More drug-related questions: Blood presssure plls, anyone?

[gremlin]

That's not an offer, I was wondering if anybody else is on 'em?

I was prescribed amlodipine about a month ago as my BP seems to stay doggedly high, despite my almost zen-like lifestyle and chilled disposition. Can't say as I'm liking the side effects which for me include flushing of the face at times, dizziness, a low but frequent headache and somewhat swollen feet. The biggest irony is that after a month of regular dosage my BP this morning was 144/89.

All the downside, none of the upside.

Got an appointment with the pharmacist on Wednesday to follow up and see what's happening. I suspect an alternative will need to be found.

[MrLongbeard]

Yes, after many years I'm still playing pill roulette to find something that works effectively (last weekly average was 140/81) my current selection is Ramipril, Indapamide (to counter water retention side effect of other pills) and Doxazosin.

I'm at the point of saying screw it, lets bin them all off, reset and come at it from another angle instead of just adding more and more pills and increasing their strength.

Aside from previously mentioned water retention (swollen foot) I also get the joys of a Ramipril cough, and very occasional dizziness (although it did put me on my arse rather forcibly over the weekend)

[636mick]

I’m on them, along with 2 x Ramipril for blood pressure. Ramipril causes a cough. The amlopidine caused headaches to begin with but that stopped within a month or two. Other side effects included a sick feeling for no reason, but the worst for me was badly disturbed sleep, bad dreams and waking for no reason. Again, these have mostly disappeared but still don’t sleep brilliantly, being sure to take them at the same time each day seemed to help. On the positive side, my BP is steady at about 125/85.
Mick

[KungFooBob]

Obviously the healthy lifestyle and multiple weekly gym visits are causing problems.

Have you tried living a sedentary lifestyle, surviving on takeaways and beer?

[gremlin]

Obviously the healthy lifestyle and multiple weekly gym visits are causing problems.

Have you tried living a sedentary lifestyle, surviving on takeaways and beer?

That irony wasn't lost on me when I went for my yearly BUPA health check. Doc sort of shrugged and said, 'All the things I'd usually tell somebody with high BP to do you do already, so I'm a bit lost as to what to say...'

[Count Steer]

Q? What dosage of amlodipine have they put you on?

After years of having high BP I decided to do something about it and they prescribed amlodipine, 5mg. (Previously I'd just tried to manage it/live with it as there were no effects - ie I felt fine/the same whatever my BP. However, this time I'd been feeling crap with hay fever type symptoms and symptoms similar to some diabetes ones - and there's IDD diabetes in the family tree. Checked out my glucose levels over 90 days. It's fine. So, off to the Doc I toddled).

Monitored my BP and systolic went down but the diastolic stayed up on the evening reading so I split the dose, 2.5mg am first thing, 2.5 mid-ish pm. Sorted. However, I feel no better than when I went to see the Doc and have some of the side effects. Inc, my feet are half a size bigger - that's after nearly 3 months. No headaches though or flushes or problems with the heat etc. Occasional vague dizziness.

It's been complicated by being stuck on a short, sharp hit of antibiotics so I'm getting that out of my system but I may be tempted to ask if there are alternatives. (I know there are but some have fewer side effects while being less effective - but that may not be an issue as it wasn't that high to start with).

One thing I did realise was I wasn't following the NHS advice on measuring BP at home - see NHS web site for the when and how. I do mine first thing in the morning and last thing at night when I monitor it now. 3 or more readings until it settles etc. That 'brought it down' too.

[gremlin]

Q? What dosage of amlodipine have they put you on?

5mg daily.

I've been taking my BP at various times of the day. Seems to be constant 130-140 Sys / 70-90 Dia, which is more or less what it was before I started taking to buggers.

[Count Steer]

Q? What dosage of amlodipine have they put you on?

5mg daily.

I'd try splitting the dose across the day as above. I think it's quite fast acting and so smoothing things out might help.

One thing they never know/tell you though is why, if your lifestyle is your BP is elevated. Be a bugger to find out your kidneys are shot but 'Hey! We got your BP down'. (To be fair, they did a load of blood tests but there's not really any useful info on the medical records apart form the results and a 'fair to middling' evaluation).

[gremlin]

One thing they never know/tell you though is why, if your lifestyle is your BP is elevated.

This is the niggling worry. If the BP is high, then what's causing it if all the usual suspects aren't present? Genetics may well be to blame and we've all gotta die of something, I suppose.

[Count Steer]

One thing they never know/tell you though is why, if your lifestyle is your BP is elevated.

This is the niggling worry. If the BP is high, then what's causing it if all the usual suspects aren't present? Genetics may well be to blame and we've all gotta die of something, I suppose.

If it was a car cooling system that the pressure was getting too high in then I don't think you'd address it by making the water pump work less well! That seems to be the mechanism that these calcium blockers use. Ah, your blood pressure is high so we'll make the pump/heart (and all your other muscles) weaker.

[Buckaroo]

Losartan. Been on it for years.

Went through the mill:coughs headaches, feeling sick.......

Losartan does the trick for me and, ironically, I worked on the plant where it was made (by the tonnes) so it had to be good

Don't try to tough it out. Try to get the best solution.

[Ian]

Tildiem Retard (diltaziem) been on it for years. No discernible side effects and controls my BP well.
Dr tried changing me to Ramipril and losartan but the side effects were too much to cope with. My guess is they were probably cheaper.

[Taipan]

I take 20mg candestarten in the morning and Doc added 5mg amlodipine last year to betaken t night. I now get lower legs and ankles like a fat old cleaning lady when walking any distance!

[wheelnut]

Q? What dosage of amlodipine have they put you on?

5mg daily.

I've been taking my BP at various times of the day. Seems to be constant 130-140 Sys / 70-90 Dia, which is more or less what it was before I started taking to buggers.

I’m in a similar boat. Pretty fit. Not a fatty. Eat fairly well. Yet my BP remained stubbornly high. I’m on 5mg of amilodipine as well. It is working, I think. My BP does vary tho. It’s only my systolic that’s high, diastolic is always spot on.

[Count Steer]

Oh yeah, I should probably have added that some doctors choose the medication to address prostate issues at the same time. It used to be popular to prescribe alpha-blockers eg Doxazosin to co-treat enlarged prostate symptoms (relaxes muscles in the prostate and bladder neck) and hypertension.

I think the alpha jobs and co-treatment have fallen out of favour a bit* but if I had to hazard a guess I'd say calcium channel blockers like amlodipine will have similar effects, given how they work.

* but some doctors are stuck in their ways.

[Bustaspoke]

I got put on Amlodipine about 6 months back & it brought my BP down but the side effects weren't good.I started on 5MG,but the BP stayed high so they put me on 10MG,I've never felt so consistently run down in my life,really tired & lower legs & ankles swelling.I was walking 50KM a month & doing 100KM a week on Zwift but I was wary of cycling outdoors in case I couldn't get back home.As soon as my BP got back down to less than 140/85 I asked to have the dosage reduced because of the side effects.They agreed to drop the dosage to 5MG & I felt a lot better,reduced side effects.After a month on the lower dosage they wanted me back at the Docs to go in to get my BP measured & they're happy but I want to get off the Amlodipine.I was told that I'll probably have to remain on them for the rest of my life as I'm not carrying any excess weight,active & these days hardly drink alcohol.I' wasn't happy about that so I've not took any meds since I left the Docs,measure my BP every day AM & PM & it's usuallly in the 120's/70's.
I really want to avoid the meds if possible..

[asmethurst99]

AIUI amlodipne is first line rx
Relatively benign but as others have mentioned it does have s/e
I’m on 5 mgs - my bp is 130 ish on mid 80’s - GP happy with that - weight and activity could be a bit better but I do try.

[gremlin]

Good news - went to see the pharmacist at the GP surgery today and she said I don't need to take Amlodipine any more.

She said I gotta take Ramipril instead.

Longer version. She agreed the side effects were pretty crappy given that the BP has remained the same. We'll try Ramipril (been forewarned re the almost inevitable cough) and see how it goes.

She shares my concerns re the persistently high BP (and that I've had incidents of hypertension for well over 20 years, on and off) given both the 6 weeks of Amlodipine and my angelic lifestyle, so will discuss with my GP. I did mention that I had private healthcare should it be decided that a referral outside of the NHS may yield a quicker turnaround. She gave a knowing smile of agreement and said she'd mention it. I expect I'll receive a call telling me to collect the letter and to bugger off up the road to the Chelsfield hospital.

Still breathing.

From the NHS: Drinking alcohol can increase the effect of ramipril, so that it lowers your blood pressure too much, which can make you feel dizzy or lightheaded. It's best not to drink alcohol until you see how ramipril affects you.

Bugger.

[Mr. Dazzle]

It always seems weird to me that you can't fix high BP by taking some blood out.

Have they tried Leeches?

[gremlin]

It always seems weird to me that you can't fix high BP by taking some blood out.

Have they tried Leeches?

Tried them. They don't half get stuck in your throat.

I'm due a two-week course of bile chanting next week and blood letting if that doesn't work.