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Old 11-03-2004, 02:14 PM   #1
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Question Plendil to Altace to Benicar, what now?

I have high blood pressure, which without meds averages 185/90. About 4 years ago, my doctor put me on a calcium channel blocker, Plendil (10mg daily), which brought my BP down to about 145/75 on average. However, I just couldn't cope with that drug's side-effects of swelling legs and breast enlargement (I'm a male). He then put me on Altace, an ACE inhibitor, which kept my BP around 150/80, but Altace resulted in a very persistent (dry) cough, so I stopped taking it.

5-days ago, he gave me samples of Benicar (20mg) an ARB inhibitor, but so far it doesn't seem to be lowering my BP at all. I was wondering if it takes more time for the Benicor to 'kick-in', or if I should move on to something else (I can't go on a diuretic because of an enlarged prostate).

Thanks in advance...
~pv

Last edited by pvsurfer; 11-03-2004 at 02:29 PM.

 
Old 11-03-2004, 02:54 PM   #2
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Re: Plendil to Altace to Benicar, what now?

I'm on Benicar 20 (no HCT). I noticed some BP improvement on the first day. The full effect from it took about 1 week. And, this was about -16 for both systolic and diastolic comparing before and after averages over a week's worth of measurements (132/82 -> 116/66). I know, the before isn't all that high. But, I used to see peaks around 150/90 quite frequently. Now, every once in a while, I'll see a peak around 130/80.

Pal

 
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Old 11-03-2004, 05:04 PM   #3
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Re: Plendil to Altace to Benicor, what now?

I have been on Altace and Plendil. Altace caused throat problems and Plendil caused rapid heartrate and palpatations. I'm now on Benicar but mine is with the HCTZ. It took about 30 days for me to see any results on the Benicar but after that it has been very consistant.
Before Benicar 142/76 - 173/87
With Benicar 113/67 - 129/70
That may not be perfect for some but it's the best control I've had in years
Cass

 
Old 11-03-2004, 07:18 PM   #4
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Re: Plendil to Altace to Benicor, what now?

Well, I've been on Benicar 20mg for 5 days now and I don't see any effectivity whatsoever! Do you think I should stick it out a while longer? My Dr. picked a fine time to go on vacation!

Btw, just what is HCT/HCTZ (in conjuction with Benicar)?

Thanks...

 
Old 11-04-2004, 12:27 AM   #5
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Re: Plendil to Altace to Benicor, what now?

Pvsurfer,

I'd give yourself some more time.

The usual starting dose for Benicar is what you've been started on: 20 milligrams once daily. Usually with this class of drug, the onset of the antihypertensive effect occurs within 1 week but is most likely to reach maxiumum effect after 2 weeks. If your blood pressure hasn't dropped sufficiently after 2 weeks, your doctor may suggest raising the dose to 40 milligrams once a day.

Benicar HCT or HCTZ (same thing) is shorthand for Benicar in combo with hydrochlorothiazide, a thiazide diuretic.

zuzu xxx

Last edited by zuzu8; 11-04-2004 at 12:32 AM. Reason: added add'l info.

 
Old 11-04-2004, 04:53 AM   #6
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Re: Plendil to Altace to Benicor, what now?

I agree with zuzu on the 40 mg.

Alternatives:
Since you got good results with a CCB in the past why not try verapamil, a calcium channel blocker that is VERY different from the Plendil (feldipine) and Norvasc (amlodipine)
There is a new transurethral heating process that often cures BPH in an office visit. Give a look.
THe HCTZ often makes ALL the difference in BP control It was the first and is close to the strongest drug, especially for people who readily retain water from excess salt. MANY people neeed a diuretic to get enough "kick" out of the ARB's.

 
Old 11-04-2004, 06:02 AM   #7
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Re: Plendil to Altace to Benicor, what now?

I agree with both zip and zulu.

I would also like to point out that the effects of adding a diuretic to an ACE or ARB were known long before these drugs were even brought to market. See:

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=372606

This was a study on dogs done back in 1978 using the first ACEI (teprotide) and ARB (saralasin). Note that the BP lowering effects of these drugs were only seen when the dogs were "sodium-depleted". In fact, they induced this condition on the test group using Lasix and a low sodium diet.

From this, it seems logical that if you are on a high-sodium diet, Benicar (or any ARB or ACEI) won't do anything for you. It also seems logical that a low-sodium diet (and/or a diuretic) will enhance the BP lowering effects. And, we knew all this back in 1978.

Pal

 
Old 11-04-2004, 03:18 PM   #8
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Re: Plendil to Altace to Benicor, what now?

I want to thank all of you for your replies. I don't want to go too long with my very high BP readings, but I guess I'll give Benicar a few more days (by then I would expect to at least see some reduction in my BP).

I can't entertain taking HCT with Benicar if it's a diuretic. As I mentioned in my earlier post, I have a prostate condition and I would be aggravating that situation by taking a diuretic.

If Benicar doesn't do it for me, I may look into Verapamil (I hadn't heard of that one)!

Thanks again. ~pv

 
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