BP increasing after starting amlodopine

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I have had borderline hypertension my entire life, but am typically just below 140/90. Recently, I had a few high readings around 145/91, so the doctor started me on 5mg amlodopine.

For the first week I had a few readings around 130/70. Having taken the medicine for about 30 days, I am constantly aware of my BP and can feel my heart beating. My BP has been reading higher lately and fluctuating a lot. I have had readings such as 151/90, 165/95, and even 160/135 on my home monitor since then, and during my stress test yesterday I passed but I started at 155/95 the BP got up to 208/90.

Now the doctor has to doubled the amlodopine to 10mg and added metopolol 25 also.

It seems like my BP is fluctuating more and has actually raised since starting Amlodopine. Has anybody else had th same issues?!?

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12 Replies

  • Posted

    Hi Andrew,

    I have noticed the fluctuations over the past couple of months and could not figure out why until I suffered a major depressive episode recently when the BP shot up to 225/125. Apparently, a lack of sufficient Flouoxitine intake could have been the trigger over several weeks. I upped the dose and after a few days the BP settled down - Stress in daily life can be a significant contributor to these fluctuations in BP.

    Dave

     

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  • Posted

    Andrew1988...I fail to understand just why doctors will double the dosage of bp meds. Doubling increases the chance of side effects. Why not take 5mg in the morning, then the next 5mg in the mid-late afternoon? Yes, that's still 10mg in total, but it's spread out. Metropolol is a good beta-blocker. It reduces bp and slows the heart, so don't be alarmed if you notice this.

    Be careful for a bit though. The Metropolol could cause you to feel a little light-headed. Get up slowly, or if you bend over, get back up slowly.

    A few years back, I was taking Amlodipine. The 5mg helped..but for a short duration. So the Dr. doubled the dose. Next thing I knew..my feet, ankles & legs swelled badly therefore he took me off the Amlodipine. I have a relative who has good success with Amlodipine. Her bp started spiking in the afternoons, so her Dr. instructed her to take 1/2 tab in the morning, then the other 1/2 tab in the afternoon. Success!!! She's only taking the 5mg tablet. So you see, everyone is different. I also know a few other people who have luck with the Amlodipine.

    If you find the 10mg is causing problems..why not ask your Dr. for Coversyl?

    Be wary of ACE's though. They have a side effect of a hard dry cough, but again not everything experiences this. I didn't.

    Good luck. Please let us know how you get on.

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  • Posted

    Hi Andrew,

    I'm wondering how old you are. The reason for asking is that these days a lot of medical opinion is more tolerant of borderline high BP after late middle age. Some doctors, however, cling to the old, reassuring rules for dear life. You say you had "a few" high readings around 145/91. So do I - and on rare occasions they've been a bit higher than that. I think it depends how often "a few" means.

    My GP prefers watchful waiting rather than just reaching for the prescription pad, especially at my age (73) where a slight rise in BP is to be expected. He insists on seeing me every six months, at which time he orders basic blood tests, and on my side I'm stepping up my exercise levels, taking extra care with diet (minimal salt and sugar, keeping carbs down a bit etc.) I'm a lifelong non-smoker by the way.

    I'm just wondering whether you actually needed the amlodipine in the first place, and I agree with Mike - your doctor had no grounds for upping the dose if you were suffering possible side-effects.

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    • Posted

      Hi Lily, I tend to agree with you, docs are only too ready to put people on meds for hypertension, this might sound a bit weird, but giraffes have got the highest blood pressure of all animals and no one's got them on meds lol. 😁

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  • Posted

    I would hope your doctor has taken paranoia about your high blood pressure into account as that's what it sounds like.  Try some relaxation techniques and occupy your mind with something else to see if it brings your blood pressure down.  

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    • Posted

      cpwood...good points!! It's a proven fact that anxiety or just plain worry shoots bp UP. I used to be nervous about it as well. When I first started on bp meds, I was never given any education about it. The Dr. did the prescription, & that was that. Mind you, I had a young cocky know-it-all for a doctor. He would double my meds, add this/that, then when I was feeling ill, he all but accused me of needlessly complaining, then with a hard cold look on his face he asked.."do you want to take meds or not. If you want to walk around with high bp that's up to you..so answer me..do you want to take meds or not".THAT was pretty much the breaking point with me having him as my Dr. Anyway, I finally made up my mind that I was not going to let numbers control my life. I also recognized that on the way to see that know-it-all made me nervous, waiting for my turn I was nervous, then when he walked into the room, I was nervous. No wonder the numbers were very high. After settling down & deciding not to worry about numbers, I dug into the idea of returning to my previous doctor, one I thoroughly trusted, felt comfortable with, & had an excellent rapport. I've never looked back. He's from the old school. You don't have to just talk about one thing, he doesn't keep looking at his watch, etc.etc...AND I'm just fine. BP readings can be a little elevated, but he explained the normalcy of it. 

      I think if Andrew were able to relax about it all, he'd see a huge difference, but this is easier said than done.

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    • Posted

      What an awful doctor you had, Mike! Reminds me of when I refused to take HRT after the menopause, 25 years ago. I'd done all the research and decided that in my case the risks of taking it outweighed the benefits. My then GP - a young woman - took a similar approach to yours, only worse. She ended up raging at me that if I didn't take it I'd have to find another doctor. (Prescribing/taking HRT was almost an article of faith for doctors and menopausal women in those days.) Well... that was do-able, so I never looked back!

      I found another doctor - an even younger woman, in fact - who was more amenable to dialogue and who never pushed HRT, but just laid out the benefits, as she saw them. 20 years on, when my BP started creeping up, she took the same approach, laying out the risks of hypertension and the benefits of taking medication, and leaving the choice to me. But I note she never once mentioned the risks involved with medication!

      Now, after a house move four years ago, I've found a real treasure, just like yours. When my BP came out at 160/95 on a recent visit, he didn't turn a hair, just chatted to me about a TV soap he'd been watching, then took it again after five minutes, when it was 140/75.

      I realise that many posters in here are from the UK, unlike me and, I suspect, you. This makes a huge difference, as their system ties them into a very limited choice of doctors - and no choice at all in some areas. Also, they can get kicked off their doctor's list for non-compliance. I'm of British origin and worked in their NHS as a nurse for 10 years as a young woman, as well as navigating my way through it during the final illnesses of both my parents.

      However, I still believe patients - in whatever part of the world - should assert themselves and insist on being heard by over-prescribing doctors who sometimes refuse to admit to the possible side-effects of medications. Every time I come onto these boards, I seem to see cases of people with only mildly raised BP being prescribed all kinds of drugs which are making them feel worse rather than better.

      I'm not saying no one should ever take BP meds. When very high BP can't be controlled any other way, especially in younger people, medication is essential.

      I'm just suggesting that we should try and take a bit more responsibility for our health and not necessarily hang on our doctor's every word as if he/she were infallible. Doctors are not infallible, nor should they be expected to be. They're human beings, with their own views, and possibly other influences on them when it comes to prescribing medication. (But let's not go there...)

       

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  • Posted

    Just so you know, when my doctor switched me from 5 to 10 mg of amlodipine and I had all the issues, he replaced the 10mg of amlodipine with 25 mg of metropolol and my blood pressure has been fine ever since.

          The guidelines on blood pressure have been changing over the last few years.  Not too long ago they came out with a study that a little higner (140s) was OK.  Not long after that they came out with a study that said you had to keep it into the 120s and people should take multiple medicines to get it there.  There was a lot of debate because of all the side effects caused by BP medications.  The problem is that if a doctor doesn't follow the guidelines and you get a heart issue from you BP, he can be sued.  I do believe doctors would be a lot more sensible if the threat of lawsuits didn't hang over them.  Unfortunately here in the US, the lawyers control congress and the idiots won't put limits on lawsuit penalties.

     

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    • Posted

      You make some good points CP. However, there's nothing like the same culture of litigation in Europe, and many doctors here still over-treat mild hypertension. I suspect there are in duce ments involved as well.

      I can only reiterate my point that we all need to take charge of our own health care to a greater extent, instead of blindly following what the doctors say. When work needs doing in your house and a builder suggests doing some kind of major reconstruction, do you just say "OK" and let him go ahead, even if you suspect the problem is quite minor? I'm guessing not. In these circumstances most of us would inform ourselves before commencing the work, even if we didn't know much about construction techniques at the outset. I can't understand why we don't do the same when it involves our own bodies.

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    • Posted

      lily65668...you make a very valid strong point! There isn't any reason why people can't speak up when it comes to their doctors or what is being prescribed to them. When it comes to testing or a 2nd opinion, if a patient feels strongly enough that something needs doing, or rechecked, then by all means say so. I've learned that saying "I WANT" rather than "I'd LIKE" can really help. 

      I have a neuro situation..pins/needles the odd times in the legs..burning feet,yet the Neuro I saw 15months ago said.."I THINK it's your sensory nerves". Then when she saw the results of the MRI of the cervical spine..she pointed a finger & said .."There..there's the problem. You have severe narrowing of a nerve opening on both sides at L5-S1, & now an osteophyte in the cervical spine at C4". Now tell me..which is it?..

      Again, at first she said "I THINK"..then pointed the blame on the spine.

      My symptoms are progressing, & I've gone back to my GP & told him all of this..& about the progression. He has referred me to another Neuro at a hospital in the city closest to me. I will be speaking with that Neuro telling him about the testing I've had & ask what is planned now. 

      We all need to be our own advocates when it comes to our health. It's not so much what we say, but what we don't say. 

      IF I find that I was treated shabbily or whatever, I'd be of two minds to check into possible litigation.

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    • Posted

      Hmm... well, speaking as a former neuro nurse, I'd say your neurologist is right on both counts. Both the sensory and motor nerves leave the spinal column at the anterior horn. Narrowing of the channel at L5-S1 would therefore cause pressure on the sensory nerves for the legs and feet.

      There could of course be other causes. Peripheral neuropathy comes to mind. I suffer from this in both hands and feet as a result of an autoimmune condition. However, intermittent tingling and altered sensation in the extremities can also be a normal symptom in advancing age (I don't know how old you are).

      I assume your GP runs regular tests for blood sugar, since diabetes (either type) is another common cause of peripheral neuropathy. Since you're clearly not backward in coming forward, I'd suggest you insist he runs full tests for inflammation markers, to rule out an obvious inflammatory cause (mainly autoimmune). If some of these come back positive, you'd be better off seeing a rheumatologist than another neuro. Rheumatologists deal with all kinds of autoimmune conditions, not just joint problems.

      However, it's equally possible that no firm cause will ever be identified, especially if, as you say, this is only an occasional occurrence. In my own case, inflammation markers in my blood go up and down on a regular basis, often disappearing completely, with no apparent correlation with my symptoms. This is a common situation with autoimmune conditions. Like many of my fellow sufferers over on the Sjogren's syndrome board, I can have high inflammation markers at a time when I'm completely symptom-free, and practically normal levels during a flare-up of multiple symptoms.

      By all means get a full range of investigations, but I'd advise against being too hasty to demand treatment if this is only an occasional symptom. If you push for medication your doctor will feel he/she has to do something to avoid litigation, and end up putting you on stuff like gabapentin, which has some pretty grim side-effects. This is how so many people fall into the medication trap. Some symptoms are better suffered in silence (once you've found the probable cause) rather than taking aggressive medications.

      And do you not think you might be part of the problem you described in your earlier post if you decided to go to litigation? As you rightly said, this is precisely the kind of thing that drives doctors to over-prescribe, especially in North America.

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    • Posted

      Hi lily65668...thanks for your very informative reply. No, I'm really not shy at coming forward, especially if I feel something isn't being done that should be done. I'm a 69yr old man..in good health, except for what's going on as I've described. As for neuropathy, I'm told I don't have it (the Neuro), because the EMG/NCD testing came back negative. However, she did say those tests checked for large fibre, not small. So, could it be possible for me to have SMALL FIBRE NEUROPATHY? About 16 months ago, she did complete bloodwork, even to having me do a glucose tolerance test to see if I were diabetic. That was negative. Also, ANA & ENA..negative. Just last Nov. a Naturopath did some bloodwork & that too came back fine, except that B12 was high, & Vitamin D a little low. So, I was told by the GP to stop the B12 (I didn't need it), & my Vitamin D wasn't that bad, but I'm taking a supplement to raise it up. Also on the bloodtest done by the Naturopath, he asked for C-Reactive Protein (High Sensitivity) to be done. I understand this checks for inflammation. THAT was ok too. My thyroid is also functioning ok.

      I'd also like to know what's causing the odd tingling just beneath my right eye at the top of the cheek. Could that be caused by the osteophyte & moderate narrowing at C4? I do have very minor spinal canal stenosis in the neck..could that be the cause? 

      As stated in one of my previous notes, nerve biopsy was not done, nor was Quantive(sp?) testing. If the EMG tests just for long fibre, it will miss small fibre. My gait is good, as is my blance, no problems with walking, no muscle wasting, etc.etc. When my feet burn, then turn dark red on the tops of the toes, & all along the bottoms of the feet. The front of my legs will burn up to the knees, but they do not turn red. The burning on the feet is very uncomfortable as you can imagine, & on the legs it feels like a mild sunburn. 

      I do not push for medication, in fact I try to avoid it. When I saw the Neuro I told her that Gabapentin does nothing for the burning sensations...nothing at all. If I were to start taking meds again for this problem, I wouldn't be able to accurately tell the Dr. if my symptoms were progressing or not. 

      All I need Lily..is an answer..what in Hell is going on? Is this something that can be halted rather than let go to progress? The Neuro I will be seeing in the very near future is different than the one who blames everything on the spine. 

      Again, all I need is an answer. Perhaps you might suggest something...how do I ask my GP to do C-Reactive Protein testing, ESR..without making him feel like I'm telling him how to do his job. I absolutely respect him, have complete faith in him, but our GP's are our 1st step in finding out our problems, hopefully before seeing a Specialist becomes necessary. Perhaps when I see the new Neuro in two weeks, he may want bloodwork done. 

      I'd value whatever else you might offer, & thank you once again!!!

      smile

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