Blood pressure meds.

[barbarac]

I am really not trying to get anyone's medical history or anything, but my Dr. keeps switching blood pressure meds. A few no one seems to have heard of or are very new. I asked to cut DynaCirc in half from 2 a day to 1 a day because my feet and ankles were so swollen it hurt--like they would burst open. Now I understand they discontinued DynaCirc (of course medco said it is back ordered, but told both my Dr.'s it is discontinued--anyone hear about that?).

Tekturna is one I take that no one seems to have heard of.

There were 2 new ones today--Diltiazem (to replace the DynaCirc) and Lisinopril (generic for Diovan I think).

Now my question. Does anyone take those with any success? Any good or bad things??

I also take Toprol XL and a water pill (HCTZ or something like that).

A lot I know, but both my GP and Endo said I need them. I don't think so. I really don't think it is that high. Plus someone is doing it wrong. It was good at the endo last time, high today at the GP (2 week difference, meds the same, on a diet now too).

If anyone would like to volunteer some blood pressure information--like if there is something that worked great for you. He is trying to do I think a Beta Blocker, a calcium ch. blocker, an ace inhibitor and I don't know what else.

All I know I am getting broke (the reason for 2 generics), frustrated, and confused. So any imput would be appreciated. Have been this route before, but things changed again.

[notme]

The question I would ask your doctor is why all the changes. You are getting medications that lower blood pressure in different ways. HCTZ or hydrochlorathiazide is a diuretic and is one of the oldest drugs your doctor has you taking. One of them is a calcium antagonist and another an ace inhibitor. Lisinopril will protect your heart if you have had problems.

Have any of the combinations worked well for you in the past? If they have, ask your doctor why the changes. He may be trying to protect your kidneys or your heart with some of the drugs.

I have taken HCTZ in the past and was taken off when I was put on a combination drug called Lotrel. My Mother takes Lisinopril and Coureg and does so to protect her damaged heart.

My suggestion is talk to your doctor about all the different meds and what he is trying to achieve besides lower blood pressure.

[barbarac]

Part of it was my fault. I take so much medication and only one of 14 was generic. Told him I need to split some, combine some or something. Getting to be too much. I am retired. He keeps saying it is not uncommon for diabetics to take many blood pressure meds (I also talked to endo about it and she said the same thing). He said there were no generics for what I am taking. So after some thinking he said to go off Diovan and take the Lisinopril (it is generic). The DynaCirc I was taking (a calcium blocker) could not be renewed--discontinued Medco told both Dr.'s, told me backordered. I was taking 2 a day, they made my ankles and feet really swell, so he cut it back to one a day. I was taking the water pill for that I believe. So since I couldn't renew the Dynacirc, he wrote a prescription for Diltiazem--which I had never heard of. Looked it up and it is listed as a generic calcium blocker (360 mg. though which is a large dose). Not sure why I take Toprol XL. At the endos office blood pressure was 128/78 (that is close without me going to look it up--under 130 I know. But when I go to him it is anyplace from 135 and today 153. I have never had any heart problems or chest pains or anything. I did take Cardura at one point (before I loaded up) and it really made me feel bad. I believe that is what the Toprol was given for. Had a stress test, all was well, and the cardiologist took me off the Cardura.

So you can see why I am so confused.

I also take Crestor and Zetia for cholesterol and they are great numbers--low overall, low LDL and triglycerides, high HDL--maybe the meds are why. He said I could go off the Zetia and try it if I wanted to.

I just don't know what to do anymore. He will just keep prescribing until I get under 130, but he would prefer under 120. My endo seems fine with my readings (except A1C's which are lousy. He said the blood pressure will cause more damage than the cholesterol and all.

I have had several endo's and switched for various reasons. I go now to a Joslin Diabetes Center. I have gone to this GP since the 70's and he knows me fairly well--I don't know who I would go to other than him--I really like him, but not all this medicine. I am just not sure I need it.

[BigcityRich]

OK, I will be glad to share.

I have been on Lisinopril since I was first diagnosed. My doc said my blood preasure was "border line" and was placed on Lisinopril 10mg daily. I am sure it is generic for something else as my insurance always gives me generic if available.

2/9/07 = 130/82
3/20/07 = 124/84
7/5/07 = 120/90
5/7/08 = 130/82

I dont really know what is good or bad. My understanding is I am taking this as a precaution since being diabetic leads to high blood preasure. I have not had any side effects that I know of.

[Cormac_Doyle]

There is evidence that low-dose ACE-inhibitors given to Diabetics with borderline High Blood pressure (or normal Blood Pressure) will reduce insulin resistance, improve cholesterol & triglyceride levels and show a marked imrovement in morbidity rates over the medium term (5 years)

Can't find the link off-hand ... sorry

[Penny]

When Hubby was having the kidney scare, they took him off the Lisinopril and put him on something new (can't think of the name for anything, he got samples). After a few weeks it made no difference in the tests he had for his kidneys, so he went back on the Lisinopril. He also takes Metoprolol. He was having trouble with his ankles swelling, one of them has 12% duiretic and that seems to be enough. I take Carvedilol (Coreg) and Avapro, although I have never had high blood pressure.....but I have had two heart attacks(??????). My BP is always higher the first time they take it at the doctors office, they do it again in 10 or 15 minutes later and it is low again.

[patricia52]

I take HCTZ for BP and swelling in my feet. I tried Lisinopril but I developed a horrible cough and my BP was often so low I felt weak and light headed. I told the doctor but she would not take me off the lisinopril. I stopped taking it and feel much better. I monitor my BP and it is still good. This morning it was 115/75. It took about three weeks for the cought to go away. Have to go back to the doctor this week to see what she will say about the lisinopril. Hope you and your doctor find good solution. Tell him money is an issue and explain that you are having a hard time scheduling all the meds. I know it would be difficult for me. I find it difficult to remember to take metformin with my evening meal.

[Noturningback]

I was taking Lisinopril but, I also started with the dreaded cough. I must admit a year later, I was diagnosed with many allergies. So, now I'm not sure if it was the Lisinopril or the allergies. I then was put on Micardis and that didn't do enough for me so, I was put on Micardis HCT with a cut back on the dose until my blood pressure was in normal range. Recently, with low carbing and weight loss my BP has gone down a bit too much so we may try Micardis minus the hydrochlorothiazide again. I have been doing well for several years now and hope to remove myself from BP medication in my future.

~Danielle

[barbarac]

I am appreciating the answers. I would not mind taking several if I thought they were working as they should or if there was some rhyme or reason why. It is sort of like "OK, let's try this one for a while". Also the gloom and doom side of it--sort of like take all these drugs or you are going to die. I do not seem to get to enjoy feeling good or feeling successes before something else seems to spring up. I mention to Dr. about people who have high cholesterol/blood pressure and his reply was "but they don't have diabetes!". I is just a downer sometimes. I am also concerned about a couple of these meds that no one seems to have heard of. Like I went to the periodontist for cleaning the other day and as they are upgrading my meds list, she said she never heard of Tekturna (think I spelled it right) or had anyone taking it. Others have commented that it is really new.

So I just appreciate some of the names and see what most are taking and what seems to work for them.

[jillrapp]

Hi Barbara,

I take lisinopril (an ACE-Inhibitor) and Atenolol (a Beta Blocker.) Both are working great for me. NO side effects of the lisinopril EXCEPT - it makes me more sensative to my insulin so lower numbers without high doses of insulin. The Atenolol was added instead of metoprolol - which made my hands and feet swell up horribly and hurt so bad I could no longer wear my wedding ring. It also made me dog tired and made it difficult to breathe. 1 day off of it and on the Atenolol and I'm doing great. Both are very inexpensive drugs, with each I get 3 months worth at Target for $10 each. The pharmacist doesn't even run this through my insurance plan because the normal price is just that low.

The Toprol XL - it's in the same class as the Atenolol - just more expensive - but more people can use it with less side effects. Good luck girl!

[Real4]

There is evidence that low-dose ACE-inhibitors given to Diabetics with borderline High Blood pressure (or normal Blood Pressure) will reduce insulin resistance, improve cholesterol & triglyceride levels and show a marked imrovement in morbidity rates over the medium term (5 years)

Can't find the link off-hand ... sorry

I expect that you can't find the link because most of what you attribute to ACE inhibitors is no so. Ace inhibitors do lower blood pressure and they serve to "protect the kidney" of diabetics, but they do not effect the diabetic condition itself, at all (or lipids).

[BlueSky]

... It is sort of like "OK, let's try this one for a while". Also the gloom and doom side of it--sort of like take all these drugs or you are going to die. I do not seem to get to enjoy feeling good or feeling successes before something else seems to spring up. I mention to Dr. about people who have high cholesterol/blood pressure and his reply was "but they don't have diabetes!". ...

It sounds to me like you are over-medicated. There is no logical or epidemiological evidence to support the notion that diabetics do better with abnormally low cholesterol and blood pressure. I don't take any medications at all (apart from insulin) because I don't believe I need them. The chart below shows that you really don't need to start worrying until your blood pressure goes over 160.

[barbarac]

Interesting chart. Thanks. Again thanks for answers all. I am just sort of trying to see what most people and Dr.'s think works. There just seem to be so many, and I would hate to think that my medicine depends on the drug rep with the best personality, cutest, or something like that. I want what works with the least side effects. I spent 50 years taking no medicine and them all of a sudden--boom!! It has all gotten so complicated and so expensive. Sometimes I think if I went off the cholesterol and blood pressure meds maybe I would feel better. Sometimes you just feel old and like you are waiting for the other shoe to drop!! I am usually a very positive upbeat person about things, but this disease and all tht is associated with it is really getting to me.

[Nita]

Interesting chart. Thanks. Again thanks for answers all. I am just sort of trying to see what most people and Dr.'s think works. There just seem to be so many, and I would hate to think that my medicine depends on the drug rep with the best personality, cutest, or something like that. I want what works with the least side effects. I spent 50 years taking no medicine and them all of a sudden--boom!! It has all gotten so complicated and so expensive. Sometimes I think if I went off the cholesterol and blood pressure meds maybe I would feel better. Sometimes you just feel old and like you are waiting for the other shoe to drop!! I am usually a very positive upbeat person about things, but this disease and all tht is associated with it is really getting to me.

I can soooo relate.....I am 74 and am just beside myself with all of the changes in my BP meds recently. I have taken Lisinopril or like ones for about 20 years and when taken off to try something else I realized the dreaded COUGH was gone. I put up with that until nearly throwing up so many mornings. I STILL have the constant clearing of my throat for half of the morning but not the violent coughing. Right now I am on Verapramil...with a higher dose recently prescribed to get the pressure down more. I am HATING it. My legs and ankles are swollen even with taking HCTZ and diabetes dr adding Lasix. Doesn't seem to help. I cannot take Beta Blockers 'cause the derm said not to with psoriasis. I was on Diovan and have a three month expensive supply sitting there not being used now and can't remember why they took me off. Everything makes my legs swell. I think I am going to ask to go back to the Ace Inhibitors. My lower legs are also breaking out and itching and the color is red and the lower part is yellow. It seems I can just watch them swell after I get up in the morning.

Being on Medicare and in the doughnut hole my meds are sooo expensive right now. Each doctor seems to give me scripts instead of samples (except PCP) and they are stacking up with lots of money spent. I am just beside myself with it being the weekend and waiting again to see a doctor. You can tell I am miserable!! I almost want to take myself off the Verapamil myself. Having other medical problems (extreme psoriasis and psoriatic arthritis using Methotrexate) I am an itching, irritable mess. Poor husband just says go to the dr.

Anyway, just ranting big time......glad this subject was addressed. Thank you,

Nita

[Mich]

Hi Barbara. I don't mind sharing either.

In the early 80's, my family doctor who was pretty up to date, read the studies showing that low dose ACE inhibitors would preserve kidney function in diabetics. He put me on Zestoretic (a combo of Zestril and HCTZ.) My insurance said no dice and switched me to Lisinopril and HCTZ separately, 20 mg each.

I went on that way for 20 years (slightly dizzy from lisinopril at first but only lasted 1-2 weeks.) In about 2003, my Endo thought I should see a heart guy for baseline testing. I did and all was fine, but this guy prescribed medicine like candy. He put me on 200 mg of Beta Blocker (Metroprolol) and doubled my Lisinopril.

Two things happened. I felt like I was filled with cement and slept late every day. Each thing I had to do was a chore. Also, I started coughing and gagging.

After two weeks, without asking, I cut myself down to one 50 mg tab of Metoprolol a day. How could I live when I couldn't even get up off the couch? Then I cut it down to 25 mg per day and stopped seeing Dr Candy pills.

I went on coughing and gagging. Since I had been taking Lisinopril for 20 years, I didn't make the connection.

My next visit to my regular doctor (Endo). He said my blood pressure was beautiful and the Lisinopril was causing my coughing. He switched me to Diovan. (No generic available in the US) which does the same job as an ACE Inhibitor, but slightly differently. It's called an ARB or angeiotensin receptor blocker.

Coughing stopped the next day. Blood pressure remains perfect. I've found my perfect combo. I'm thinking you will too. My target is to protect my heart & vasculature on the least possible dose of medications. I run slightly high cholesterol with Zetia only but everyone in my family has lived a long time with the same numbers (130) so I don't worry much. I can't tolerate statins and am not sure I would take them if I could.

And by the way, when I asked my Endo if I could discontinue the Beta Blocker (Metoprolol) he said it was protecting my heart by making it not work so hard, so the Beta Blocker stays at the low dose.

Mich