Blood pressure medications and side effects

In My Humble Opinion
1

You are neither my doctor nor necessarily even A doctor (although doctors are welcome to respond). I am under the care of a physician.

Recently my PCP put me on Losartan 100 mg for my blood pressure. It took a couple of months but gradually increasing insomnia caused me to stop taking it. Also, I hadn’t been sure of it, but after stopping this medicine my sex drive came back from almost nothing, to relatively normal (for me), so it was also killing my sex drive. These are both listed potential side effects.

He asked if I was willing to try 50 mg, but I declined. I don’t know how a lower dosage would work vis-à-vis side effects, but even a little insomnia is very unpleasant for me. Also loss of sex drive is no fun either.

So now he has prescribed Lisinopril (not sure of the dosage yet, it hasn’t arrived from the pharmacy). The listed possible non-serious side effects include extreme tiredness (I am already tired much of the time due to trying to accomplish a lot at the gym), weakness (ditto), rash (I already have dermatitis which is mostly under control) and lower sex drive (again?).

This is my 3rd med, added to montelukast (for asthma and allergies) and a statin for cholesterol. I haven’t had side effects from anything before, that I recall. The work I am doing at the gym (losing weight gradually, improving strength and balance) should help the blood pressure, but that could take a year at the rate I’m going. So I guess I’m stuck with taking something in the meantime.

I’m not sure what I’m hoping for from this thread. Commiseration maybe, advice from people with knowledge and/or experience certainly, encouragement even. I guess I’ll take whatever you’ve got. Hit me.

2

I’ve got commiseration, and a little bit of hope. About ten years ago, I started having incredibly severe headaches, so severe that I still consider them to be the worst pain I have ever experienced. After having a head MRI and various other tests, it was determined that the problem was out-of-control blood pressure. So I was put on blood pressure medication. But not only did it cause side effects, including a rash, it did nothing to control my blood pressure. Over the course of several months, I tried a total of four different medications, each one of which had bad side effects without helping my blood pressure. Finally my doctor had to write a letter to the insurance company allowing me to try a medication that wasn’t in the formulary. Fortunately, the fifth one was the charm and I have been using it successfully with no side effects ever since.

So my advice is not to give up. Keep trying medications until you find one that reduces your blood pressure without causing unmanageable side effects. There are a lot of different options for hypertension. Also, while the gym thing is healthy for a lot of reasons, I tried it and even though I lost a large amount of weight, it unfortunately had no impact on my blood pressure.

3

My doctor used to have me on Toprol for my high blood pressure. It kept my blood pressure in check and I didn’t notice any side effects. Until one time I ran out of pills and it was going to be a few days before I could get my prescription refilled. And about the third day after I ran out of Toprol I suddenly noticed my brain felt clear. I suddenly felt like I had been in a mental fog for the past couple of years and hadn’t noticed it. I called my doctor and told him I didn’t want to take any more Toprol. He switched me to Lisonopril.

4

I was once on HCT - a dirt cheap, effective hypertensive med.
I can’t use it due to kidney failure, so I am on 2 different meds.
I asked about the efficacy of two drugs, and was told that many people use 4 or 5 different meds to control BP.

Your search for a single ‘magic bullet’ may be leading you astray.

(Atenolol and amlopidene (spelling doesn’t count))

5

I must have used at least a dozen BP meds over the past 30 years. The most common problem is that they work well for a while and then gradually begin to be less effective. Some of them have produced strange side effects.

I am currently (for the past several years) using amlodipine (a.k.a. Norvasc, a calcium channel blocker), losartan (Cozaar, an angiotensin II receptor antagonist), and HCTZ. Various BP pills come in combined form, with HCTZ and some other drug combined.

Lisinopril (an ACE inhibitor) has another side-effect that I didn’t see mentioned above: It can cause a persistent dry-cough. If you have any pre-existing chronic respiratory problems (which I do), this can be a bigger problem. I had to quit lisinopril because of it, and use losartan (which I think is more expensive).

I used metoprolol (a.k.a. Lopressor, a beta blocker) and also briefly atenolol (Tenormin, another beta blocker). Metoprolol was very effective and is one of the common meds of first resort for BP management. But it caused neurological side-effects. I gradually became very tremorous (to the extent that I thought I was going to collapse in the street at any moment) and I began to have memory lapses. The doctor suggested that maybe I shouldn’t use any beta blockers again. Later, a cardiologist prescribed atenolol for heart palpitations. I used that for two or three days, then out of nowhere I fainted at work. That had never happened before, nor since. I assume it must have been the atenolol.

Then there are alpha blockers. They tend to make me a bit groggy. One that I’ve used is terazosin (Hytrin). I am currently using tamsulosin (Flomax), a more specifically targeted alpha blocker for (ahem) older male problems. I briefly used clonidine (Catapres), prescribed for me to manage klonopin withdrawal symptoms. (It didn’t work.) One doctor prescribed; hardly a month later, another doctor told me (exact quote): “Clonodine makes people feel shitty.” (He was right, too.)

Clonodine seems to be used for a lot of disparate things. It’s also used for ADHD. I know how it works for controlling blood pressure, though: You read the drug data sheet that comes with it, which has a list of side effects that reaches seven times to the moon and back, and then you faint. ETA: Not only that, if you are taking a certain other BP med at the same time, which I was (I don’t remember which one it was), and you are going to quit one or both, you MUST quit them in the right order otherwise you will have life-threatening BP spikes. Ugh.

6

**bolding **is mine

Statins are also known to lower sex drive. Unfortunately any cholesterol lowering drugs will have this side effect.

You body uses cholesterol in the process of making testosterone. Lowering cholesterol lowers the raw material available to make testosterone.
Maybe the BP meds acting in concert with the statin was enough to produce a noticeable effect where the statin alone wasn’t causing a problem.

7

The only Rx medication I’m on right now is Losartan. 50mg twice a day since January 2014. I haven’t noticed any side effects. BP is well controlled, and I’m finally facing my eating issues and losing weight. (With the hope I’ll also stop needing the Rx eventually.)

I think there can also be issues whether a medication is taken once or twice daily. A lot of meds are more effective with fewer side effects when a smaller dose is taken more often. Unfortunately, people have been deemed general non-compliant morons who can’t remember to take their meds if it’s more than once a day - so anything that can remotely be taken once a day is scripted that way. My doctor and I talked about it, and since I have cats on BID meds, it’s not a big deal for me to remember to take mine twice daily, either. So instead of one big 100mg dose a day, I take 50 twice - and she said it’s more effective taken that way, too.

Of course all drugs are different and affect different people differently, but don’t dismiss the idea of trying a smaller dose more often if you’re not a total dip who can’t remember to take a medication every 12 hours. Or my doctor is full of shit. But the thing about trying to make as many meds as possible to be taken once daily is definitely a thing.

8

My PCP is my age (57) with a history of hypertension that matches mine. In addition he is African American, which is a risk factor.

We both take Atenolol 50 mg, Amlodopine 10 mg, and Losartan 50 mg, each once daily.

I once was concerned about irritability as a possible side effect. I told him I was being a real dick lately. He told me that behavior predated the medication. I pointed out it was affecting him similarly.

Luckily my pressure is well controlled.

9

I’ve had the dry cough from Lisinopril.

I hate beta blockers. I like to do aerobic sports and BBs work by artificially lowering the heart rate. Try riding a bicycle up a steep hill on 100mg of Metoprolol!! Gradually my cardiologist reduced the dosage down to 25 mg and recently took me completely off the BB. :smiley:

My worse side effect was from a diuretic. It worked like a charm in that my blood pressure dropped 10 points about overnight. On the other hand, I started having gout attacks about monthly when once a year was the normal. I blame myself as I know dehydration can lead to gout attacks and a diuretic basically keeps a person a little dehydrated all the time.

10

I have been on Lisinopril for a couple of years now without any noticeable side effects. I am not taking any other medications and I regularly exercise. It would not surprise me if the effects of exercising are lessening any side effects from the medication.

11

Heavy emphasis, on I’m NOT a doctor.

That! Try doing all things naturally first. Although not all, most people that have high blood pressure are overweight. You can probably have some remarkable results by losing a few pounds. There are various rules of thumb, one is for every pound loss, you can expect about a ½ point drop in both the diastolic and systolic blood pressure. May not sound like much, but that’s kind of similar to the same drops that much of the blood pressure medicine can give.

Also what do you eat? You don’t have to give up meats, but cutting back on red meat intake, fried foods, perhaps colas, and adding more vegetables, fruits, nuts, etc, has a good chance of helping your body as a whole.

You are already exercising, might add some walking or running into your regime too. Whether walking or running, it’s roughly the same amount of calories burned per mile.

If you smoke, quit, or cut back, and of course drinking in moderation.

If over time, all of these haven’t helped, I would definitely get and stay on some kind of blood pressure medication. I’ve seen the statistics for those who had high blood pressure that took the medicine to control it, and they fared way, way better than those that choose to do nothing.

12

For what it’s worth, I’ve been on 20mg Lisinopril for about five years now. It’s worked well for me with no real side effects other than intermittent lower leg rashes which may or may not be related to the meds. I suspect though that I’ve going to have to either switch meds or up my dosage. My last checkup was marginal and I’ve been getting the same kind of headaches I had before getting treatment.

13

Lisinopril–I lasted 2 mos. before my SO pretty much made me call the doc. to change it-the cough was pretty much non-stop and I could not sleep w/o a healthy dose of cough syrup.

14

I forgot about the cough. I certainly had it when I switched to Lisinopril. But I’ve found it’s faded away with time.

15

There are various lifestyle interventions for hypertension also.

Isometric hand grip exercises
high intensity interval training
deep breathing exercises
weight-loss
sleep apnea treatment, if you suffer from it
a high potassium, low sodium diet
I believe each of these is roughly as effective as a medication.

Coq10, among other things may help too. There are options if medication alone has too many side effects.

16

Toprol and HCTZ have worked well for me. No real issues and I have missed/been off both at various times.

Monopril almost killed me; a case of ballistic shits, dehydration, weakness, racing heart and more. That one was bad enough that it went in my chart as “allergic”.

17

Very interesting and informative posts so far, thanks.

Well, well. The things one’s doctor doesn’t tell one. My cholesterol did not respond enough to weight loss before, so I don’t have much hope of getting off the statins.

I am overweight, and although I am 66 I have never had blood pressure problems before, even when I was more overweight than now. But I put a lot of weight on rather rapidly over the past 3 years, maybe that’s what set it off. Your formula indicates I would have to lose 60 pounds to get my BP where it should be, and my (not necessarily completely realistic) goal is 100 pounds, at the rate of 50 pounds per year.

Hmm, I have asthma, which the doctor knows, I don’t know if that puts me more at risk for this particular side effect, I guess I’ll find out.

18

Helpful hint for anyone taking 50 mg Losartan and purchasing it through the mail…

100 Losartan 100 mg tablets cost only slightly more than 100 Losartan 50 mg tablets. I buy the 100mg tabs and break them in half.