brebre
10-13-2008, 09:48 PM
I am still in search of a good blood pressure medication. I am allergic to ace inhibitors and angiotensin drugs.
My doc suggest hctz and norvasc or hctz and labetalol. Has anyone here had any experience with these combinations? I was reading that CCB cause heart attacks and that kind of scared me.
Beta blockers make me so drunk and drowsy, I have to be very very alert for my job.
Thanks
Bre
My doc suggest hctz and norvasc or hctz and labetalol. Has anyone here had any experience with these combinations? I was reading that CCB cause heart attacks and that kind of scared me.
Beta blockers make me so drunk and drowsy, I have to be very very alert for my job.
Thanks
Bre
Sponsor
ACE28
10-14-2008, 04:20 PM
BYSTOLIC (NEBIVOLOL) is the newest of the beta blockers which avoids many of the older beta-blocker side effects (if beta blocker side effects were an issue in the past). Ask your doctor for samples. Tolerabilty (according to many) is excellent..
flowergirl2day
10-14-2008, 06:13 PM
Hi Bre, :)
The main problem with labetalol is that it causes dizziness, nausea and drowsiness. A pretty nasty combination when one has to work. The side effects are usually dose dependent. The higher the dose, the more likely they are to occur and the more severe they become. Therefore, depending on your type of hypertension, and your blood pressure response to medication, if you could get by on a smaller dose, you might be fine. The thing to remember is that it is still a beta blocker - the ratio is 3 (beta) :1(alpha) in oral dosing. This is why the usual side effects of beta blockers apply. The ones I named, when they occur together, can be quite disabling. It it a good thing I was off work during the time I was on labetalol. On some days I could not function at all. I once had to leave a half-filled grocery cart at the store and get myself home while it was still possible. Another time, I had to excuse myself, leaving my girlfriends at Starbucks, before we even had a chance to visit, and go home to bed. I don't know how others might be affected -we react differently to medication. Many factors, such as medical condition, drug tolerance, other medications in the drug regimen etc. affect how our bodies handle the drugs. Everyone on these types of drugs has to find a way to fit them into his lifestyle. More accurately, we have to adjust our lifestyle to correspond to our medication schedule. Fam has done that successfully. She takes a huge dose of Labetalol and has found a way to live with (and around) its side effects. :)
ACE's suggestion is an excellent one. It is a good, sound advice and is based on his extensive experience with beta blockers. The most likely reason why your doctor has been considering labetalol a good treatment option for you is that it is in fact a combination of TWO drugs, a selective alpha1 agonist and non-selective beta2 blocker that work synergistically, thus VERY effectively. You might need a higher dose of the beta blocker alone (with the diuretic and without the alpha blocker) to control your blood pressure to an acceptable level.
In my experience, the CCB and a diuretic combination results in swollen feet, ankles and legs. This usually becomes evident (if it is to occur) within 3 weeks of starting the therapy. I was on felodipine until a few months ago. In the few months I've been on Norvasc, I have not noticed any difference. I get puffy and swollen with both. This side effect is also dose dependent, so a smaller dose should not be too bad. The question is how big a dose will you ultimately need to control your blood pressure well? You want to keep the diuretic dose below or at 25mg a day.
The bottom line is that you might have to -guess what?- experiment with your medication a little bit longer. :dizzy: Both options you mentioned could result in nasty side effects, depending on the amount of final daily maintenance dose. A third generation beta blocker with a diuretic of up to 25mg should be fine and certainly worth trying. Good luck with your decision! :) :)
flowergirl
The main problem with labetalol is that it causes dizziness, nausea and drowsiness. A pretty nasty combination when one has to work. The side effects are usually dose dependent. The higher the dose, the more likely they are to occur and the more severe they become. Therefore, depending on your type of hypertension, and your blood pressure response to medication, if you could get by on a smaller dose, you might be fine. The thing to remember is that it is still a beta blocker - the ratio is 3 (beta) :1(alpha) in oral dosing. This is why the usual side effects of beta blockers apply. The ones I named, when they occur together, can be quite disabling. It it a good thing I was off work during the time I was on labetalol. On some days I could not function at all. I once had to leave a half-filled grocery cart at the store and get myself home while it was still possible. Another time, I had to excuse myself, leaving my girlfriends at Starbucks, before we even had a chance to visit, and go home to bed. I don't know how others might be affected -we react differently to medication. Many factors, such as medical condition, drug tolerance, other medications in the drug regimen etc. affect how our bodies handle the drugs. Everyone on these types of drugs has to find a way to fit them into his lifestyle. More accurately, we have to adjust our lifestyle to correspond to our medication schedule. Fam has done that successfully. She takes a huge dose of Labetalol and has found a way to live with (and around) its side effects. :)
ACE's suggestion is an excellent one. It is a good, sound advice and is based on his extensive experience with beta blockers. The most likely reason why your doctor has been considering labetalol a good treatment option for you is that it is in fact a combination of TWO drugs, a selective alpha1 agonist and non-selective beta2 blocker that work synergistically, thus VERY effectively. You might need a higher dose of the beta blocker alone (with the diuretic and without the alpha blocker) to control your blood pressure to an acceptable level.
In my experience, the CCB and a diuretic combination results in swollen feet, ankles and legs. This usually becomes evident (if it is to occur) within 3 weeks of starting the therapy. I was on felodipine until a few months ago. In the few months I've been on Norvasc, I have not noticed any difference. I get puffy and swollen with both. This side effect is also dose dependent, so a smaller dose should not be too bad. The question is how big a dose will you ultimately need to control your blood pressure well? You want to keep the diuretic dose below or at 25mg a day.
The bottom line is that you might have to -guess what?- experiment with your medication a little bit longer. :dizzy: Both options you mentioned could result in nasty side effects, depending on the amount of final daily maintenance dose. A third generation beta blocker with a diuretic of up to 25mg should be fine and certainly worth trying. Good luck with your decision! :) :)
flowergirl
famnd
10-14-2008, 07:13 PM
Your post is familiar. I believe I've already responded to you regarding labetalol so I will give you a shorter response this time.
I'm on 900mg twice a day dosing of labetalol & 25mg of HCTZ. Fatigue is my main side of effect of labetalol. HCTZ gives me no short term side effects but I know there are potential long term side effects. I, too, have tried many drugs with serious side effects.
After much experimenting, I've finally found the best routine for me is to go with the flow. Since labetalol causes fatigue, I take my dose & then go to bed for a nap in the Am & then take it at night for my usual bedtime. I avoided this for a long time because I have acid reflux. I've found if I sleep on my left side for 1/2 the night & take my meds with pumpkin custard & a slice of cheese (not fat free), I can avoid acid reflux. At first I did have some increased dreaming but no nightmares. Now I just go to sleep. I do have 2 glasses of hot chocolate earlier plus a light salad earlier so there is probably some other food in my stomach (I have delayed stomach emptying.)
Taking HCTZ involves a whole lot of planning: increased water intake, a Gout diet, increased potassium containing foods, some salt (don't go salt free.), but I find if I adhere to my plan I don't have any problems.
The best news is that I have finally found a way to stop getting up at night to urinate. If I take my Hctz around 11-12 Noon instead of the usual morning dosing, I can sleep 6 hrs without getting up. It's been about 5 yrs since I have taken b/p meds & have had my sleep disturbed. I am estatic. I hated to get up at night!!! It's kind of funny because my two youngest grandkids just started to sleep all night too:).
With both drugs I would titrate the dose. This means you start out with a small dose & work up to the level that controls your b/p. Most people only need 12.5mg of HCTZ. I'm going to try & cut back to that. I was on Clonidine when I started HCTZ. Clonidine may have raised my b/p so now that I am off of it, I may not need it. Good luck. Fam
I'm on 900mg twice a day dosing of labetalol & 25mg of HCTZ. Fatigue is my main side of effect of labetalol. HCTZ gives me no short term side effects but I know there are potential long term side effects. I, too, have tried many drugs with serious side effects.
After much experimenting, I've finally found the best routine for me is to go with the flow. Since labetalol causes fatigue, I take my dose & then go to bed for a nap in the Am & then take it at night for my usual bedtime. I avoided this for a long time because I have acid reflux. I've found if I sleep on my left side for 1/2 the night & take my meds with pumpkin custard & a slice of cheese (not fat free), I can avoid acid reflux. At first I did have some increased dreaming but no nightmares. Now I just go to sleep. I do have 2 glasses of hot chocolate earlier plus a light salad earlier so there is probably some other food in my stomach (I have delayed stomach emptying.)
Taking HCTZ involves a whole lot of planning: increased water intake, a Gout diet, increased potassium containing foods, some salt (don't go salt free.), but I find if I adhere to my plan I don't have any problems.
The best news is that I have finally found a way to stop getting up at night to urinate. If I take my Hctz around 11-12 Noon instead of the usual morning dosing, I can sleep 6 hrs without getting up. It's been about 5 yrs since I have taken b/p meds & have had my sleep disturbed. I am estatic. I hated to get up at night!!! It's kind of funny because my two youngest grandkids just started to sleep all night too:).
With both drugs I would titrate the dose. This means you start out with a small dose & work up to the level that controls your b/p. Most people only need 12.5mg of HCTZ. I'm going to try & cut back to that. I was on Clonidine when I started HCTZ. Clonidine may have raised my b/p so now that I am off of it, I may not need it. Good luck. Fam
brebre
10-14-2008, 07:42 PM
Thanks for the responses. Is it ok to take 1/2 the dose in the morning and half at night even if it is ordered for once a day.For example I take Norvasc 10mg once a day.
I will ask about Bystolic very soon.I have read that beta blocker and diuretic is better than CCB and diuretic.
Bre
I will ask about Bystolic very soon.I have read that beta blocker and diuretic is better than CCB and diuretic.
Bre
famnd
10-14-2008, 08:43 PM
It depends on the drug & if it is time-release. Best to get the package insert & see what the manufacturer says is best. Fam
ACE28
10-15-2008, 03:29 PM
Thanks for the responses. Is it ok to take 1/2 the dose in the morning and half at night even if it is ordered for once a day.For example I take Norvasc 10mg once a day.
I will ask about Bystolic very soon.I have read that beta blocker and diuretic is better than CCB and diuretic.
Bre
Brebre,
You are right about the beta blocker and diuretic combination being the best. Beta blockers are probably the most effective and proven class of medicine currently in use. Beta blockers have a long history (along with diuretics) for almost all heart related ailments. The problem with diuretics is the depletion of essential minerals such as magnesium, potassium etc.. This creates a terrible imbalance which can effect the heart and kidneys over time.
Beta blockers can cause slight weight gain, cholesterol and glucose increases. The interesting point about these beta blocker/diuretic side effects is the positives appear to outweigh the negatives. People with hypertension and heart problems are living longer (including diabetics) who are currently prescribed beta blockers or diuretics. Other classes of much more expensive HBP medications cannot boast these results (aside from maybe ace inhibitors) My parents are in their 80's and have been taken METOPROLOL/TOPROL/diuretic for over 20 years. Beta blockers appear to be the cardiologists most effective tool. All blood pressure pills will lower blood pressure, but I think it makes sense to take a pill or class of pill with a proven
track record, and most important, the least side effects. As flowergirl mentioned, labetalol is a beta blocker with both Alpha and Beta properties. It can lower blood pressure very quickly by targeting both these properties. About a year ago my cousin had a hypertensive crisis which affected his kidneys (blood in urine etc.) The hospital prescribed him LABETALOL. He was also prescribed NORVASC, DYAZIDE and ALTACE. When I spoke to him recently, he said he feels better than ever and has not experienced any side effects at all. I'm currently taking only one medication complain about side effects. This goes to prove, that we all experience different side effects and are somewhat unique in our medication tolerability.
I will ask about Bystolic very soon.I have read that beta blocker and diuretic is better than CCB and diuretic.
Bre
Brebre,
You are right about the beta blocker and diuretic combination being the best. Beta blockers are probably the most effective and proven class of medicine currently in use. Beta blockers have a long history (along with diuretics) for almost all heart related ailments. The problem with diuretics is the depletion of essential minerals such as magnesium, potassium etc.. This creates a terrible imbalance which can effect the heart and kidneys over time.
Beta blockers can cause slight weight gain, cholesterol and glucose increases. The interesting point about these beta blocker/diuretic side effects is the positives appear to outweigh the negatives. People with hypertension and heart problems are living longer (including diabetics) who are currently prescribed beta blockers or diuretics. Other classes of much more expensive HBP medications cannot boast these results (aside from maybe ace inhibitors) My parents are in their 80's and have been taken METOPROLOL/TOPROL/diuretic for over 20 years. Beta blockers appear to be the cardiologists most effective tool. All blood pressure pills will lower blood pressure, but I think it makes sense to take a pill or class of pill with a proven
track record, and most important, the least side effects. As flowergirl mentioned, labetalol is a beta blocker with both Alpha and Beta properties. It can lower blood pressure very quickly by targeting both these properties. About a year ago my cousin had a hypertensive crisis which affected his kidneys (blood in urine etc.) The hospital prescribed him LABETALOL. He was also prescribed NORVASC, DYAZIDE and ALTACE. When I spoke to him recently, he said he feels better than ever and has not experienced any side effects at all. I'm currently taking only one medication complain about side effects. This goes to prove, that we all experience different side effects and are somewhat unique in our medication tolerability.
famnd
10-15-2008, 06:57 PM
Hi ACE,
I think most people can overcome the mineral imbalance from diuretics by consistently eating a healthy diet. Food must be seen as medicine to prevent mineral imbalance. I made a list of my favorite foods & the potassium content. Even when I'm sick with a cold & don't feel like eating there are foods on my list that I can eat to reach my mineral balance for the day. When I got my first cold while on HCTZ, I just didn't feel like eating, so I didn't. I learned quickly not to do that again. Fam
I think most people can overcome the mineral imbalance from diuretics by consistently eating a healthy diet. Food must be seen as medicine to prevent mineral imbalance. I made a list of my favorite foods & the potassium content. Even when I'm sick with a cold & don't feel like eating there are foods on my list that I can eat to reach my mineral balance for the day. When I got my first cold while on HCTZ, I just didn't feel like eating, so I didn't. I learned quickly not to do that again. Fam
flowergirl2day
10-15-2008, 11:58 PM
If and when the mineral imbalances occur, they are fairly easily corrected in most people. The doctors monitor electrolytes, liver and kidney function on a regular basis, so these potential metabolic disturbances are not as much of a concern anymore.
How good to know your parents have done well on a beta blocker and a diuretic combination, ACE! Thanks for sharing that. We need to hear such success stories. :)
flowergirl
How good to know your parents have done well on a beta blocker and a diuretic combination, ACE! Thanks for sharing that. We need to hear such success stories. :)
flowergirl