BP meds and side effects

[davebray]

I've been through a handful of blood pressure meds and each one has given me side effects. Initially, it was the dizziness that I didn't like, so I switched, then it was the fact that my BP would sometimes go too low, then when I found one I thought would work (Cozaar) frequent urination set in like a plague. I am now back on Cardura, but it keeps me sexually dysfunctional. Does anyone know which BP med has the least side effects? Incidentally, I also contend with IBS (irritable bowel synd) and so I have to guard against digestive upset. I'm 52 yrs. old.

[Palamedes]

Originally Posted by davebray

I've been through a handful of blood pressure meds and each one has given me side effects. Initially, it was the dizziness that I didn't like, so I switched, then it was the fact that my BP would sometimes go too low,

What is your average BP? Both, at the doctor and at home? The fact that your BP is going too low (I assume on one drug) indicates you may not need meds at all.

Originally Posted by davebray

then when I found one I thought would work (Cozaar) frequent urination set in like a plague. I am now back on Cardura, but it keeps me sexually dysfunctional. Does anyone know which BP med has the least side effects? Incidentally, I also contend with IBS (irritable bowel synd) and so I have to guard against digestive upset. I'm 52 yrs. old.

Yes, frequent urination can be a side-effect of an ARB. It blocks angiotensin II - including at the adrenal glands. This results in a lower level of aldosterone. And, aldosterone causes sodium retention. So, the net effect can be similar to a mild diuretic. However, I would expect this to settle down after a week or two as things stabilize. Over time, this helps you get to a sodium depleted state which is required for the drug to work at all.

Other classes to try? That's a tough one. Cozaar is in the most side-effect free class (ARB) there is. A diuretic would be much worse with your "frequent urination". However, with a diuretic, this would only happen after you take the meds (not 24/7). But, I don't think a diuretic would do much for you since your experience with Cozaar leads me to believe you must have a fairly active renin-angiotension system. A beta-blocker would probably work for your BP control. But, now we are talking about serious side effects. A CCB would most likely be a disaster for you. You're currently on an alpha-blocker. So, I guess you need to weigh BP control vs. urination vs. sexual dysfunction.

All this leads me back to my first question... What is your BP? Both at home and the doctor.

Pal

[CASSIEBEL]

Over time, this helps you get to a sodium depleted state which is required for the drug to work at all.

Pal, Could you help me out here. I have been on Benicar HCT for over 6mos now and I just had my annual physical. Although my sodium level is within the normal range, it is high normal. 140, normal range being 134-145
(according to my report.)

My question to you, If my medication has me in a sodium depleted state wouldn't the numbers be on the low side? Does that mean the HCT isn't working for me or could it be something I'm doing wrong?

[zuzu8]

DAVE,

As Palamedes said, Cozaar and its cousins (the ARBs- angiotensin 2 receptor blockers) have the least side effects of BP meds.

May I suggest that you try a different ARB. In reading up on the pharmaceutical literature for all the ARBS, it appears that DIOVAN has the absolute least side effects in the entire class. It's very well tolerated.

I also have IBS and have no problems (bowel or otherwise!) on Diovan, but DID on beta blockers, diuretics and ACE inhibitors.

Urinary frequency has been reported in clinical trials for Cozaar (although extremely rare and almost always transient), but it does not appear anywhere that I can see in the monographs for Diovan.

And yes, switching drugs within class sometimes makes all the difference!

zuzu xx

[Lenin]

Cassiebel,

Sodium depletion really doesn't show up on a blood test to any degree worth considering. What happens as the body gets sodium depleted, the volume of the blood is decreased by the elimination of water. The ratio of sodium/water is highly guarded and as near a constant as anything in the body can be.

So basically speaking, sodium depletion means water depletion. Probably the easiest way to determine it is by the loss of a couple pounds body weight (all water and a little salt.)