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Old 06-22-2005, 01:11 PM   #1
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questions for those using or had used ACEIs

I take 180 mg tiazac (calcium channel blocker) once a day, and clonidine, .05 mg three times a day. I've been trying to wean off the clonidine, but it looks like I can't get by with just the tiazac. I had a bad reaction to increasing tiazac to 240 mg once, so am not ready to try that again yet.

I had an old prescription for captopril (ACEI) that I hadn't really used, so thought I'd give it a try. I got a terrible cough from Lotrel. I can't remember the dose for the captopril, but I think it is about the lowest dose. Monday I started taking one captopril in the morning, so I've taken it for 3 days now (no cough yet! ;-> )

So far I can't tell if it has made a definite impact on my blood pressure. I might be seeing minor improvements, but the stuff I've read says it can take a couple weeks for it to kick in, and this is just my 3rd day. I do notice a decrease in some of the tiazac/clonidine side effects I experience. This is unexpected, and I can't think of why it would happen, but I ain't looking a gift horse in the mouth, so to speak. These decreases started after taking captopril for 2 days. I haven't changed anything else in my life, so it must be the new drug.

My questions for ACEI users, and especially if you have experience with captopril:
1. Do you take your full dose at one time, or multiple doses during the day?
2. Do you take your ACEI with your other bp drugs, or take your drugs at different times of the day?
3. If you didn't develop a cough on a low dose, did you develop a cough going to a higher dose?
4. Is a cough less likely to develop if you take small doses twice or more a day rather than one big dose once a day?

I have a doctor's appointment July 11, so thought I'd experiment with the captopril in the mean time. I'm going to take all 3 drugs for at least a week, and then see if I can't wean some more off the clonidine, provided I don't get the cough.

I was thinking of asking my doctor if I could try an ARB like avapro or benicar, but if captopril works and I don't get the cough, maybe I should stick with it. Besides, its dirt cheap. Which is a better combination, a ccb plus ACEI, or ccb plus ARB?

 
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Old 06-22-2005, 03:40 PM   #2
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Re: questions for those using or had used ACEIs

Quote:
Originally Posted by mgraylorn
I take 180 mg tiazac (calcium channel blocker) once a day, and clonidine, .05 mg three times a day. I've been trying to wean off the clonidine, but it looks like I can't get by with just the tiazac. I had a bad reaction to increasing tiazac to 240 mg once, so am not ready to try that again yet.

I had an old prescription for captopril (ACEI) that I hadn't really used, so thought I'd give it a try. I got a terrible cough from Lotrel. I can't remember the dose for the captopril, but I think it is about the lowest dose. Monday I started taking one captopril in the morning, so I've taken it for 3 days now (no cough yet! ;-> )

So far I can't tell if it has made a definite impact on my blood pressure. I might be seeing minor improvements, but the stuff I've read says it can take a couple weeks for it to kick in, and this is just my 3rd day. I do notice a decrease in some of the tiazac/clonidine side effects I experience. This is unexpected, and I can't think of why it would happen, but I ain't looking a gift horse in the mouth, so to speak. These decreases started after taking captopril for 2 days. I haven't changed anything else in my life, so it must be the new drug.

My questions for ACEI users, and especially if you have experience with captopril:
1. Do you take your full dose at one time, or multiple doses during the day?
2. Do you take your ACEI with your other bp drugs, or take your drugs at different times of the day?
3. If you didn't develop a cough on a low dose, did you develop a cough going to a higher dose?
4. Is a cough less likely to develop if you take small doses twice or more a day rather than one big dose once a day?
I take 10 mgs of altace, Full dose in the am. At night I take 25mgs of atenolol and 1/2 of .1 mg of clonidine.

Sorry, can't comment on the cough as I never developed it.

I am curious about how the ACEI lessened your side effects from clonidine. I don't think I am experencing any difference there.


Quote:
I was thinking of asking my doctor if I could try an ARB like avapro or benicar, but if captopril works and I don't get the cough, maybe I should stick with it. Besides, its dirt cheap. Which is a better combination, a ccb plus ACEI, or ccb plus ARB?
I think they both work very equally well with diltiazem. At least my doc thinks they do.

Personally I like the ACE better cause I got joint pain from Benicar. But then I never got the cough and I understand very few get the joint pain. ( I always get the weird stuff though)

I would really like to drop the clonidine too but so far haven't been able to.

Hope the good luck keeps up for you!

Cass

 
Old 06-22-2005, 05:30 PM   #3
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Re: questions for those using or had used ACEIs

Quote:
Originally Posted by mgraylorn
Which is a better combination, a ccb plus ACEI, or ccb plus ARB?
I take a CCB (Verapamil), an ACEI (Quinapril) and an Arb (Avapro). From experimenting, I have found that each one has a lowering effect on my blood pressure.

I take the ACEI once in the morning, the Arb once a day, an hour away from the ACEI and the CCB at least three hours from all of my other meds.

Good luck with your ACEI experiment! I hope that it works for you.

 
Old 06-22-2005, 11:16 PM   #4
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Re: questions for those using or had used ACEIs

I'm off BP meds now, but was on an ACE1 for five years, a few months at 10 mg Lisinopril, then four years at 30 mg, then one year back at 10 mg. I never developed a cough from either dosage. I tried to take it in the morning, but realistically, I ended up taking it just about any time of day, as I have such a bad memory that I'd forget to take it when I was supposed to.

 
Old 06-23-2005, 09:39 AM   #5
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Re: questions for those using or had used ACEIs

Right now I take the captopril 25 mg upon getting up in the morning, since it says take it on an empty stomach. Waking up, feeding cats, catching a bit of news, showering, etc. takes about an hour or more before I am ready for breakfast. After breakfast I take the tiazac and the first dose of .05 mg clonidine. I was curious if it would be better to take captopril in the AM and tiazac at bedtime, or some staggering of more than one hour. Sometimes I experience a morning jolt of feeling not quite right (not low bp though), which I wonder if maybe is all the drugs zapping me at once.

My side effects from the ccb are some constipation, almost constant ringing in my ears of various loudness, sometimes strong heart beat (not fast), and a nearly constant hearing/feeling of pulse throbbing in my left ear. From the clonidine I get more constipation, more ear ringing, and as my dose starts to wear off I get often get jittery and experince increased heartrate.

Adding in the captopril has seemed to negate the consipation (increasing the effect of eating lots of prunes in the AM and dried apricots in the PM), reduces or eliminates the pulse throbbing in my ear and chest pounding, and reduces or eliminates the ringing in my ears. I'm also having a smoother transition when my clonidine dose is wearing off. I have noticed some increase in heart rate. Resting can range from the 50s to the 90s. Back when I was taking .1 mg clonidine 3 times a day, resting heart rate was in the 50s and 60s. When I take my bp the higher pulse surprises me - before with the pounding heart and ear throb I could always tell when the heartrate was up. Now I can feel relaxed and have a pulse of 86. I think my pre-medicated pulse rate was in the low to mid 80s.

I appreciate everyone's comments.

 
Old 06-24-2005, 04:39 PM   #6
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Re: questions for those using or had used ACEIs

I took Altsace (sp) for awhile and had a little coughing but not too bothersome. MGraylorn, how come you're weaning off the Clonidine? That was my next drug to try out as soon as the Norvasc gets completely out of my system. I will have to take that twice a day. I still have the prescription sitting on my dresser and I am reluctant to start it because of all the bad side effects I experienced on Norvasc. Currently, I'm only on 50mg Atenolol, but I know eventually I will need something more to keep my BP down.

Last edited by las7715; 06-24-2005 at 04:39 PM.

 
Old 06-24-2005, 04:51 PM   #7
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Re: questions for those using or had used ACEIs

Quote:
Originally Posted by las7715
I took Altsace (sp) for awhile and had a little coughing but not too bothersome. MGraylorn, how come you're weaning off the Clonidine? That was my next drug to try out as soon as the Norvasc gets completely out of my system. I will have to take that twice a day. I still have the prescription sitting on my dresser and I am reluctant to start it because of all the bad side effects I experienced on Norvasc. Currently, I'm only on 50mg Atenolol, but I know eventually I will need something more to keep my BP down.
Is your doctor going to have you take atenolol and clonidine at the same time? In my opinion, that's a mistake. Once you get on these two together it's almost impossible to get off either.

And they seem to emphasize each others side effects.

Cass

 
Old 06-27-2005, 09:51 AM   #8
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Re: questions for those using or had used ACEIs

I am slowly weaning myself off the Atenolol. The Clonidine, so far, is working great, brought my numbers down dramatically within 15 minutes of taking the very first dose.

Last edited by las7715; 06-27-2005 at 09:52 AM.

 
Old 06-28-2005, 08:46 AM   #9
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Re: questions for those using or had used ACEIs

Yea, you don't want to take clonidine and a beta blocker at the same time. It makes it harder to get off the Atenolol. Good thing you are weaning off it.

Clonidine is a great drug in some ways, in that it brings bp down really fast. Unfortunately it usually requires 2 or 3 times daily dosage.

Clonidine was a lifesaver for me when I had a bad experience with Toprol, another beta blocker. The reason I want to get off it is that when I was on 3 times a day dosage, I would often get a bit jittery and some increased heartrate at about 7 hours. Oddly, this would go away after a bit and I could stretch out the dose to 9 or more hours. Its a pain to have to keep up with 3 times a day dosage. I also think that it might add to my insomnia at night and sleepiness during the day. Now that its hot and I have been trying to do yard work, I think that I have more problems with heat effects and dehydration. I guess this makes sense. Clonidine is a centrally acting agent. If I stress my body too much, it can't correct quite as easily.

So far so good with the captopril experiment. This starts my second week at 25 mg and no coughing. I've been able to cut my clonidine down to .05 mg twice a day. My heart rate is a bit more variable, but settling down, and my bp numbers are in the 100s-110s/60s most of the time with a few up into the low 120s/low70s. This weekend I will try to go to once a day with the clonidine. I tried that several days ago and had rebound/withdrawal whatever after 15 hours. For a total daily dose of .15 mg per day, one should not experience withdrawal from clonidine, my pharmacist says. But something went on for me.

If you are having trouble getting blood pressure control with the standard drugs, and you aren't taking a beta blocker, then by all means try clonidine. You might also try it in patch form, especially if you only need a small dose. That requires once a week patch changing. I did the patch, but got some slight skin irritation and the patches are unsightly in sleeveless weather. My patches also had a tendency to peel up at the edges, so I always had to apply the larger sticky patch over it. The medicated patch is band-aid color, the sticky is white and says "here I am!"

One other thing, clonidine is sometimes used to help aleviate hot flashes and night sweats. When I get there, if I have a problem with nighttime menopausal symptoms, I'll try the clonidine again for sure. It seems safer than estrogen suppliments.

Last edited by mgraylorn; 06-28-2005 at 08:52 AM.

 
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