<s>[INST] For the last few nights, my blood pressure has gone up to 188/105. I do have RX medications...Bystolic 10 mg taken.  Daily and Edarbyclor  40 mg for emergencys.  So far adding the Edarbyclor when it goes that high brings it down in 3-4hours,but wonder when it would be advisable to go to the ER.         How high is too high? [/INST] HI, thanks for using Chat Doctor If you are not experiencing any symptoms related to the high blood pressure or there is no acute damage to the organs then you do not necessary have to go the ER. Symptoms would include headache, blurred vision, weakness on one side of the body, chest pain, shortness of breath, palpitations, abdominal pain, decreased urinary output. It is concerning however that the blood pressure is fluctuating to these levels. It has been shown that a blood pressure that fluctuates to these high levels is associated with as many complications as one that is consistently high. It would be best for your blood pressure to be maintained within normal range at all time. You need to consider visiting your doctor for reassessment of your medication to achieve this result. I hope this helps </s>