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  • I need help...Pleeze!

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    Old 06-19-2004, 07:54 AM   #1
    jtu91952
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    I need help...Pleeze!

    Hi guys/gals, its poor ole me again. I started the thread for avapro and the horrors. I tried to take everybodys advice about the avapro, but my dr refuse to help me. I ended up in urgent care last w/e becuz of severe thigh pain and hives in my eyes, face, lips and toes. In urgent care i was told to stop the avapro and take benadryl and zantac. Yesterday i called my dr and his stand-in dr told me to take a 1/2 more pill of verapamil. My bp shot up to 188/72. Right now i'm taking verapamil 240, hctz 25 for bp and he said to take 1/2 more of verapamil. Is this safe? He also said becuz i took lisinopril, and zestoric b4 and now avapro, there's nothing else they can do for me. I AM SO FRUSTRATED. From reading this board, it seems to me I am not the only person that have problems with bp meds. I have such a delicate and sensitive system. Any and all advice would be greatly appreciated. I cut sodium out my diet, I've tried everything i possible can, but now the drs are saying they don't know what to do for me. Plz advise.

     
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    Old 06-19-2004, 12:00 PM   #2
    zuzu8
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    Re: I need help...Pleeze!

    Jtu,
    I would up the Verapamil as per the doctor's instructions and see what happens. You've tolerated this drug pretty well for 5 years now, so increasing the dosage should be okay.

    However,for your doctor to shrug and kind of "give up" on you is not exactly the kind of physician I would want.

    You have mentioned in previous posts that you are diabetic, have had 2 heart attacks, plus mini-strokes and this doc would not refer you to a cardiologist. Is this STILL the case?
    If so, I would find a good cardio person, even if this higher dose of Verapamil works. With your heart history you absolutely need one. Plus no one knows hypertension (and drug management for it) better!

    zuzu xx

    Last edited by zuzu8; 06-19-2004 at 12:02 PM.

     
    Old 06-19-2004, 02:22 PM   #3
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    Re: I need help...Pleeze!

    Excellent advice from Zuzu. If I might add, if you have an HMO like I do that requires a referral and your dr won't give you one Please call your Ins co and tell them. You do really need to be in the care of a cardiologist. my goodness! there are hundreds of HBP drugs on the market. I have just been through about 6 combos in the last 6 mos because my CC blocker ( diltiazem) quit working. I used to take Verapamil 240 and once when it went really high (due to anxiety ) my dr told me to double it. There was no problem.
    Best of Luck and keep us posted,
    Cass

     
    Old 06-19-2004, 05:17 PM   #4
    jtu91952
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    Re: I need help...Pleeze!

    Thank u both for your kind words. I've already doubled the verapamil last nite and checked my bp this am and it was 151/68. It came down a little today, yesterday it was 188/72. It's the top # that bugs me. Yes zuzu i am diabetic and i used to see a cardio dr but when i switched practioners that changed. My gp didn't even want me to see an endo for my diabetes & thyroid problem, but i was already a patient with the endo. I am so frustrated with my gp, he insist on me taking lisinopril or avapro. He says they are the best for diabetes becuz they help protect the kidneys. I am almost well. I have not worked since 1999when all this mess started.

    I quit one gp becuz i never saw him only got to see student drs. They put me on 24 pills and caused me to become more ill. So i went back to my old gp for 20 yrs and he seems to have changed. He insist i take bp meds that caused severe hives and side effects. I think you're right, its time to find another dr.

     
    Old 06-19-2004, 08:18 PM   #5
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    Re: I need help...Pleeze!

    Jtu-

    Scientists have made great progress in developing methods that slow the onset and progression of kidney disease in people with diabetes and it's true that ACE inhibitors have been "favored" to slow the progression of kidney disease significantly.HOWEVER, calcium channel blockers ( e.g. your verapamil), also show promise in this area.

    On the Mayo Clinic's website I found the following info:
    Calcium channel blockers (calcium antagonists) (amlodipine, diltiazem, nifedipine, verapamil, others). These medications help relax blood vessel muscles. Some slow your heart rate.

    Additional benefits:

    They can be used to treat angina.
    Some types treat a rapid heart rate.
    Some may be useful for protecting your kidneys, particularly if you have diabetes or can't take an ACE inhibitor or ARB.
    They may be helpful for persistent diarrhea related to irritable bowel syndrome they can reduce your number of bowel movements per day.
    They may be useful in treating migraines and may benefit people with Raynaud's disease.
    Older people may benefit from certain calcium blockers in preventing stroke.

    Regarding your reaction to AVAPRO, just because one ARB did this to you, doesn't mean another will. If verapamil alone doesn't get your #s down to an acceptable level, you might want to discuss the possibility of adding to it, one of the newer ARBS, particularly BENICAR (olmesartan).

    I posted the following info in a thread that Sunny6 started called "Zuzu, JJ and others"....and I'll repeat it here for you so you don't have to go crazy searching:

    Paraphrased and shortened by me:
    The antihypertensive efficacy of Benicar has been evaluated based on pooled data from seven placebo-controlled trials and two head-to-head trials that directly compared it with other ARBs.

    The seven multicenter, randomized, placebo-controlled, double-blind clinical trials, conducted in the United States (three centers) and in Europe (four centers), were designed to evaluate Benicar VERSUS 3 other ARBS.

    Paraphrased QUOTE-"Olmesartan medoxomil has consistently been associated with double-digit BP-lowering efficacy for both systolic and and diastolic blood pressure using the recommended starting and maximum dosages of 20 mg/day and 40 mg/day, respectively. This was observed in the integrated analysis of seven placebo-controlled trials and in both head-to-head comparisons vs. other ARBs, despite olmesartan medoxomil having been initiated in one of the head-to-head trials at 10 mg/d, half the recommended starting dosage. Compared to baseline, DBP and SBP were reduced by approximately 12 and 15 mm Hg, respectively, in subjects treated with olmesartan medoxomil at the recommended starting dosage of 20 mg once daily. These BP reductions appear greater than those achieved with other ARBs, as demonstrated in two meta-analyses which generally showed only single-digit reductions in diastolic BP at the recommended starting dosage.

    Furthermore, these extrapolations were substantiated in direct head-to-head studies in which Benicar demonstrated significantly greater antihypertensive efficacy than the ARBs losartan potassium (Cozaar), valsartan (Diovan), and irbesartan (Avapro).
    UNQUOTE

    First though, let's see what happens on the verapamil alone. The increased dosage may just do the trick.
    I understand your doc loving the idea of you having an ACE in the mix to reduce or slow progression of kidney damage (ARB's are similar and therefore would count as an ACE and have been shown to be kidney protective as well), so if you need to, adding Benicar instead of Avapro might be an option.
    Hives will not necessarily ensue!

    And, yes, a new doc might be a good idea. Make it a cardiologist!

    zuzu xxx

    Last edited by zuzu8; 06-19-2004 at 08:20 PM.

     
    Old 06-20-2004, 04:53 PM   #6
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    Re: I need help...Pleeze!

    If I might add to Zuzu's post. I once took Avepro for 1 day. At the time I was taking Micardis. ( asked to be switched to another ARB because of the way Micardis is packaged-that's another story ) anyway after 1 day I went back to Micardis on my own. I had terrible side effects including - leg, back & hip pain; rapid heart rate; & higher BP. I later asked to be switched to Diovan ( no side effects but not quite good enough BP control) so Cardiologist switched me to Benicar HCT ( no side effects and BP 120's / 70's to 130's / 70's) and my BP is hard to control.
    As Zuzu said if you can, see a cardiologist.
    Cass

     
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