Could you tell me if person has atrial fibrillation, is taking metoprolol , valium as needed .also now require second medication for high blood pressure which one can go with valium above.

Adjust Metoprolol: Most antihypertensives may be used. However, my first choice is to adjust the dose of metoprolol. Rate control is more important than rhythm control with atrial fibrillation. Thus, metoprolol should be adjusted to maintain the heart rate at 65-75 beats per minute. Another medication to consider is dilantin. Dilantin is very safe, and is an effective anti-arrhythmic. See book by jack dreyfus.

Diuretic: Hydrochlorothiazide would be inexpensive, once a day, free of side effects for most people, safe and effective if kidney function is normal and one is not allergic to the med. It would go well with metoprolol and valium.

Any: Being on valium does not affect the choice of your high blood pressure medication. If your heart rate is not well controlled while in atrial fibrillationwith metoprolol, you may benefit from a calcium channel blocker (diltiazem or verapmil) which would help control your heart rate and also lower the blood pressure.