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    Old 01-25-2008, 02:17 PM   #1
    10sboi
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    HP Med check

    Hello everyone,

    What a great resource! I've been averaging 140/90 for quite some time. I've been on Norvasc 5mg. My doctor bumped it up to Norvasc 10mg. After week of not having any significant progress, he added Toprol 100mg. Today was the first day and boy, what a bad rush.

    My concern is that both of these BP med labels say for patience with angina, etc. Is this too much medicene? Granted I am overweight (5'6, 245) but am working daily to lose it and to eat right and cutting down on sodium etc.

    Any input would be greatly appreciated, I most certainly would like to get off these meds and believe it can be done but I'm realistic as well.

     
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    Old 01-25-2008, 11:01 PM   #2
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    Re: HP Med check

    Hi,

    Quote:
    I've been averaging 140/90 for quite some time. I've been on Norvasc 5mg. My doctor bumped it up to Norvasc 10mg. After week of not having any significant progress, he added Toprol 100mg. Today was the first day and boy, what a bad rush.
    Your doctor should have waited a little bit longer. It takes between one and two weeks to achieve a maximum response on Norvasc at the beginning of treatment or after a dose adjustment. The average reduction in mild to moderate hypertension using this drug is 12/6mmHg and is directly dose-related. Older people get a better reduction in systolic blood pressure with this drug for some reason.

    I have been taking a CCB concomitantly with a beta blocker for a year. This is not generally recommended because of an interaction between the two medications, but our physicians prescribe these two drugs together anyway.

    When Norvasc and Toprol are administered concomitantly, there is an additive reduction in heart rate. This can result in a severe hypotension. The same can be said about cardiac conduction and contractility, especially if any ventricular or conduction disorders are present. This combination of drugs is useful but also potentially dangerous. It would seem you've been spared any cardiological problems. Why this particular choice of drugs? Why not diuretics and an ACE? There is a good chance there will be heart rhythm and heart rate abnormalities as a direct result of using this drug combo. For this reason, the heart function should be monitored periodically. You might start noticing changes in your ECGs. Be prepared to wait a minimum of at least 10 days for determining your blood pressure response.

    A warning about the dosing - and this comes from personal experience: because the incidence and severity of side effects are directly dose related, try to keep your meds at reasonable amounts. I suffered through very unpleasant experiences with edema as well as cardiological adverse effects on the 10mg dose. To date, I remain on this dose. My side effects included chest pain, palpitations and heart rhythm changes. Did you know that both of these drugs can cause edema? Thus, your chances of getting edema sooner or later are pretty good!

    Low dosing of Metoprolol affects the blood pressure control which will not last the entire 24hr period. For this reason, the low dose should be split and taken more frequently -like twice daily. The only problem I see with that is that people stay awake all night and are unable to get any rest. Taking the beta blockers in the evening is definitely NOT a good idea! They should be taken much earlier in the day I think. I take mine just once daily in the a.m. I took my twice daily 5mg Norvasc earlier this evening and am having palpitations and chest discomfort. This is my second day on it - got switched from another CCB, felodipine. I guess Norvasc takes some getting used to. I'd like to point out that these are just my own thoughts and observations. Like everyone else, I rely on my doctors' opinions and let them make the decisions regarding treatment options. Doctors usually have reasons for selecting a particular drug therapy. Anyway, I hope this helps.

    I am curious about this choice of drugs in a normal, uncomplicated hypertension. A little strange. Do what you can to get off the meds if possible - good luck to you!

    flowergirl

    Last edited by flowergirl2day; 01-25-2008 at 11:27 PM.

     
    Old 01-25-2008, 11:25 PM   #3
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    Re: HP Med check

    Quote:
    Originally Posted by flowergirl2day View Post
    Hi,



    Your doctor should have waited a little bit longer. It takes between one and two weeks to achieve a maximum response on Norvasc at the beginning of treatment or after a dose adjustment. The average reduction in mild to moderate hypertension using this drug is 12/6mmHg and is directly dose-related. Older people get a better reduction in systolic blood pressure with this drug for some reason.

    I have been taking a CCB concomitantly with a beta blocker for a year. This is not generally recommended because of an interaction between the two medications, but our physicians prescribe these two drugs together anyway.

    When Norvasc and Toprol are administered concomitantly, there is an additive reduction in heart rate. This can result in a severe hypotension. The same can be said about cardiac conduction and contractility, especially if any ventricular or conduction disorders are present. This combination of drugs is useful but also potentially dangerous. It would seem you've been spared any cardiological problems. Why this particular choice of drugs? Why not diuretics and an ACE? There is a good chance there will be heart rhythm and heart rate abnormalities as a direct result of using this drug combo. For this reason, the heart function should be monitored periodically. You might start noticing changes in your ECGs. Be prepared to wait a minimum of at least 10 days for determining your blood pressure response.

    A warning about the dosing - and this comes from personal experience: because the incidence and severity of side effects are directly dose related, try to keep your meds at reasonable amounts. I suffered through very unpleasant experiences with edema as well as cardiological adverse effects on the 10mg dose. To date, I remain on this dose. My side effects included chest pain, palpitations and heart rhythm changes. Did you know that both of these drugs can cause edema? Thus, your chances of getting edema sooner or later are pretty good!

    Low dosing of Metoprolol affects the blood pressure control which will not last the entire 24hr period. For this reason, it should be taken more frequently. The only problem I see with that is that people stay awake at night and are unable to get proper rest. Taking the beta blockers in the evening is definitely NOT a good idea! It should be taken much earlier. I took my twice daily 5mg Norvasc earlier this evening and am having palpitations and chest discomfort. This is my second day on it - got switched from another CCB, felodipine. I guess Norvasc takes some getting used to. I'd like to point out that these are just my own thoughts and observations. Like everyone else, I rely on my doctors' opinions and let them make the decisions regarding treatment options. Doctors usually have reasons for selecting a particular drug therapy. Anyway, I hope this helps.

    I am curious about this choice of drugs in a normal, uncomplicated hypertension. A little strange. Do what you can to get off the meds if possible - good luck to you!

    flowergirl
    Thank you very much for your reply. I'm going to DASH and exercise my way off or have my meds greatly reduced. My main concern is that I don't feel there was enough time to let the meds do their work as well. I'm seriously thinking about getting a second opinion. Just in regards to the meds. It's no doubt that I need them, but I don't know if I need that much right now, but they are the professionals.

    I was born with a bundle-branch block (right side I believe). I had the whole shibang done a couple of years ago and everything came back negative. Thumbs up from the cardiologist. My internist does and should have this information available. Hopefully he considered it in my diagnosis.

    Certainly frustrating as I'm 42 male eager for the tennis season to kick in. Not sure how this new combo will work. But I'll post updates.

     
    Old 01-26-2008, 10:58 AM   #4
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    Re: HP Med check

    Wow, what a ride, an unpleasant one though. Good news is my BP today is 123/82 which is what the doctor wanted. It's just the trip getting there in just a day or two with the increased dosage makes me feel blah. Hopefully it's just temporary.

     
    Old 01-26-2008, 02:52 PM   #5
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    Re: HP Med check

    Are you having any other side effects? Glad your B/P came down!

     
    Old 01-26-2008, 06:34 PM   #6
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    Re: HP Med check

    10sboi,

    Good to hear this drug combination seems to be working for you. If you are lucky, you won't get any additional side effects besides those you've already mentioned. Some people seem to tolerate drugs better than others. You could be one of those!
    While at work earlier today I noticed flushing on my face in two symetrical triangular areas. I panicked, thinking it was some weird type of a rash, before recognizing it for what it was - a side effect of Norvasc. Aside from that I just noticed several inflamed areas of skin on my chest. That's it for side effects so far. I hope you are feeling better today. Things will get easier after a while. How is your breathing?

    Good luck with your therapy and blood pressure control!
    flowergirl

    Last edited by flowergirl2day; 01-26-2008 at 06:35 PM.

     
    Old 01-26-2008, 06:51 PM   #7
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    Re: HP Med check

    Quote:
    Originally Posted by flowergirl2day View Post
    10sboi,

    Good to hear this drug combination seems to be working for you. If you are lucky, you won't get any additional side effects besides those you've already mentioned. Some people seem to tolerate drugs better than others. You could be one of those!
    While at work earlier today I noticed flushing on my face in two symetrical triangular areas. I panicked, thinking it was some weird type of a rash, before recognizing it for what it was - a side effect of Norvasc. Aside from that I just noticed several inflamed areas of skin on my chest. That's it for side effects so far. I hope you are feeling better today. Things will get easier after a while. How is your breathing?

    Good luck with your therapy and blood pressure control!
    flowergirl
    Thanks, so far nothing noticeable other than I can't really just get up and go right now. It seems like my body is lagging behind. I have to get up carefully so I don't get too woozy. I'm going to focus on being positive and hopefully I'll get out of this little fog here quickly. Tonight at church friends could tell I wasn't my usual self. Hopefully my body will adjust to the lower bp soon.

     
    Old 01-28-2008, 03:17 PM   #8
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    Re: HP Med check

    Quote:
    Originally Posted by flowergirl2day View Post
    ...While at work earlier today I noticed flushing on my face in two symetrical triangular areas. I panicked, thinking it was some weird type of a rash, before recognizing it for what it was - a side effect of Norvasc....
    Flowergirl,

    You are describing the "butterfly" rash that my girlfriend developed while on hydrochlorothiazide...although it may be the norvasc (a rash is an allergic reaction to a drug), the butterfly rash seems to be associated with the hct in particular..as is the breathing problems, elevated cholesterol, and elevated blood sugars. Norvasc is known for flushing (turning red), headaches, gas, heartburn....

    And just for your info, it took her several months after she stopped taking the medication to get rid of the rash. It was the only med she was taking at the time.

    Bethsheba

    Last edited by bethsheba; 01-28-2008 at 03:21 PM.

     
    Old 01-28-2008, 03:20 PM   #9
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    Re: HP Med check

    Quote:
    Originally Posted by 10sboi View Post
    ... Hopefully my body will adjust to the lower bp soon.
    Hi sboi,

    I suspect it isn't your lower bp that your body is responding to...I, like previous posters, think that you were prescribed a second drug before realizing the effects of the first.

    Beware...I wouldn't drive or do anything to endanger your well being given how you are feeling. If you are overmedicated you could pass out at a moment's notice and it could be fatal for you or for someone else if you are driving a car, climbing a ladder, working with machinery, etc.

    Bethsheba

     
    Old 01-28-2008, 07:46 PM   #10
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    Re: HP Med check

    Quote:
    Originally Posted by bethsheba View Post
    Hi sboi,

    I suspect it isn't your lower bp that your body is responding to...I, like previous posters, think that you were prescribed a second drug before realizing the effects of the first.

    Beware...I wouldn't drive or do anything to endanger your well being given how you are feeling. If you are overmedicated you could pass out at a moment's notice and it could be fatal for you or for someone else if you are driving a car, climbing a ladder, working with machinery, etc.

    Bethsheba
    It's been very disappointing to say the least. I think my doctor was too aggressive. I feel trapped now with this medicine. Where I used to have a nice and vigorous walk on a treadmill for 30 minutes at 3.0 mph, today I did a light walk, closely watching myself. Amazing how so much changed from two weeks ago.

    I callled my doctor's nurse today and told her what I was going through, she was going to talk to the doctor and let me know. Haven't heard back, yet.

     
    Old 01-28-2008, 08:05 PM   #11
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    Re: HP Med check

    Beth,

    Quote:
    You are describing the "butterfly" rash that my girlfriend developed while on hydrochlorothiazide...although it may be the norvasc (a rash is an allergic reaction to a drug), the butterfly rash seems to be associated with the hct in particular..as is the breathing problems, elevated cholesterol, and elevated blood sugars. Norvasc is known for flushing (turning red), headaches, gas, heartburn....

    And just for your info, it took her several months after she stopped taking the medication to get rid of the rash. It was the only med she was taking at the time.

    I am happy to say the rash/whatever it was on my face was (thank goodness!!!!) only transient and is completely GONE, at least for now. I hate rashes now that I seem to have them all the time. It's not surprising since most drugs have this side-effect and I take several that do for sure. Strangely, the only areas affected are my chest and infrequently the thighs. I hope it stays that way - it may seem like a strange thing to say.
    I've finally ordered the dermatology book recommended by Fam. I expect to be referring to it often. The way I see it, there are far worse side effects some of us have to deal with than rash. Unless it appears on the face, which would bother me a lot. I have almost resigned myself to living with rash. Mine is just normal and nearly not as bad as Fam's.
    I hope I don't get any new side effects from Norvasc. Hopefully, it's not much different from Felodipine. As a matter of fact, it's supposed to have less intense (milder) side effects on high doses than Felodipine. I remain doubtful but certainly hope so.

    flowergirl

     
    Old 01-29-2008, 10:45 AM   #12
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    Re: HP Med check

    Quote:
    Originally Posted by flowergirl2day View Post
    Beth,




    I am happy to say the rash/whatever it was on my face was (thank goodness!!!!) only transient and is completely GONE, at least for now. I hate rashes now that I seem to have them all the time. It's not surprising since most drugs have this side-effect and I take several that do for sure. Strangely, the only areas affected are my chest and infrequently the thighs. I hope it stays that way - it may seem like a strange thing to say.
    I've finally ordered the dermatology book recommended by Fam. I expect to be referring to it often. The way I see it, there are far worse side effects some of us have to deal with than rash. Unless it appears on the face, which would bother me a lot. I have almost resigned myself to living with rash. Mine is just normal and nearly not as bad as Fam's.
    I hope I don't get any new side effects from Norvasc. Hopefully, it's not much different from Felodipine. As a matter of fact, it's supposed to have less intense (milder) side effects on high doses than Felodipine. I remain doubtful but certainly hope so.

    flowergirl


    Hi Flowergirl,

    In regard to NORVASC and other Calcium Blockers, I also experienced similar side effects (mainly gastro-related issues) while on NORVASC. I then tried CARDIZEM which was much better. The latest CALCIUM Blocker which (supposedly) has less side effects and is also being used to improve memory and PARKINSONS disease is called ISRADIPINE.

    I was removed from CALCIUM BLOCKERS years ago when I began to take a beta blocker TOPROL + ALTACE. If I had to take a Calcium Blocker again I would definitely try ISRADIPINE, but in my opinion (due to many people I know who developed edema and ankle swelling etc.) I'd prefer not to take this class of drug. In the past (mid 1990's), several calcium blockers (short acting) were linked to a very high rate of strokes and heart attacks.

     
    Old 01-29-2008, 01:24 PM   #13
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    Re: HP Med check

    Hi ACE,

    I really really appreciate your post. It certainly gives me something to think about. The drug you recommend, ISRADIPINE, sounds very similar to FELODIPINE. Felodipine caused me episodes of severe edema which I hope I'll never have to deal with again, especially after learning from one of the doctors that the edema CAN also affect the lungs. Mine got as far as lower chest. I was terrified at the time it would get into my lungs and I wouldn't be able to breathe.
    I am well aware of the potential harm some of the CCBs can cause. I experienced firsthand the painful and very scary withdrawal symptoms. I don't think I can handle being without it anymore and will not attempt tapering off or stopping it abruptly again. Thus, I might have to deal with the edema again in the future. I am hoping that high dose of Norvasc has fewer and less severe side effects than that of Felodipine, as one of my drug books states. I have no choice but to take this drug because, as one of my doctors put it, when it comes to drugs, we've run out of options. (this is because I can't tolerate the ARBs).
    Thank you so much for your post, ACE

    PS. I forgot to mention that so far, my blood pressure on Norvasc has been picture perfect with several unexplained spikes but generally good. I only wish it would stay that way!

    take care,
    flowergirl

    Last edited by flowergirl2day; 01-29-2008 at 01:35 PM. Reason: Adding PS

     
    Old 01-29-2008, 04:27 PM   #14
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    Re: HP Med check

    Hi Flower!

    Glad that the Norvasc seems to be working so well for you!!

    What drugs do you take for your B/P?

    Nessa

     
    Old 01-29-2008, 05:31 PM   #15
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    Re: HP Med check

    Hi Vanessa,

    I too am glad Norvasc is working for now. I've been down this road many times before though. My blood pressure is always good for a while after I start taking a new drug. (It was 141/86 this morning compared to the 110-127/77-86 or so of the last few days) I hope my readings remain low.
    I take the following drugs for blood pressure control: Ramipril, Bisoprolol, Hctz, Spironolactone and Norvasc. My blood pressure had been on the higher side for a while prior to starting Norvasc. I attributed it mostly to the lower effectiveness of the generic Felodipine, though there could have been other reasons for that as well.
    I hope your response to your new medication will be a positive one, allowing you to reach your blood pressure target. I also hope that your breathing will get better!

    Good luck!
    flowergirl

     
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