Alpha-blocker BP med

[Athena]

Hi all,
I've just started on my my 3rd additional BP med to try to better control my BP - a low dose selective Alph-blocker by the name of Prazosin. I've been running scared all day because of there is a risk of initial dose extreme hypotension. But so far so good. It really has reduced my BP. Has anyone ever been on this one or is currently taking it?

The only symptom I had today was feeling like my legs were too weak to exercise much today. I felt tired and just kind of "funny".

I am on an ACE inhibitor and a calcium channel blocker - but they haven't been doing a good enough job lately so that is why I need an additional one.

[kickingandscreaming]

I always get alpha and beta confused, but here is something you might be interested in. http://www.diabetesincontrol.com/blood-pressure-drug-verapamil-diabetes-study/?xtor=-[DCMS%20#299%20(1)]--[www_diabetesincontrol_com_bloo]-[MTExNjQyNDMzMjY0S0]--  It's a calcium channel blocker.  Sounds like it could be a twofer.

I've have lots of trouble with BP meds.  Rashes, worsened kidney function, serious allergic reaction (angioedema).  So I've never even been able to take "protective" ACEi or ARBs.

[Michael Murphy]

In 2008 after a heart attack I was placed on beta blocker, and I could feel myself getting stupider by the day.  I made my living as a systems person and all of a sudden i was unable to remember critical parts of my job.  I told the cardiologist and he stopped the beta blocker. While getting stupid was no fun over the next two weeks I felt smarter every day.





sp mod Cas

[Athena]

I always get alpha and beta confused, but here is something you might be interested in. http://www.diabetesincontrol.com/blood-pressure-drug-verapamil-diabetes-study/?xtor=-[DCMS%20#299%20(1)]--[www_diabetesincontrol_com_bloo]-[MTExNjQyNDMzMjY0S0]--  It's a calcium channel blocker.  Sounds like it could be a twofer.

I've have lots of trouble with BP meds.  Rashes, worsened kidney function, serious allergic reaction (angioedema).  So I've never even been able to take "protective" ACEi or ARBs.

K&S, I'm starting to feel some doubt towards these so-called kidney protective ACEi & ARBs to be quite honest. The evidence is overwhelmingly in their favour, so I have little chance of curtailing my use of my ACE and appearing like a rational & sane person by the medical profession!

They are renowned for increasing potassium levels and sooner or later, when kidney function worsens, people need to get off them. When I started them a few years ago, there was a noticeable increase in eGFR levels which the Neph explained is a beneficial effect of the med - not a fundamental change in my level of real kidney functioning. Ever since then, I am accustomed to thinking that my 'true GFR' is better than what it is in my lab results.

[Athena]

In 2008 after a heart attack I was placed on beta blocker, and I could feel myself getting stupider by the day.  I made my living as a systems person and all of a sudden i was unable to remember critical parts of my job.  I told the cardiologist and he me stop the beta blocker. While getting stupid was no fun over the next two weeks I felt smarter every day.

Michael, I have heard that beta-blockers can do that to some people. I cannot ever be given a beta-blocker because it is contraindicated in people with insulin-dependent diabetes.

My med is an ALPHA-blocker. As far as I can tell, I am still not stupid (or any stupider). 

[kickingandscreaming]

Mine is norvasc (calcium channel blocker) and hydralazine (very old drug) a vasodilator and Hydrazinophthalazine class.  I'm not sure how much they do, but I think they have thinned out my formerly thick and wavy hair.  I went through a ton of BP meds before finding any that didn't have some dire side effect.  I don't think either of them makes me dumb. I think it's beta blockers that I can't take because I have asthma.

[Athena]

K&S, I would think that maybe the effect on your hair may just be the harshness of D, rather than any BP med - (although who's to know exactly?).

What I've noticed is my fingernails have become brittle and weak; I've developed an extreme intolerance to the cold and as of last year, one toenail has become thickened and wavy/disfigured. My dermatologist has told me that it takes a long time for a toenail to renew itself back to normal after illness or trauma has caused it to go bad (I had major medication-reaction illness in Jan 15 and then surgery in April).

I think my BP has become more difficult to manage because it is winter now in my neck of the woods. Something about the cold affecting the blood vessels. I hope to cease my Alpha-blocker when the warmer months arrive.

[kickingandscreaming]

K&S, I would think that maybe the effect on your hair may just be the harshness of D, rather than any BP med - (although who's to know exactly?).

The hair business started long before D and pretty much coincides with BP meds.

[kristina]

Hello Athena,
Many years ago I was put on Alpha-blocker “Atenolol” and it did not go well and even failed to control my hypertension
and at the same time I was constantly sleepy and intellectually not alert and my pulse-rate was kept very slow by "Atenolol" ...
and whilst being on "Atenolol" my whole body slowed down considerably and I could hardly get up in the mornings ...
... These days I take a different Alpha-blocker "Doxazosin" once every day and it controls my BP extremely well and shows no side-effects whatsoever...
... Maybe the pharmaceutical companies have developed more agreeable Alpha-blockers these days and it "only" depends on us to find the most agreeable anti-hypertensives?
... Perhaps it would be a good idea to work together with your doctor in order to find a BP-medication which keeps your hypertension well in check
and also agrees with your body and your rhythm of life without giving you any of these side-effects... ?
Best wishes and good luck from Kristina.

[Athena]

Kristina, thanks for that. That's very interesting how one in the same class worked for you but another didn't. It's why I now regard all medical matters to be an invisible Russian roulette gamble.

Now that I've been on this new BP med for 3 days, I can definitely see why the dosage needs to be in 2 doses within 24 hours - the BP lowering effect doesn't last for a full day! This is a bummer for me because I can only remember to take my pills first thing in the morning as I get too busy throughout the day attending to a stressful life.

I suppose I can take one in the morning and take the other one at night (along with my sleeping pill). But the effect still does not seem consistent and stable. I will have to carefully try increasing my dosage.

 

[Athena]

It's been about one week now on the new BP alpha-blocker med and I am starting to have reservations about it. I don't feel mentally less alert BUT I do feel unwell on a more psychological level. Feel more stressed, depressed and "quite out of it". Exercising feels more stressful as well.

Apart from this, it doesn't even really work as an effective BP med. The last in line is getting a diuretic med to lower my BP.

Is a diuretic safe from the point of view of CKD progression? I believe diuretic are not permitted for diabetics.

I'm feeling rather confused right now!

[DayaraLee]

Hi, Athena. My husband is on an ARB, beta-blocker, and diuretic to help control BP. He's still in stage 3, and we're maintaining right now. He's a diabetic, too, and his new diabetic med seems to be a super-charged diuretic (canagliflozin), so I'm always concerned about dehydration and this causing a worsening of kidney function. In general, though, regarding your concern about diabetics and diuretics, I do believe it's okay to be prescribed them help control BP.    I hope you soon find the combination that best fits your needs!

[Athena]

Hi, Athena. My husband is on an ARB, beta-blocker, and diuretic to help control BP. He's still in stage 3, and we're maintaining right now. He's a diabetic, too, and his new diabetic med seems to be a super-charged diuretic (canagliflozin), so I'm always concerned about dehydration and this causing a worsening of kidney function. In general, though, regarding your concern about diabetics and diuretics, I do believe it's okay to be prescribed them help control BP.    I hope you soon find the combination that best fits your needs!

Thanks for your reply to my earlier post DayaraLee. I too am finding that the Alpha-blocker acts like a diuretic - I am peeing more each night than ever before! So if Alpha-blockers are not supposed to have a strong diuretic effect - then I know that advice is flawed.

I too worry about dehydration. Not just in response to this med but in general when it comes to CKD. I believe we are more at risk of becoming dehydrated without even realiising it in diabetic CKD.

My BP is always now in the systolic 130s/140s & up to 150 now. It just doesn't seem to be working. My neph is increasing my dosage.