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Health Blog :: Getting to Know Your Medicines.

August 25, 2022

There are many kinds of medicines available to bring down your blood pressure if it is elevated. Different people respond differently to each type of medicine. Your doctor probably has chosen specific tablets most suitable for your situation. A combination of Blood Pressure Medicines is often needed to control one’s blood pressure to a goal and target levels.

A lot of times there are no warning signs with high blood pressure. If left uncontrolled and elevated, blood pressure can cause health problems like heart disease and cause damage to your kidneys, so it is important to continue taking your tablets to lower the blood pressure to minimize the damage. If you experience side effects from the medications, then you should speak to your doctor. The tablets listed below are ones most prescribed and used. If you are taking a tablet not listed and would like more information, then you can speak to your doctor or pharmacist about it.

CALCIUM CHANNEL BLOCKERS

This class of drugs work by relaxing the blood vessels, opening them and lowering blood pressure.

Amlodipine is usually taken once a day in the morning. Common side effects can include headache, dizziness, and ankle swelling.

Nifedipine is another tablet in this family and can be taken once or twice a day. You should avoid grapefruit and grapefruit juice for one hour before taking the tablets. Side effects can include headache, flushing and ankle swelling, just like amlodipine.
Nifedipine comes as different forms of tablets, or capsules. Please follow the directions for the type given to you and always stick to the same brand.

Other types of calcium channel blockers include diltiazem, felodipine and verapamil, but they are less common. Verapamil can cause constipation.

BETA BLOCKERS

Beta blockers work by blocking the effects of a hormone called epinephrine, or adrenaline. Beta blockers slow down the heart to beat and make the heart pump with less force, which lowers the blood pressure.

Atenolol is an old beta blocker that is usually taken once a day in the morning. Side effects can include tiredness and cold hands and feet.

Metoprolol treats high blood pressure, heart problems and migraine. Metoprolol can slow down your heartbeat, cause dizziness or faintness, blurry vision, and unusual tiredness or weakness. Metoprolol comes in a long-acting form called succinate that can be taken once a day. The shorter acting, tartrate form, is taken twice daily.

Carvedilol, like other beta blockers, works by slowing down your heartbeat and making it easier for your heart to pump blood around your body. It also works like an alpha blocker mentioned below to relax and widen some of your blood vessels. This helps lower your blood pressure. Carvedilol can cause ankle swelling in addition to dizziness or lightheadedness.

Other types of beta blockers include bisoprolol (Zebeta), nebivolol (Bystolic), propranolol (Inderal).

ALPHA BLOCKERS

Alpha blockers lower blood pressure by preventing a hormone called norepinephrine from tightening the muscles in the walls of smaller blood vessels making them relaxed and widened, therefore, improving blood flow and lowering blood pressure.

Doxazosin (Cardura) is an alpha blocker used for lower blood pressure and relaxing the prostate in men. It is taken once or twice a day. Side effects can include dizziness, headache, nasal stuffiness, and nausea. You may want to take it with food. Some people also complain of decreased ejaculation.

Other types of alpha blockers include terazosin, and prazosin.

ACE INHIBITORS

Angiotensin-converting enzyme (ACE) produces angiotensin II, a substance that narrows blood vessels by constricting them. ACE inhibitors are medications that prevent angiotensin II formation and help relax the veins and arteries to lower blood pressure.

Most prescribed ACE inhibitors are enalapril and lisinopril. It can help lower urine protein leakage.

Enalapril (Vasotec) is usually taken once or twice a day. Side effects can include fatigue, and nausea. Some people may get a dry cough; if this occurs, tell your doctor who may be able to consider an alternative for you.

Lisinopril (Zestril) is usually taken once a day in the evening, or it can be prescribed twice a day if blood pressure remains uncontrolled. Side effects can include tiredness and feeling sick. Sometimes you may get a dry cough like enalapril.

Rarely, some people can get allergic reactions to ACE Inhibitors called angioedema. This may include itching, a rash or swelling of the lips and face. If this happens you should stop taking your tablets and immediately seek attention.

Other ACE inhibitors include quinapril, benazepril and ramipril.

ANGIOTENSIN RECEPTOR BLOCKERS

Angiotensin II is a chemical in the body that narrows the blood vessels. This will cause an increase in your blood pressure and force your heart to work harder.

Angiotensin II receptor blockers (ARB) block the action of angiotensin II. As a result, the medication allows your veins and arteries to relax and widen (dilate).

Losartan is an ARB usually taken once daily. It can help lower protein in your urine as well. It is also used as an alternative if you cannot take ACE inhibitors. Side effects are usually minimal and mild but can include tiredness, dizziness and stomach upsets.

Other common ARBs include valsartan, irbesartan and candesartan.

Rarely, some people can get allergic reactions to angiotensin receptor blockers, called angioedema, less commonly than ACE-inhibitors.

DIURETICS OR WATER PILLS

Diuretics, sometimes called water pills, help your kidneys release more sodium and water into your urine. The sodium helps remove water from your blood, decreasing the amount of fluid flowing through your veins and arteries. This in turn reduces blood pressure.

Chlorthalidone and Hydrochlorothiazide are the most common diuretics used for blood pressure.

Diuretics are generally safe. Side effects include increased urination and sodium loss.

Diuretics can also affect blood potassium levels. If you take a thiazide diuretic, your potassium level can drop too low (hypokalemia), which can cause life-threatening problems with your heartbeat. If you're on a potassium-sparing diuretic, you can have too much potassium in your blood.

Other possible side effects of diuretics include dizziness, headaches, dehydration, muscle cramps, gout attack.

Other diuretics used include furosemide (Lasix), bumetanide (Bumex) and Spironolactone (Aldactone).

OTHER BLOOD PRESSURE TABLETS

Hydralazine is dilator of your blood vessels, sometimes used when your blood pressure is still high after a combination of other tables. It has to be taken several times daily. Side effects can include a buildup of fluid in your body (fluid retention) and palpitations or fast heartbeat.

Clonidine lowers blood pressure by acting on the nervous system and decreasing the constricting tone on the blood vessels. It is taken twice or three times a day. It also comes as a slow-release patch you apply to your skin where it is absorbed slowly. The side effects include dry mouth, sleepiness, confusion and anxiety. The patch can cause a rash.

Moxonidine is a new generation clonidine.

Aliskerin is a new drug that is sometimes used instead of ACE inhibitors or angiotensin antagonists. Side effects can include an upset stomach and rash.

Minoxidil, like hydralazine, works by relaxing blood vessels so that blood passes through them more easily. It is usually used when other medicines are not working to lower the blood pressure. Minoxidil has other effects that could be bothersome for some patients including increased hair growth, salt and water retention and weight gain, fast heartbeat, and chest pain.

STORING YOUR MEDICINE

You should store the tablets in their original bottle in a cool, dry place out of the sight and reach of children with secure caps.
Do not throw out any expired or unwanted medicine by flushing them down the toilet or throwing them away as they may pollute the environment. Take those to your local pharmacy where they have bins you can dispose them safely.

BLOOD PRESSURE MEDICATIONS AND DIALYSIS

Sometimes blood pressure medications can cause your blood pressure to fall too low during dialysis, causing unwanted symptoms. If this happens the type of blood pressure medication you take may be changed or your nurse or doctor may advise you to wait and take your medication after you have finished your dialysis session. Sometimes dialysis removes the blood pressure medicines from your body and blood pressure might go up. For example, lisinopril is removed by dialysis and losartan might be a better choice for most dialysis patients.

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