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ForumsSide Effects & ManagementDizziness and orthostatic hypotension on GLP-1 — looking for input Page 2

Dizziness and orthostatic hypotension on GLP-1 — looking for input

paul_denver Fri, Sep 26, 2025 at 10:27 AM 14 replies 1,020 viewsPage 2 of 3
Dr.MetabolicMD
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Rochester, MN
Sep 26, 2025 at 1:17 PM#6

Excellent point. This is called therapeutic competition — the GLP-1 RA is doing what your other medications were doing, so the combined effect is too much. Any patient on:

  • Antihypertensives (ACE inhibitors, ARBs, beta-blockers, diuretics)
  • Sulfonylureas (glipizide, glyburide, glimepiride)
  • Insulin
  • Metformin (to a lesser degree)

...should have proactive dose adjustments as they lose weight and as the GLP-1 RA's own metabolic effects take hold. This should be part of the prescriber's plan from the start, not a reactive adjustment when the patient gets dizzy or hypoglycemic.

Advocate for yourself — ask your doctor: "As I lose weight on this medication, when should we revisit my other prescriptions?"

Last edited: Sep 26, 2025 at 3:17 PM
42 7SleepDoc_PDX, RegAffairsDC, BiostatsBrad and 39 others
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BiostatsBrad
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Jul 2024
Durham, NC
Sep 26, 2025 at 1:34 PM#7

So I checked my BP (borrowed my mom's cuff) and it's 98/62 standing. Normally I'm 130s/80s. I AM on losartan 50 mg for blood pressure. Calling my doctor tomorrow morning to discuss reducing it. In the meantime, drinking electrolyte water like my life depends on it and getting up from chairs like a 90-year-old. Thank you all! 😂

14 9Dr.BariatricHTX, LindaRN_retired, tommy_boulder and 11 others
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MikeFit_NJ
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Apr 2024
New Jersey
Sep 26, 2025 at 1:51 PM#8

98/62 on losartan while on tirz — yeah, your doctor will almost certainly lower or possibly discontinue your BP med. That's actually a GOOD thing! One of the underappreciated benefits of GLP-1s is that many patients can reduce or come off blood pressure and cholesterol medications as they lose weight. It's just that the transition period can be rough if medication adjustments lag behind the weight loss.

Keep monitoring your BP at home and stay hydrated. You'll feel better soon.

17 22DeniseRN_TPA, SandraNC_45, Dr.EndoIndy and 14 others
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