If you are going to wing it without drugs except for your ARB and Colbenemid, why not switch from Micardis (telmisartan) to Cozaar (losartan.) At least you’ll be using a uricosuric. Also, consider taking things down even one more notch and taking just probenecid, if your nephrologist thinks it will be okay with your diminished kidney. Keep the colchicine on hand for attacks which you might not get.
Some people get better BP numbers using a split Cozaar dosage, like 50mg. AM and 50 mg. PM.
Nothing to lose…if BP control isn’t good enough after a month, switch back to Micardis.
Remember though, I found out through my own experience that there are two distinct types of hypertensives: salt sensitive volume dependent hypertensives for whom the ONLY answer is diuretics about 25% of us; and renin-angiotensin driven hypertensives who get benefit from ARB’s, ACEI’s, calcium channel blockers, etc. For the unlucky 25%, the latter pile are about as useful as a handful of M&M’s.
And upside: MERCK JUST lost the Cozaar patent in April , so it’s available for 6 months as the generic exclusive to TEVA. After October it will be generic for all manufacturers and it will become a penny drug. The only one of the ARB’s that will be cheap.
[original post July 20, 2010 at 9:19 am]