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Old 01-09-2008, 10:49 AM   #1
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What Medication Next?

Four years I was diagnosed with HBP (I was 28 then) - said it was hereditary. I was placed on a low does of Verapamil and after 2 weeks on it had an AWFUL reaction and ended up in the ER -- such horrid chest pain and tightness - thought I was having an asthma attack - though at that time I had not been diagnosed with asthma yet. -- Not an attack - just an adverse reaction to the Verapamil.

I was taken off that and placed on 25mg of Toprol and then increased to 50 mg 2 years later. Also, about the time I was taken off Verapamil my Dr. diagnosed me with asthma though my pulmonary test came back fine???

So I take Toprol 50 MG and FLovent 2 puffs times 2 times per day and Ventolin as needed. Well in October my breathing became BAD - had not had ANY problems with in since being diagnosed?? But out of nowhere.

So takes me off Toprol (in 4 days??? the withdrawl was HORRID) - tries me on Diovan -- HORRID COUGH and upper chest tightness, then on a Diuretic - again horrid horrid chest tightness (no cough) - but leg cramping.

Go back and puts me back on 25 mg Toprol and 80 mg Diovan (which I had to stop AGAIN because of the cough and chest tightness) - and also tells me to start taking Prilosec for GERD and poossible Hiatal Hernia.....

Well long story short, breathing bad again and I go back Friday to try yet ANOTHER NEW HBP med -- what is left for me to try?????

Thank you......

 
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Old 01-09-2008, 11:45 AM   #2
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Re: What Medication Next?

Hi Vanessa,

I know you are awaiting your doctors' appointment anxiously. As discussed previously in another post, beta blockers should be avoided completely in people with asthma unless otherwise indicated.

The one antihypertensive medication you might not have tried is an ACE inhibitor. Some people get pretty bad cough as a side effect. Otherwise, all things considered it is an excellent medication for a number of reasons. It is used in treating several medical conditions and has been proven very effective in blood pressure control. It is often combined with a diuretic for a greater reduction in blood pressure.
Some people with an elevated blood pressure find that a single drug, a diuretic, is enough to maintain their target blood pressure. The drug therapy needed to bring the blood pressure to goal depends on the overall health of patient & CVD risk factors, the type of hypertension and its severity. The response to drug therapy varies from patient to patient.
I too experienced extreme reaction to two drugs from the ARB class of antihypertensives, Diovan and Micardis. I cannot tolerate them at all. I wonder if you could be experiencing side effects from your asthma drug interaction with the other meds. I was on Advair for a time with no relief in symptoms and stopped taking it altogether. The fewer meds we take, the better.
Good luck with your appointment! I hope you feel better soon and your breathing improves.

flowergirl

 
Old 01-09-2008, 01:28 PM   #3
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Re: What Medication Next?

Thank you so much for your input. I too tried Diovan and had a HORRID reaction to it - an AWFUL cough and the most horrid upper chest tightness. So I am scared to try another ACE Inhibitor....

I wonder if he (my Dr.) - will let me go off all my meds just for a while to purify my body and then add one at a time to better determine what is going on. I have lost 16 pounds and radically modified my diet to help with my health.

I am probably just wishful thinking! My B/P is pretty high so he probably won't go for this!!

I would really love to stop the Flovent because it does not seem to be working, the last 5 nights I have woken up every hour unable to breath - it never ever used to be this bad at night - now I am afraid to sleep. I am afraid to stop the Flovent because I am afraid I will have an asthma attack.

Thank you for all your posts - you have an incredible wealth of knowledge. I have been reading all your posts - and you have inspired me to order some books and start educating myself on my conditions.

Thanks again!

 
Old 01-11-2008, 04:58 PM   #4
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Re: What Medication Next?

Hi Flower

Went today - B/P was HIGH. My Dr. decided to keep me on the Toporol for now because he listened to me and I was not wheezing. Said that Toporol can cuase wheezing??? He feels that my breathing is not from the Toprol but rather from Acid Reflux - so he gave me a stronger med (Prevacid) for that.

He said that if the B/P does not come down - he wil try a diuretic?

Also he said that I have a high anxiety/stress level (VERY TRUE!!!) - which is making the B/P much worse so wants me to try Lexapro for that???

 
Old 01-11-2008, 07:59 PM   #5
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Re: What Medication Next?

Vanessa,

Thank you for the update!

I was told just yesterday that anxiety makes everything worse. I suppose it can. My doctor feels I have an anxiety issue. Well, I don't most of the time - I am too busy for that. I do get a little tense listening to him because I feel he does not take me seriously enough. I find his indifference very annoying and I guess it shows.
Luckily (for him!!!), he has not offered any medication for it.
Your meds sound OK. You will know shortly whether or not the beta blocker is the right medication for you. You will achieve a good blood pressure control eventually. Your doctor will make sure.

I hope that your doctor was right and that the betas are not responsible for your shortness of breath. You'll know soon enough! If your doctor ever explains the mechanism that causes the breathing problems in people with GERD, would you please share? I remember reading something about GERD causing a malfunction of the breathing muscle in some people. The muscle has a name which I can't remember. I wish I had written the info down. I have looked for it since reading the original article but can't find it. The reason for my breathing difficulties has not been determined. I am still looking for answers.

Good luck with your treatment!

flowergirl

Last edited by flowergirl2day; 01-11-2008 at 08:05 PM.

 
Old 01-11-2008, 08:12 PM   #6
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Re: What Medication Next?

FG,

Is the breathing muscle that you are thinking about the Diaphragm.

In my experience, acid reflux does cause breathing problems. Acid gets down the trachea (windpipe) & it is very difficult to breath. The b/p decreases the pressure in the opening into the stomach from the esophagus. I've experienced this. Lifestyle changes can prevent this from happening most of the time. A lot of these b/p meds cause acid reflux. Fam

 
Old 01-11-2008, 10:52 PM   #7
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Re: What Medication Next?

Thank you Fam!

What an unpleasant and annoying disorder to have to deal with! Oh well. I guess it will take some getting used to.
Thank you for the information. When I have some time, I'll try to find out more. I know that breathing problems are very common in people with this disorder. Weight loss helps supposedly.

FG

 
Old 01-12-2008, 05:18 AM   #8
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Re: What Medication Next?

Quote:
Originally Posted by Vanessa74 View Post
Hi Flower

Went today - B/P was HIGH. My Dr. decided to keep me on the Toporol for now because he listened to me and I was not wheezing. Said that Toporol can cuase wheezing??? He feels that my breathing is not from the Toprol but rather from Acid Reflux - so he gave me a stronger med (Prevacid) for that.

He said that if the B/P does not come down - he wil try a diuretic?

Also he said that I have a high anxiety/stress level (VERY TRUE!!!) - which is making the B/P much worse so wants me to try Lexapro for that???
Toprol can cause breathing problems and stomach problems. If you haven't experienced these before, it is possible that your breathing problems and acid refluc is from the toprol and your doctor is treating your side effects with more meds.

Beware of the diuretics...I didn't have any noticable breathing problems before meds until I was on a diuretic, hydrochlorothiazide, and then ended up with 3 prescriptions for my breathing problems. My breathing problems ceased after discoing my hct and didn't start again until getting another med that contained a small amount of hct...a beta blocker, atenolol, also caused more breathing problems. Do read the package insert BEFORE purchasing any new medication...it may prevent problems down the road.

Vanessa,

You've mentioned problems with breathing, with stomach acid, and with anxiety. Although bp meds can cause these symptoms, sleep disorders can cause them as well. Have you considered this possibility? MOST doctors, including specialists, overlook obvious symptoms...for this reason, I strongly suggest doing your own research. Treatment for sleeping disorders is often med/surgery free, and can bring down blood pressures considerably.

Good luck!

Bethsheba

 
Old 01-12-2008, 07:07 AM   #9
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Re: What Medication Next?

Thank you all for your posts and insights - they are so helpful.

The breathing problems started after being on Toprol for 4 years -- AND after being changed to the generic version without my knowledge - within a month of taking the generic my breathing issues started horribly and got worse - as did stomach pain and acid. I switched back to the regular - but the damage was done. So I believe that you are right in the Toprol causing the problems.

I am scared to try anymore new medications for my B/P because I have had so many negative and unwanted reactions.

I am a nervous and fearful person by nature - TOTAL TYPE A and a chronic worrier. I know that this is contributing significantly to my sever HBP as I have had some tragedies in the past two years that put me over the 'anxiety edge' so to speak.

I want to add exercies and meditation to my regiment. I will also check into the sleep disorder.

What type of breathing problems did you develop on the diuretic?

Thank you all again - I find so much peace and comfort here.

 
Old 01-12-2008, 10:00 PM   #10
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Re: What Medication Next?

Vanessa,

Quote:
The breathing problems started after being on Toprol for 4 years -- AND after being changed to the generic version without my knowledge - within a month of taking the generic my breathing issues started horribly and got worse - as did stomach pain and acid. I switched back to the regular - but the damage was done. So I believe that you are right in the Toprol causing the problems
How did they switch your meds without your knowlege? They did the same with one of mine a month ago when filling my prescription for several meds. I refused to pay for it after being informed about the substitution. The reason I was given was that the pharmacy had decided not to stock that brand name medication anymore. I rely on my medication extensively and am not willing to experiment with the generics. (They now stock it again... )

We can avoid some of the unwanted side effects of our meds by taking fewer of them. Certain lifestyle changes, including exercises and meditation you mentioned, should prove helpful. We might be stuck with the meds for a while because severe hypertension does not simply go away.

I know you will enjoy the meditation and am glad you've decided to do it. I can't meditate because I'd fall asleep if I tried. I don't sleep much when I should and get tired when I shouldn't. Should your breathing problems persist, you might find exercising of any kind quite a challenge. When the SOB becomes severe enough, even normal activities such as walking a very short distance or moving the arms can become very tiresome. I hope your breathing improves.

Toprol XL is metabolized by CYP2D6. This is an enzyme that some of us lack, resulting in poor metabolization of the drug. Some people metabolize this drug poorly even if they have this enzyme. Unfortunately, the enzyme can be inhibited by other drugs taken concomittantly. When this happens, the blood levels of Toprol increase significantly.
With the increase in blood concentration of the beta blocker some of the cardioselectivity is lost and beta2 receptors are affected as with non-selective beta blockers.
Thus the breathing problems, especially in the presence of asthma or COPD, with cardioselective beta blockers.

My breathing difficulties were attributed to asthma. Highly unlikely. The shortness of breath, tolerable at first, grew progressively worse and eventually became severe.
I think that medication and GERD were the most likely causes. There were several other possibilities for the SOB as well. I don't think the diuretics affected my breathing directly. The non-selective beta blockers combined with an ACE inhibitor and a CCB probably did. Your breathing should get much better through time. If it does not improve, a change in medication will be necessary.

Good luck!

flowergirl

Last edited by flowergirl2day; 01-12-2008 at 10:14 PM.

 
Old 01-13-2008, 05:34 AM   #11
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Re: What Medication Next?

Quote:
Originally Posted by Vanessa74 View Post
...I am scared to try anymore new medications for my B/P because I have had so many negative and unwanted reactions....
I feel the same way...but I am wiser now. I now realize the importance of doing my homework BEFORE filling a prescription, and if I choose to fill that prescription, I will know what side effects to look for, and how and when to stop taking the medication (very important because some medications shouldn't be stopped suddenly). And I don't believe everything the doctors tell me, at least not without checking it out first!!!

Quote:
...I am a nervous and fearful person by nature - TOTAL TYPE A and a chronic worrier.
This is not necessarily a bad thing...to a degree we need these qualities for survival.

Quote:
...I know that this is contributing significantly to my sever HBP as I have had some tragedies in the past two years that put me over the 'anxiety edge' so to speak.
It may be that the stress has elevated your bp...but with life tragedies and life stresses we sometimes forget that our eating habits, exercise, sleeping, smoking and drinking habits often change. So although it may be stress, other factors (which, unlike some forms of stress, may be controllable) may play a significant role here.

Quote:
...I want to add exercies and meditation to my regiment. I will also check into the sleep disorder.
Yes, all of these would have the potential for dropping your pressures "naturally".

Quote:
...What type of breathing problems did you develop on the diuretic?...
I had three different respiratory problems on the diuretic...

Air born allergens caused a dry non productive cough. It's kind of hard to describe, but although I was coughing like crazy, and although I was getting air into my lungs, air didn't seem to get to the rest of my body, ...I remember having a Christmas tree in the house and realizing that although I had Christmas trees for years and years, I would no longer be able to do so because I knew it was making me cough. Candles that burned in my neighbor's apartment were another source of coughing fits (that lasted for hours) as were different scents. Other airborne allergens must have bothered me as I would wake up in the middle of the night with a coughing fit. I didn't realize my breathing problems were a side effect of my medication (apparently my doctor didn't either) and an inhaler, advair, was prescribed for this. Compounding the coughing problem, was a lack of bladder control (a definite side effect of the hct)...the coughing fits would require ongoing changes of clothing.

The second problem I had was with congestion. I sleep with a cpap mask that fits over my nose when I sleep, and I couldn't sleep with my machine because I was so congested. Nasonex was prescribed for this.

The third problem I experienced, was a nose that ran non stop for 2 days (this only happened once during this time, but believe me, once was enough!) and I was prescribed another medication for this...I didn't fill the third medication because by that time red flags started waving.

I sleep with my cpap regularly because I have little or no congestion, haven't had coughing fits, and haven't had a runny nose (even with the cold I had this fall) since discoing the hct and the atenolol (12 or more months ago)....and no, I haven't used the inhaler or the nasonex since that time.

Those were only the respiratory problems I experienced on the diuretic...the other problems were much, much worse.

Quote:
...I find so much peace and comfort here.
Yes, I do, too. I only wish I had found this place before taking my first prescription medication.

Bethsheba

Last edited by bethsheba; 01-13-2008 at 09:33 AM. Reason: grammer

 
Old 01-13-2008, 02:03 PM   #12
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Re: What Medication Next?

Beth,

Thank you so much for sharing - you made me feel a lot better. Best of luck to you and best of health.

I am still thinking my problem is the Toprol - I think I just need a different medications - I feel a definite connection there... We shall see!

 
Old 01-13-2008, 02:10 PM   #13
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Re: What Medication Next?

Hi Flower!

My med switch was odd- I went to pick it up one day and the price was less - when I asked WHY - they said the price had gone down??? I didn't question and began taking it - when I started to feel bad I looked at the bottle and realized I had been given the generic - It was awful. Unfortunately it took me almost 20 days to discover what was wrong - and since I have NOT been the same.... Think the generic may have done some permanent damage.

My breathing problems are SOB, hard time getting a breath all the way down and tightness across my back and stomach - sometimes so severe I thought I would pass out. Once I started the PPI these almost went away completely???

Since starting the PPI's NEW breathing problems have surfaced - tightness is the UPPER chest and back and difficulty breathing period. My pulmonologist is insisting that I have asthma but my regular Dr. is not sure????

I am wondering if the Toprol and Prilosec are interacting with each other????

 
Old 01-13-2008, 02:44 PM   #14
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Re: What Medication Next?

Vanessa,

You should get the package insert for the generic & your regular Toprol. Then compare the list of inactive ingredients. You need to know if there was a different ingredient or ingredients between the two.

This is how I finally figured out that I was allergic to yellow dye #6 A.L. The pharmacist at Walgreens was quite surprised.

You need to know this information so that you don't come in contact with a possible ingredient in the generic again. I take breathing problems seriously as they can point to an allergic reaction. Fam

 
Old 01-13-2008, 03:13 PM   #15
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Re: What Medication Next?

Quote:
Originally Posted by famnd;33***82
... I take breathing problems seriously as they can point to an allergic reaction. Fam
Yes, breathing problems are serious! And yes, they can point to an (often overlooked) allergic reaction.

Unfortunately we sometimes get caught up looking for a "diagnosis", but the bottom line is we need to be able to breath no matter what the cause. My primary said I was having bronchspasms, and my pulmonary specialist suggested something else (I was too sleep deprived due to hct at the time to remember what he called my problem but it was not the same diagnosis as my primary) but neither diagnosis made a difference in my ability to breath...only discontinuing the blood pressure made the difference.

Bethsheba

 
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