Over the years Dr Lobo has encountered and treated a large number of patients who suffer from terrible side effects from their anti-hypertensive drugs and as a result has developed a special interest in their diagnosis and management. Recently he and his team have termed this clinical problem ‘multi-drug intolerant hypertension’ and have presented on this topic in various national and international meetings.

These patients are particularly challenging for their doctors to manage as there is often little experience of how to get around the intolerances. Dr Lobo has formulated a pragmatic stratified medicines approach based upon the following steps:

  • Use of fractional tablet dosing
  • Use of liquid formulations of anti-hypertensives (sucrose/lactose free)
  • Use of patch formulations of anti-hypertensives
  • Use of unlicensed (off-label) medications

If these approaches fail, then it is possible to consider device therapy of hypertension for some patients.