleep (with no monitoring available during sleep time). What do you think? Agree?
I prefer to administer Alpha blockers at bed time to avoid the postural hypotension and beta blockers at morning.
Beta blockers are preferred during day time and avoided during night mostly as during sleep there is increased parasympathetic drive which reduces the resting heart rate.
Better to give bisoprolol in morning.
Tamsulosin is a selective alpha blocker and has minimal effect on the alpha 1 receptors present in the blood vessels which reduces it's chances of causing hypotension as expected from a non selective alpha blocker like prazosin.
So continue Tamsulosin at night and consider bisoprolol at morning
Hello..
An evening dose of beta blocker more effective than morning dose in reversing advers change in CHF patients while alpha blocker (Tamsulosin) after meal by 3o min once daily (time spacing must occure to avoid increasing in hypotension)
Dr.Yasmin, any evidence that support administrating Beta blocker during evening rather than morning?
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