While a heart rate of 90 beats per minute is technically within the normal range, the sensation of palpitations can be very uncomfortable. For quick relief, try slow, deep belly breathing or splashing cold water on your face to help calm your nervous system. Please do not stop your medication suddenly. I recommend consulting your prescribing doctor soon so they can safely adjust your propranolol dosage or explore other options to help you feel better.

It is generally safe to take your period medications, Dysmen and Pause (which contain mefenamic acid and tranexamic acid), at the same time as your daily anxiety medication, Ciplar (propranolol). There are no major or dangerous interactions between these medicines. However, pain relievers can sometimes cause mild stomach upset, so it is best to take your period medications with food. To be safe and ensure maximum comfort, you can space them an hour or two apart from your daily anxiety medicine. Please consult your prescribing doctor if you experience any unusual symptoms or if your heavy bleeding persists.

A blood pressure reading of 94/63 is lower than your usual range, but it is not immediately alarming, especially since you are feeling dehydrated. Your morning medication, Ciplar 20 LA (propranolol), naturally lowers your blood pressure, and dehydration significantly amplifies this effect, causing evening dizziness. Please sit or lie down safely to prevent falls, and slowly sip water or an electrolyte drink to rehydrate, which should help raise your blood pressure. Avoid standing up too quickly. If you experience fainting, chest pain, or severe shortness of breath, please seek immediate medical care.

Since you take Thyroxine for your thyroid, it is also important to have your hormone levels checked, as improper thyroid levels can sometimes trigger shivering feelings. Please do not adjust any of your medications on your own. A neurologist, in coordination with your primary doctor, can safely review your regimen and help you find relief.

Persistent headaches can be frustrating, especially while balancing late-night studying. Irregular sleep is a very common trigger that can make migraines worse and harder to treat, even with daily preventatives like propranolol and escitalopram. Your current rescue medications, naproxen and domperidone, are appropriate, but using them too frequently can sometimes cause rebound headaches. I gently recommend keeping a headache diary to track your sleep and triggers. Discussing a consistent sleep schedule and clarifying your diagnosis with a headache specialist would be a wonderful next step.

These 'internal tremors' are often linked to heightened anxiety or your nervous system adapting to medications like clonazepam and Ciplar (propranolol). At 0.25 mg, your clonazepam dose is very low, and sometimes these sensations persist as your body adjusts or if anxiety isn't fully managed. It is very important not to change your dosage on your own. Please discuss this with your doctor, who can safely evaluate your progress and adjust your treatment plan to help you find relief.