Hypertensive Drugs

[thaibeachlovers]

I was just started on Adalat Retard 20mg and Moduretic. Today the Dr started me on Cinnarizine 25 mgto counter some of the side effects. He also prescribed Norgesic 25 mg for headaches, but as I haven't had headache I haven't taken any yet.

Checking on the internet, all those drugs have LOTS of potential side effects. Has anyone experienced severe side effects?

The information also mentions having blood tests to check levels of the drugs and potential organ damage- is this necessary? My Dr didn't mention anything about them.

Incidentally, the drugs worked well, and at present my BP is where it should be, instead of at stroke inducing levels.

Thanks for any helpful replies.

[Kalbo]

I'm just curious, but what was your blood pressure before starting this medication ?

[hhgz]

Every medication has side-effects. The question is, are you willing to accept the side-effects to lower the risk of a health issue? Cinnirazine has its own side-effects.

[thaibeachlovers]

I'm just curious, but what was your blood pressure before starting this medication ?

210/120

[thaibeachlovers]

Every medication has side-effects. The question is, are you willing to accept the side-effects to lower the risk of a health issue? Cinnirazine has its own side-effects.

My post was to find if anyone has had less side effects on different drugs. Cinnirazine has so many side effects that I'm not using it, and hoping the worst side effects will diminish as my body adjusts to the drugs. I was so tired a couple of days ago that I barely made it till 2100, but today it's better. Hopefully the improvement will continue.

Thanks for the replies.

[notbkk]

Yes, all drugs have side-effects! I have been on Norvasc for years, wich made my ankles swell. A bit more than a year ago a changed to Coversyl (perindopril) which worked better for me, but causes me to cough. (itchy throat, resulting in coughing). I went back on norvasc for a month in Dec/Jan and my ankles became swollen, but my cough dissappeared. This month I went back on Coversyl and my ankles are fine. However, my cough is coming back! Now I am investigating a third option...any ideas, anyone?

[meatboy]

i to are taking perindopril no side affects,also been taking amlodipine no side affects ask your dr about them.

[thaibeachlovers]

Yes, all drugs have side-effects! I have been on Norvasc for years, wich made my ankles swell. A bit more than a year ago a changed to Coversyl (perindopril) which worked better for me, but causes me to cough. (itchy throat, resulting in coughing). I went back on norvasc for a month in Dec/Jan and my ankles became swollen, but my cough dissappeared. This month I went back on Coversyl and my ankles are fine. However, my cough is coming back! Now I am investigating a third option...any ideas, anyone?

Have you been put on a diuretic? From my research that is commonly used with antihypertensives for ankle oedema. Should be potassium sparing.

Adalat makes me want to die! Been getting worse over the few days Ive been on it. Tachycardic, nausea and can barely stand up.Have a follow up appointment, so it'll be back to square one.

Thanks for the replies.

[crab]

I first tried Enaril, but that gave me a very dry mouth and rasping cough. I changed to Coversyl, and still have the same symptoms but at a lesser, more manageable degree. I also have a diuretic, Dichlotride. For me the most unfortunate side-effect of all this medication is a significant loss of libido.

[Route21]

I've been on hypertension medication for almost 4 years now. Been through a number of proprietary medications, with a number of side effects, such as the cough (and ED - thought I was just getting too old!).

Changed, about 18 months ago, to generic medication and find them not only a lot cheaper but have also lost the side effects.

Am now on Lorsartan (http://en.wikipedia.org/wiki/Losartan) and Carvedilol (http://en.wikipedia.org/wiki/Carvedilol), with Simvastatin (http://en.wikipedia.org/wiki/Simvastatin) for Cholesterol and, of course, "baby" Aspirin - get them via a chemist in Tesco-Lotus.

BP down from 150+/90+ to as low as (most recently) 100/52 on occasions.

R21

PS also lost a fair bit of weight - 36Kg (by diet only - minimal exercise).

[Route21]

Re the OP:

See:

http://en.wikipedia.org/wiki/Adalat_Retard - the side effects on this one look a bit scarey!

http://en.wikipedia.org/wiki/Moduretic

http://en.wikipedia.org/wiki/Norgesic- "It's available in Scandinavia, but has been discontinued in some other countries"

http://en.wikipedia.org/wiki/Cinnarizine

Hope these help, if not already seen.

Regards

R21

[Sheryl]

Yes, all drugs have side effects.

That said, the OP is on rather a lot of meds, and also expensive ones and ones of a very specific class not usually the first drugs of choice, but there may be reasons for that relating to other medical conditions or his past medical history, or other risk factors we don't know about.

Specifically he is on a calcium antagonist and also a combined diuretic but he also apparently started with extremely high BP. Without knowing why these particular drugs were chosen for him I would be hesitant to suggest a change.

Given that he was put on the most expensive imported brands of these drugs, one wonders if the profit motive was at work as well as the entrenched belief in Thailand that patients prefer to get many different drugs and equate that with good care. In particular I question the heavy hand in terms of prescribing the norgesic and cinnarizine. Neither are going to treat the hypertension and with the BP better controlled should not be necessary to treat headache and dizizness (which is what they are for, though IMO simple paracetemol would be better).

There are severral locally made generic equivalents to Moduretic and also to the Adalat.

Again, not knowing why a calcium antagonist was chosen I don't dare suggest a change, What I do suggest, especially given the lavish prescribing of so many different things together, is

(1) ditch the norgesic and cinnarizine NOW, if you are having headaches that paracetemol doesn't relieve, then something is wrong, ditto if suffering dizziness not related to suddenly sitting or standing up (that is common in people on BP meds and best dealt with by just being sure to get up slowly, sit up a bot before standing up etc - not by medication)

(2) get a second opinion from a well qualified doctor re the BP meds and specifically ask whether there is any reason why a calcium antaginist is indicated in your case and if not, whether an ACE or angiotensin inhibitor would be suitable . I'd also indicate to the doctor a preference for fewer drugs and for local generics.

[thaibeachlovers]

I've been on hypertension medication for almost 4 years now. Been through a number of proprietary medications, with a number of side effects, such as the cough (and ED - thought I was just getting too old!).

Changed, about 18 months ago, to generic medication and find them not only a lot cheaper but have also lost the side effects.

Am now on Lorsartan (http://en.wikipedia.org/wiki/Losartan) and Carvedilol (http://en.wikipedia....wiki/Carvedilol), with Simvastatin (http://en.wikipedia....iki/Simvastatin) for Cholesterol and, of course, "baby" Aspirin - get them via a chemist in Tesco-Lotus.

BP down from 150+/90+ to as low as (most recently) 100/52 on occasions.

R21

PS also lost a fair bit of weight - 36Kg (by diet only - minimal exercise).

If your systolic is regulary 100, you might need to be careful that you don't start fainting. Plenty of info about hypotension on the internet.

[thaibeachlovers]

Yes, all drugs have side effects.

That said, the OP is on rather a lot of meds, and also expensive ones and ones of a very specific class not usually the first drugs of choice, but there may be reasons for that relating to other medical conditions or his past medical history, or other risk factors we don't know about.

Specifically he is on a calcium antagonist and also a combined diuretic but he also apparently started with extremely high BP. Without knowing why these particular drugs were chosen for him I would be hesitant to suggest a change.

Given that he was put on the most expensive imported brands of these drugs, one wonders if the profit motive was at work as well as the entrenched belief in Thailand that patients prefer to get many different drugs and equate that with good care. In particular I question the heavy hand in terms of prescribing the norgesic and cinnarizine. Neither are going to treat the hypertension and with the BP better controlled should not be necessary to treat headache and dizizness (which is what they are for, though IMO simple paracetemol would be better).

There are severral locally made generic equivalents to Moduretic and also to the Adalat.

Again, not knowing why a calcium antagonist was chosen I don't dare suggest a change, What I do suggest, especially given the lavish prescribing of so many different things together, is

(1) ditch the norgesic and cinnarizine NOW, if you are having headaches that paracetemol doesn't relieve, then something is wrong, ditto if suffering dizziness not related to suddenly sitting or standing up (that is common in people on BP meds and best dealt with by just being sure to get up slowly, sit up a bot before standing up etc - not by medication)

(2) get a second opinion from a well qualified doctor re the BP meds and specifically ask whether there is any reason why a calcium antaginist is indicated in your case and if not, whether an ACE or angiotensin inhibitor would be suitable . I'd also indicate to the doctor a preference for fewer drugs and for local generics.

<the profit motive was at work>

Would be my theory. No history was taken at all, so there is nothing to say why those drugs were prescribed rather than another. However, it is a starting point, and hopefully something better will eventuate.

Haven't had a headache since the BP came down, so never took the Norgesic. The Cinnarzine was prescribed to help the side effects, but seems of little use.

I stopped taking the morning meds, as it was difficult to get out of bed for the overwhelming fatigue and nausea. The night time dose does keep the worst effects till I'm asleep, but I have to wait till about 10 am till they wear off sufficiently for me to function. Going back for the one week follow up tomorrow, so I'll see what eventuates.

Thanks to all for the replies.

[Kalbo]

I'm just curious, but what was your blood pressure before starting this medication ?

210/120

Ahhhhh,ok. I was wondering why you were taking so much medication, but I see the reason now !

[thaibeachlovers]

So, went back to the Dr. He stopped all the original meds and prescribed Enalapril 5mg. Few side fx compared to the dreaded nifedipine. No diuretic either.

He also prescribed Neurobion, but I'm surprised to find that it is only a Vit B supplement- nothing to do with ^BP. Considering he didn't discuss it with me, I wonder if it's just to sell more drugs to the "rich" farang. Anyway, perhaps some B vits will put a bit of sparkle back into the body, so I'll see how they go.

However, nearly 2 days since I last took Adalat, and my BP has stayed down. Must be a long time to get rid of the drug from the blood. As I have now also developed severe postural hypotension from the drugs, I won't start the new one till my BP goes up again.

Today is the first day since I started on Adalat that I feel "normal". Hopefully the Enalapril won't knock me back. Hhgz asked <are you willing to accept the side-effects to lower the risk of a health issue>. Well, I guess if the "cure" is worse than the illness it's a good question to ponder. Not much of a life if one feels sick all the time and can barely function out of bed.At least when I just had high BP I could do anything, and just had a slight headache, occasionally. I do realise that there is then the chance of dropping dead, but as long as it was quick, not such a bad way to go. What scares me, is living after a stroke.

[Route21]

If your systolic is regulary 100, you might need to be careful that you don't start fainting. Plenty of info about hypotension on the internet.

It's not the systolic that I particularly need to watch for hypotension, I believe, it's the diastolic.

Hypotension is when the diastolic goes below 60, but it's not a problem unless their are symptoms associated with it (such as fainting).

I only tend to have slight dizziness problems once a year when wandering round in the heat during Songkran - but I put that down, primarily, to dehydration as a quick iced tea drink in the car with the A/C on and I'm OK again.

Regards

R21

[thaibeachlovers]

If your systolic is regulary 100, you might need to be careful that you don't start fainting. Plenty of info about hypotension on the internet.

It's not the systolic that I particularly need to watch for hypotension, I believe, it's the diastolic.

Hypotension is when the diastolic goes below 60, but it's not a problem unless their are symptoms associated with it (such as fainting).

I only tend to have slight dizziness problems once a year when wandering round in the heat during Songkran - but I put that down, primarily, to dehydration as a quick iced tea drink in the car with the A/C on and I'm OK again.

Regards

R21

Fair enough.

Unfortunately, I get fairly frequent dizzy spells with postural hypotension, even after I became hypertensive.

I also have different BP on either side- strange.

[Route21]

He also prescribed Neurobion, but I'm surprised to find that it is only a Vit B supplement- nothing to do with ^BP. Considering he didn't discuss it with me, I wonder if it's just to sell more drugs to the "rich" farang. Anyway, perhaps some B vits will put a bit of sparkle back into the body, so I'll see how they go.

The only (instant) connection I can spot between Vitamin B and BP, via Wiki, is with B6:

http://en.wikipedia.org/wiki/Vitamin_B Vitamin B₆ pyridoxine Deficiency may lead to ......... high blood pressure (hypertension) .......

I fully agree with Sheryl about doing everything via your cardiologist - but with the added caveat (here) of also back-checking it on Wiki.

When considering coming out to Thailand, and changing to generic medication, I checked what was available here with a great clinic up at Chiang Mai, via a fellow TV member. I then checked that out with my company's Chief Medical Officer and then my cardiologist. They all fully supported the Chiang Mai recommendation. I changed to the generic medication 2 months before I made the move to Thailand, giving ample time, if necessary, to adjust the dosage. Didn't need to make any changes - they were spot on!

Regards

R21

[thaibeachlovers]

He also prescribed Neurobion, but I'm surprised to find that it is only a Vit B supplement- nothing to do with ^BP. Considering he didn't discuss it with me, I wonder if it's just to sell more drugs to the "rich" farang. Anyway, perhaps some B vits will put a bit of sparkle back into the body, so I'll see how they go.

The only (instant) connection I can spot between Vitamin B and BP, via Wiki, is with B6:

http://en.wikipedia.org/wiki/Vitamin_B Vitamin B₆ pyridoxine Deficiency may lead to ......... high blood pressure (hypertension) .......

I fully agree with Sheryl about doing everything via your cardiologist - but with the added caveat (here) of also back-checking it on Wiki.

When considering coming out to Thailand, and changing to generic medication, I checked what was available here with a great clinic up at Chiang Mai, via a fellow TV member. I then checked that out with my company's Chief Medical Officer and then my cardiologist. They all fully supported the Chiang Mai recommendation. I changed to the generic medication 2 months before I made the move to Thailand, giving ample time, if necessary, to adjust the dosage. Didn't need to make any changes - they were spot on!

Regards

R21

Hmmm. Perhaps, but why didn't he start me on it at the beginning if that's the case? I have no idea if he's a cardiologist or just a medical consultant. They aren't into giving out information. It's all " the DR is God, just take these pills and pay at the cashier".

Could you let me know what the C M clinic name is please. I live in Lamphun, and could go there for a second opinion.

If you don't want to put it out here, perhaps you could PM me, please.

Thanks.

[Route21]

If you don't want to put it out here, perhaps you could PM me, please.

Thanks.

PM sent

Hope it helps

R21

[Sheryl]

So, went back to the Dr. He stopped all the original meds and prescribed Enalapril 5mg. Few side fx compared to the dreaded nifedipine. No diuretic either.

He also prescribed Neurobion, but I'm surprised to find that it is only a Vit B supplement- nothing to do with ^BP. Considering he didn't discuss it with me, I wonder if it's just to sell more drugs to the "rich" farang. Anyway, perhaps some B vits will put a bit of sparkle back into the body, so I'll see how they go.

However, nearly 2 days since I last took Adalat, and my BP has stayed down. Must be a long time to get rid of the drug from the blood. As I have now also developed severe postural hypotension from the drugs, I won't start the new one till my BP goes up again.

Today is the first day since I started on Adalat that I feel "normal". Hopefully the Enalapril won't knock me back. Hhgz asked <are you willing to accept the side-effects to lower the risk of a health issue>. Well, I guess if the "cure" is worse than the illness it's a good question to ponder. Not much of a life if one feels sick all the time and can barely function out of bed.At least when I just had high BP I could do anything, and just had a slight headache, occasionally. I do realise that there is then the chance of dropping dead, but as long as it was quick, not such a bad way to go. What scares me, is living after a stroke.

Yes, the neurobion is almost certainly the usual over-prescribing...normal in Thailand and they do it with Thai patients just as much. In fact many Thai patients consider themselves to have been poorly treated if given "only one" drug. It is common to add on a vitamin in order to give what is considered to be the minimum "acceptable" number of medications (at least 2, preferrably 3!).

You can safely skip it unless you overindulge in alcohol and/or have an inadequate diet..in which cases better to address those issues directly. In either case nothing to do with your BP.

Enalapril seems a more normal approach than the original slew of meds you were given. Hopefully it is a local brand, if not, there are plenty of them and dirt cheap.

Don't wait any longer to start on it though. The meds do not act instantly. It takes time to build up to a therapeutic blood level and given how high your BP ran before starting meds, you shouldn't take chances.

I very, very much doubt the doctor you saw was a cardiologist and I do not recommend seeing anyone in Lampun, Nor should you put up with no information about a doctor's credentials and no info on why meds are prescribed. Come on into CM and go to Sripat and get under the care of a proper specialist. While you are at it, since the hypertension is new you should have a complete check up inclusive of basic labs (inc. full lipid profile) and a stress test.

[thaibeachlovers]

Thanks all.

[Kananga]

If your systolic is regulary 100, you might need to be careful that you don't start fainting. Plenty of info about hypotension on the internet.

It's not the systolic that I particularly need to watch for hypotension, I believe, it's the diastolic.

Hypotension is when the diastolic goes below 60, but it's not a problem unless their are symptoms associated with it (such as fainting).

I only tend to have slight dizziness problems once a year when wandering round in the heat during Songkran - but I put that down, primarily, to dehydration as a quick iced tea drink in the car with the A/C on and I'm OK again.

Regards

R21

Fair enough.

Unfortunately, I get fairly frequent dizzy spells with postural hypotension, even after I became hypertensive.

I also have different BP on either side- strange.

Different BP on each side?

Oops! http://www.bbc.co.uk/news/health-17442996

[Route21]

"Different BP on each side?

Oops! http://www.bbc.co.uk...health-17442996

Many thanks for the link reminder - there was also an earlier link, that I should have posted in my post immediately after the "both arms" comment: http://www.bbc.co.uk...health-16739682

Regards to all

R21

[bangkokburning]

For what its worth I have some crazy high blood pressure but not insane like yours. I am about 140/105 maybe higher on a bad day - without the medicine. I take cheap Enalaril 20mg. Sorry it did not work out for you. It's mainly for controlling the diastolic I had read (I believe). But honestly has worked a treat and at about 3-4B a tablet at any chemist or even Tesco.

I asked the Dr for a non dieuritic (sp), figured with the heat and all I want to retain as much water as possible.

I'd get some excercise in and really change up my diet. That's pretty serious situation you have there. I honestly think that you have so much serious meds - there is at least potential for them alone to make you sick.

[Route21]

Enalaril.

For further details on "Enalaril" see: http://en.wikipedia.org/wiki/Enalapril

Been around a long time and minimal side effects other than the typical cough associated with such medications.

R21

Edited March 22, 2012 by Route21

[thaibeachlovers]

Update-

5 mg didn't do anything, so upped me to 20 mg. That worked, but only for 8 hours. put me on Moduretic as well, and I've now got a BP haven't had since I were a lad! Now I get postural hypotension- can't win.

Unfortunately, I think the Moduretic is killing my stamina. After a few hours shovelling gravel yesterday, I had to go to bed!

Other than that, no side effects at all.

Once I get the all clear from the Doc, I'll be converting to the generic versions. Full price from the hospital is a bit much.

[bangkokburning]

I had the Dr give me 5mg did not do anything so I self medicated up to 20mg and that is working great. I have no issues with cough.

Some of these meds are pretty serious stuff - I was freaking out when I was reading about them and what might be the next step if Enalaril did not work.

I'd say be careful about mixing them all up, take your time and make certain that one medications effects are out of your system before you start a another.

I don't know anything about Moduretic but its all serious stuff. Are you otherwise in great health that shoveling gravel is a non issue?

Consistent excercise is a great leveler with this problem. Even walking helps a bit. Sitting about and sitting about drinking and eating poorly is a great way to stroke.

[spiritrace]

OMG! 210/120 !!!!! Lucky you got it down.....I was on Adalat and after a year or so became VERY allergic to it. Broke out in a miserable rash. I've been on Nifedipine and Lisinopril for a few years now and doing great.....Not supposed to deplete my Potassium but it does so when I start to get leg cramps I take a Potassium and Magnesium together and the cramps are gone in 20 minutes......So obviously it works.Gawd I hate getting old..... My body is wore out but my mind is still young. Really sucks.