Felodopine 2.5 mgs

Just one word of caution Jane, and that is to keep an eye on your BP as too low a reading is not good either.

I would be interested to hear how you go on with Felodopine, as some of the patient feedback on it does confict.

Hi Arch...yes I'm definitely with you on that!! I do think my BP is affected by my state of mind a lot, and often feel when its high, its as though its "stuck" in a type of vice, so off I go on a fast walk or swim and it brings it down. I will keep you informed how it goes.

O'h that's a brilliant suggestion, holiday i.e!!

I've thought the same too - i.e., leaving the second drug out as I'm determined to quit and exercise. I'm in two minds. I'm already having side-effects from having taken one tablet, so halved my second one as the tummy syptoms creep in.

Thanks MrsO, good luck in finding a compatible med...I'm not sure which one would suit with your underlying problem, as many have a direct effect on kidney function. Have you looked in to alternatives? Exercise goes a long way in helping. I've just returned from a 5 km fast walk (lot of hills). Took another measurement and its 127/83, which is fine. I'm off to the chemist to buy a tablet cutter - think I will stick to half a tablet to see how it goes.

Were you not OK on Losartan initially? There are contra indictions for it with kidney problems.

Jane, I doubt Felodipine is enteric-coated as I haven't come across a BP pill yet that is.  However, do just make sure, as enteric-coated pills must not be cut - they are designed to release in a different part of the stomach.

I am under a kidney consultant who is trialling the different meds on me so yes I have tried several alternatives but unfortunately my body is very sensitive and produces nasty side effect.  I haven't been able to do my usual daily walk for the last few weeks due to a fractured little toe and injured foot, so hoping that is the only reason that my blood pressure has now gone through the roof.  Slowly getting back to a very short walk in the last day or two - apparently it will take 6 weeks for the toe to heal completely!  Good luck with the half pill.

Derek, I do so hope that isn't the case.  So far the only discernible  side effect from Losartan has been to increase my creatinine but they seem happy for this to happen with some of the BP meds, within reason of course.  Can't go to a higher dose for better control because of the creatinine aspect.  I'm a lost cause - "an awkward patient" in my consultant's words! 

That is interesting, and yes I was fine on Losartan 50 mgs for the last ten years or so I thought. But I slipped up with going back to smoking and worry - the worst combination. Last month my gp upped Losartan to 100 mgs and I felt too ill, along with itchy skin probs. I said I would try to fix it by exercise and watching my diet. Of course, within no time, I was back to my old habits. Btw, having the 24 hr BP monitor strapped to my arm made me feel anxious, I could barely sleep - it just heightened anxiety along with my BP. I don't have kidney probs but my mother had so I wonder if there stems the problem. You'd think with six monthly blood checks it would be obvious. 

Well who knows, "a lost cause, an awkward patient", there must be something out there. Youtube has some advice regarding alternatives.

Could you take up swimming if it's not too painful? I will be doing this possibly starting tomorrow - lane swimming that is!

Now Jane thank you very much for the suggestion but.....I can't swim!  I told you I was a lost cause! I have just managed a very short walk followed by a couple of minutes on the exercise bike.xx

Heck! You'll just need to stick with the exercise bike in that case - do a few miles every day! I'm off early morning for a swim with a friend. I haven't swum in over 30 years!!! I hope I remember how to do it!

When I was taking modified release verapamil the tablets were scored and could be taken as half a dose.

No such luck with mine, that's why I went and bought a pill cutter.

Good on you Jane - enjoy it.  They say learning to swim is like riding a bike - guess what?   I've never done that either!  Now youi're probably all thinking I'm totally useless!

Yes, if I remember rightly the Amlodipine were scored as well - I certainly remember having to cut one BP pill in half.    It's only enteric-coated pills that must not be cut.

May not be a problem for you but a packet insert said:

"Dont take if you are known to have narrowing or blockage of the blood vessels leading to your kidneys or if you have received a kidney transplant recently"

" In rare cases, losartan can cause a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, and dark colored urine."

I just checked on it as when I had the MRI scan it showed a slight narrowing of one of my kidney arteries.

I don't like the BP monitor as I am constantly waiting for it pump up the cuff. It wakens me in the night and then I don't get back to sleep. My blood tests have been OK. Had some last week and waiting for the results.

That's a coincidence, Derek, because someone I know suggested to me just a couple of days ago that I should have the arterys to my sole kidney checked for any narrowing.  I note that you had an MRI scan to check for this but with my kidney problem the contrast they use could actually be detrimental for my kidney.  In fact, it was just a few months after an MRI scan for another condition some 9 years ago that my kidney disease was diagnosed.  I believe there are two different types of contrast and one is saferfor the kidney than the other.  My dilemma is putting my trust in the technicians who do the scans to use the right dye.  You'd expect them to know but when I had a CT scan about 4 years ago, I told them I couldn't have dye (it was supposed to already be in my notes for them) but the technician really probed as to why I couldn't have dye, looking quite put out.  I'm hoping that a doppler ultrasound which doesn't use dye would be sufficient to check the artery.

I'm guessing that I don't have this problem as I have been on the Losartan for coming up for a year now and haven't noticed anythig untoward.  I certainly had the "muscle pain, weakness and unusual tiredness" on Indapamide recently though - that was stopped after just under a month when it really messed up several blood tests.

Really appreciate your kindness in going to the trouble of posting this, Derek - many thanks. 

The MRI was to check for any cause for my hypertension but the only comment was a slight narrowing of one artery that is of no consequence except he said that I it would rule me out from having renal denervation when the trials start up again.   

Your consultant will know if the dye can be used for you. 

Sort of good news and bad for you then Derek, especially when you were so keen to go ahead with the renal denervation.  How about the latest trial with the metal clip in the leg - would you be interested in that, perhaps?

Yes, my consultant should know but it's amazing how you seem to have to prompt them about everything.

Like you my problem is labile hypertension so would the Rox Coupler lower my lows too much? The consultant at the hypertension centre says that he does not understand how or why it works. At least it is reversable.

My local hospital was doing a trial on both  denervation and the Rox Coupler in 2013. As I was being considered for denervation at that time I did not think it politic to ask for the other as well.    

I E-Mailed the company making the coupler but they did not reply.

One loses confidence when having to prompt and remind them of things.

Isn't it amazing how the scientists can invent a procedure for a possible cure for something and yet not know "how or why it works".  If my memory serves me correctly, I believe that applies to Paracetamol as well.

Perhaps you haven't received a reply about the coupler because they simply had too many enquiries and couldn't cope with the replies.  I guess that they may not know the answer at this stage as to whether the coupler might lower your BP too much - that is why the trials are taking place.  Although, like you, by blood pressure has been described as "labile", I don't think it ever goes as low as your's does - it's never normal so if it does ever come down it's only to the still above normal point.  I don't know whether I've mentioned it before, but my friend in Australia had the denervation therapy because all the BP meds failed to control her high BP - she was one of the first ever during trials in Australia.  She is still on several BP meds but at least they now control things.

Right I've spent far too long on here today so I'm off now and will try and do more constructive things tomorrow!! 

 

Medtronic have a few new versions of their renal denervation on trial.

From CardioBuzz  a blog for readers with an interest in cardiology.

" The renal denervation story has been a roller-coaster that started out shooting high with dramatic blood pressure reductions then unexpectedly dropping low with failure in the U.S. pivotal trial of one device and halting of that for a second.

Then just when we thought the ride was over, it started climbing again slowly with an analysis suggesting that maybe the procedure itself wasn't a dud but was tripped up by confounding from variation in performance and from medication use and adherence

And now denervation catheter-maker Medtronic has said in an investors' earnings call that the company hasn't abandoned research.

Instead, it's going to seek approval from the FDA to start a new trial with a next-generation device.

The first-generation Medtronic Symplicity device used in the pivotal SYMPLICITY HTN-3 trial was a single-electrode device, whereas the company has been working on a catheter that would fire multiple electrodes simultaneously with an updated radiofrequency generator.

MedPage Today previously reported from the SYMPLICITY HTN-3 analysis: 

Consistently greater reductions in office and ambulatory blood pressure and heart rate were associated with a higher number of ablation procedures.

While most patients got at least eight ablations, only 19 of the hundreds treated received four-quadrant ablations in both renal arteries. 

"In our analysis, the lack of ablations in all four quadrants and the number of ablation attempts were highly correlated with blood pressure reductions," the researchers had written in the paper. "These two variables may be correlated, and more ablation attempts may well increase the probability of ablating within all four quadrants." 

Medtronic declined to comment further on the design of the trial, which a spokesperson said it intends to announce in the next few weeks along with the company's entire clinical strategy for renal denervation.

Meanwhile, the full results from the global SYMPLICITY registry have been published, affirming the average office systolic blood pressure reduction of nearly 12 mmHg at 6 months overall and more than 20 mmHg for those with severe treatment refractory hypertension as enrolled in the pivotal trial. 

Mean 24-hour values on ambulatory monitoring showed reductions of 6.6 and 8.9 mmHg, respectively.

Gosh you've done a good bit of research there, Derek, which is very interesting.  I guess there's a lot of trialling and fine-tuning ahead but, no doubt, Medtronic will keep  working away at it - after all there's probably a lot of money in it for them!  Good news for us "awkward" patients though if it eventually is proved successful.  Many thanks for posting it.

The CardioBuzz blog is worth looking at as it has much of interest.