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Which pill should be added in order to reduce high systolic blood pressure?

Posted , 3 users are following.

george16314
george16314

Good evening to all,

My father is 78 years old and recently we noticed that he has a Kidney Failure.

He started to take the following medicines over four months ago:

[u]MEDICINES[/u]:

   

MORNING:

1. GALVUS 50mg - 1 pill (for DIABETES)

2. HYDRALAZINE 25mg - 1 pill (for BLOOD PRESSURE) -[u] Now increased to 2 pills x25mg = 50mg[/u]

3. EX-FORGE 10/160 mg - 1 pill (10 mg of amlodipine and 160 mg valsartan)

4. BICITRA SYROP - 10ml

5. EXELON (Evertas) 6 mg - 1 Capsule

 

MIDDAY:

1. HYDRALAZINE 25mg - 1 pill (for BLOOD PRESSURE) - [u]Now increased to 2 pills x25mg = 50mg[/u]

2. BICITRA SYROP - 10ml

3. EMARFEN ALFACALCIDOL 1mcg (VITAMINS) - 1 pill every other day

    

NIGHT

1. HYDRALAZINE 25mg - 1 pill (for BLOOD PRESSURE) - [u]Now increased to 2 pills x25mg = 50mg[/u]

2. BICITRA SYROP - 10ml

3. PAMSVAX XL 400 micrograms (TAMSULOSIN) - 1 Capsule

4. EXELON (Evertas) 6 mg - 1 Capsule

5. REMERON (Mirtazapine) 15 mg - 2 pills before bed

6. SEROQUEL 100mg -  1 pill before bed

Last month, his doctor has increased HYDRALAZINE from 25mg x three times a day to [u]50mg x three times[/u] . The reason was that his systolic blood pressure was too HIGH ([u]SYS is between 160-180mm Hg[/u]).

His[u] systolic[/u] blood pressure is still high!!! but [u]diastolic[/u] blood pressure is normal to LOW (DIA is between 63-77mm Hg).

[u]Question[/u]:

Which pill should be added in order to reduce high [u]systolic[/u] blood pressure?

PLEASE ADVISE!

Thanks

0 likes, 15 replies

15 Replies

  • matt66
    matt66 george16314

    Posted

    You should consult the doc with your father to discuss. I don't think anyone here can really give you advice on what to add, just tell you what we may take currently.

    im CKD 4 (running about 17%) and for BP I take amlodopine 10mg in the AM and doxasosin 8mg AM and PM.

    theres a lot of different bp MEDS out there all depending on what other MEDS you take and all the other history in a persons medical history. Don't just up anything he takes, but those are 2 that I take.

    hope the doc can help you (your Dad) out.

    • george16314
      george16314 matt66

      Posted

      matt66 - Many thanks for the update !

      I will speak again with my dad's doctor.

      Can you clarify, the total mg of doxasozin you take per day?

      For example: 4mg morning and 4mg at night = Total 8mg per day?

      Also, can you clarify the type you get? For example, you take Doxadura XL 4mg Prolonged Release Tablets?

      Thanks!!!

       

  • helen54849
    helen54849 george16314

    Posted

    Hi,

    When you say you have recently noticed your father has kidney failure do you mean he has recently been diagnosed? If you father was diagnosed at the ospital they will have given him a stage by his renal function, I am sure they will also keep a regular check on his blood pressure as this is important as failing kidneys don't like high BP.  I am not medically trained so my advice would be go with him to his next appointment and raise your concerns and ask if there is another tablet he could try to see if this helps.

    Good luck

    • george16314
      george16314 helen54849

      Posted

      helen54849

      Thanks  for your interest!

      On January 2011, his blood analysis tests were near to Normal: UREA - 57.3 mg/dL, Creatinine - 1.38 mg/dL , Uric Acid - 5.4 mg/dL.

      Almost 3 years later, on November 2013 my father had been hospitalized for another reason (has broken his collar bone) and before surgery, his blood analysis tests had showed: UREA - 85 mg/dL, Creatinine - 2.65 mg/dL , Uric Acid - 6.9 mg/dL.

      Since November 2013, after surgery, doctors did not mention anything about kidney failure or Chronic kidney disease.

      This year, on summer-August 2014 my father was suffering with back pain and he did MRI test which showed a disk damage. Those days, the doctors gave him potent anti-inflammatory pills. Fortunately, he has refrained the SURGERY but the potent anti-inflammatory pills had cause kidney damage!!! Therefore, on August 2014 he had been hospitalized for 15 days for kidney failure with these results: UREA - 256 mg/dL, Creatinine- 5.28 mg/dL , Uric Acid - 8.3 mg/dL.

      Today, with the medication his condition is stable, except the high SYSTOLIC blood pressure. Recent results show: UREA - 140 mg/dL, Creatinine- 3.34 mg/dL , Uric Acid - 3.9 mg/dL.

    • helen54849
      helen54849 george16314

      Posted

      Hi,

      Are you abroad as the blood results don't look the same as the ones I have.  My creatinine was 500 before I started dialysis.  The most important thing I can advise is under no circumstances take any more anti inflamitory medication, I would be complaining that he has been given this medication if there was the slightest idea there could be kidney failure.  I have always been told not to take them.  I take monoxodine 200mg twice per day one in the am one in the pm and the same with Amlodopine 5mg.  My BP use to be high but its 117/69 now that I have started dialysis.  What is your fathers GFR (kidney function in a % figure).  He should have regular appointments now but if you are not in the uk I am not sure how things are managed.  Always remember to ask questions no question is a silly question and you have the right to do this.

      Good Luck

    • george16314
      george16314 helen54849

      Posted

      Hi Helen,

      We live in Cyprus. You are right! "I would be complaining that he has been given this medication if there was the slightest idea there could be kidney failure."

      Doctors who work in Public sector in Cyprus are not care enough. Generally, hospitalization in public sector here in Cyprus is unacceptable!!!! Doctors should warned us since November 2013 when my father had been hospitalized for another reason where his blood analysis tests had showed HIGH LEVELS OF: UREA - 85 mg/dL, Creatinine - 2.65 mg/dL , Uric Acid - 6.9 mg/dL.

      Thank you once again for your help!

    • helen54849
      helen54849 george16314

      Posted

      Arr Cyprys my favourite place I got married there and we have been many times my family have a place in Peiya, lovely people.  The most important thing here is regular checks that can be as simple as a blood test in the doctors surgery if this is posible I would say every 3 months while he is stable.  I think I have found a conversion table and your dad creatinine level is about 176 in english terms to put this in perspective for you mine was about 500 before I started dialisys and its about 285 now I have been on dialysis for about 3 weeks so your dads looks ok at the moment but I would speak to the doctor and ask about trying a different BP med or infact a combination, there are lots to try and it may be trial and error to find some that work but persivere as its important.  Keep me posted and take care
    • george16314
      george16314 helen54849

      Posted

      By the way, as per matt66's comments, my father's private cardiologist suggested to try CARDURA (Doxazosin mesilate) 2mg and from tonight my father stopped HYDRALAZINE (Apresoline) and he started (switched to) CARDURA (Doxazosin mesilate).

       

      This is an updated description of what he gets (from today-night):

      MORNING

      1. GALVUS - 50mg Vildagliptin) - 1 PILL (Antidiabetic)

      2. EXFORGE - 10MG/160MG (10 mg Amlodipine /160 mg Valsartan) - 1 PILL [High blood pressure (hypertension)]

      3. CARDURA (Doxazosin mesilate) - 2mg - 1 PILL  (Hypertension & Prostate)

      4. SALUREX - 40mg (LASIX) - (Furosemide) - 1 PILL (Diuretic)

      5. SODIUM BICARBONATE - 500 mg (Antacids) - 1 Capsule

      6. EVERTAS - 6 mg (EXELON) - (Rivastigmine) - 1 Capsule (Alzheimer)

          

      MIDDAY

      1. EMARFEN ALFACALCIDOL 1mcg (VITAMINS) Alfacalcidol -  1 pill every OTHER day

          

      NIGHT

      1. CARDURA (Doxazosin mesilate) - 2mg - 1 PILL  (Hypertension & Prostate)

      2. SODIUM BICARBONATE - 500 mg (Antacids) - 1 Capsule

      3. EVERTAS - 6 mg (EXELON) - (Rivastigmine) - 1 Capsule (Alzheimer)

      4. REMERON (Mirtazapine) 15 mg - 2 PILLS before bed (Antidepressant)

      5. SEROQUEL - 100mg (Quetiapine)  - 1 PILL before bed (Antipsychotic)

      NOTES: 

      1. EPOETIN INJECTION 10.000 mg (EVERY WEEK) - Treat Anemia - Recombinant human Erythropoietin ONE INJECTION (10.000 mg) EVERY WEEK

      2.  XANAX 0.5 mg-When needed

    • helen54849
      helen54849 george16314

      Posted

      Hi,

      I cant see your first post as its being moderated? but all what you have put looks good so far, the only thing I found (everyone is different) the bicarb tablets increase BP I am ok with one but if I take anymore my BP goes sky high its basically sodium, which is salt but they are important to balance the blood acid levels.

      You say your dad is on EPO is he having this on its own or with iron suppliments or an infusion.  EPO does'nt work on its own to treat animea it has to have iron with it as EPO only does part of it.

      Good luck

    • george16314
      george16314 helen54849

      Posted

      He used to take MALTOFER 100mg (IRON - VITAMINS) - Antianemic agent  - 1 chewable tablet  WITH LUNCH but he stopped it because last month he had itching all over his body. His Nephrologists said to stop it for a while until he passes the itching.

      My next appointment with his Nephrologists is on January 2015 and I think my father should start taking MALTOFER (IRON - VITAMINS) again because his IRON level is very low: His IRON IS BETWEEN  23 - 28 µg/dL or 4.117 - 5.012 µmol/L.

      Also, his HGB Hemoglobin was very low but now is near to normal 12.1 g/dL.

      Thanks for your support!!!

      Merry Christmas and a Happy New Year to all of you! smile

       

    • george16314
      george16314 helen54849

      Posted

      LATEST UPDATED REPORT - 13.8.15

      Problems: 

      1.      Chronic Kidney Disease with serum creatinine 2.7mg/dl. Serum creat was 2.65mg/dl in Nov 2011.

      2.      Hypertension for about 20-30 years

      3.      Hyperparathyroidism

      4.      Non Insulin Dependent Diabetes Mellitus 2011

      5.      Psychiatric illness

      6.      Cholelithiasis

      7.      Multilevel vertebral disc lesions

      8.      Ex smoker.

      9.      Memory impairment (on Exelon)

      10.  Left inguinal hernia

      Drug History : 

      1.      Eprex 5000 u weekly

      2.      Amlodipine 10mg od

      3.      Micardis 80mg daily

      4.      Cardura 2mg TDS

      5.      Frusemide 40mg daily

      6.      Galvus

      7.      Alphacalcidol 1mcg alt days

      8.      Maltofer 100mg daily

      9.      Exelon (Rivastigmine)  bd

      10.  Remeron (Mirazepine)

      11.  Serequel

      12.  Xanax o.5mg PRN

      Allergies: Lamb and Fish

      Past Medical History

      Fractured clavicle 2011

      Appendisectomy

      Plan:

      Increase cardura 4/2/2mg

      Decrease Frusemide 20mg daily

      Change Galvus to Tragenta 5mg daily

      Decrease Exelon and then stop (potentially increases serum creat levels)

      Treat Vit B complex and Folic Acid 5mg daily

      Correct hernia

       

      Check Vit D3 and bicarbonate levels

      Check serum and urine electrophoresis and immunofixation

      FBCM CRP

      Glucose, urea, creat, Na, K, Ca, Po4, albumin, urate, LFTs, CPK, bicarbonate

      Msu

        SPOT URINE PROTEIN

        SPOT URINE CREATININE

  • matt66
    matt66 george16314

    Posted

    Hope it does the trick for him! Best of luck & happy holidays
    • george16314
      george16314 matt66

      Posted

      LATEST UPDATED REPORT - 13.8.15

      Problems: 

      1.      Chronic Kidney Disease with serum creatinine 2.7mg/dl. Serum creat was 2.65mg/dl in Nov 2011.

      2.      Hypertension for about 20-30 years

      3.      Hyperparathyroidism

      4.      Non Insulin Dependent Diabetes Mellitus 2011

      5.      Psychiatric illness

      6.      Cholelithiasis

      7.      Multilevel vertebral disc lesions

      8.      Ex smoker.

      9.      Memory impairment (on Exelon)

      10.  Left inguinal hernia

      Drug History : 

      1.      Eprex 5000 u weekly

      2.      Amlodipine 10mg od

      3.      Micardis 80mg daily

      4.      Cardura 2mg TDS

      5.      Frusemide 40mg daily

      6.      Galvus

      7.      Alphacalcidol 1mcg alt days

      8.      Maltofer 100mg daily

      9.      Exelon (Rivastigmine)  bd

      10.  Remeron (Mirazepine)

      11.  Serequel

      12.  Xanax o.5mg PRN

      Allergies: Lamb and Fish

      Past Medical History

      Fractured clavicle 2011

      Appendisectomy

      Plan:

      Increase cardura 4/2/2mg

      Decrease Frusemide 20mg daily

      Change Galvus to Tragenta 5mg daily

      Decrease Exelon and then stop (potentially increases serum creat levels)

      Treat Vit B complex and Folic Acid 5mg daily

      Correct hernia

       

      Check Vit D3 and bicarbonate levels

      Check serum and urine electrophoresis and immunofixation

      FBCM CRP

      Glucose, urea, creat, Na, K, Ca, Po4, albumin, urate, LFTs, CPK, bicarbonate

      Msu

        SPOT URINE PROTEIN

        SPOT URINE CREATININE

    • george16314
      george16314 matt66

      Posted

      LATEST UPDATED REPORT - 13.8.15

      Problems: 

      1.      Chronic Kidney Disease with serum creatinine 2.7mg/dl. Serum creat was 2.65mg/dl in Nov 2011.

      2.      Hypertension for about 20-30 years

      3.      Hyperparathyroidism

      4.      Non Insulin Dependent Diabetes Mellitus 2011

      5.      Psychiatric illness

      6.      Cholelithiasis

      7.      Multilevel vertebral disc lesions

      8.      Ex smoker.

      9.      Memory impairment (on Exelon)

      10.  Left inguinal hernia

      Drug History : 

      1.      Eprex 5000 u weekly

      2.      Amlodipine 10mg od

      3.      Micardis 80mg daily

      4.      Cardura 2mg TDS

      5.      Frusemide 40mg daily

      6.      Galvus

      7.      Alphacalcidol 1mcg alt days

      8.      Maltofer 100mg daily

      9.      Exelon (Rivastigmine)  bd

      10.  Remeron (Mirazepine)

      11.  Serequel

      12.  Xanax o.5mg PRN

      Allergies: Lamb and Fish

      Past Medical History

      Fractured clavicle 2011

      Appendisectomy

      Plan:

      Increase cardura 4/2/2mg

      Decrease Frusemide 20mg daily

      Change Galvus to Tragenta 5mg daily

      Decrease Exelon and then stop (potentially increases serum creat levels)

      Treat Vit B complex and Folic Acid 5mg daily

      Correct hernia

       

      Check Vit D3 and bicarbonate levels

      Check serum and urine electrophoresis and immunofixation

      FBCM CRP

      Glucose, urea, creat, Na, K, Ca, Po4, albumin, urate, LFTs, CPK, bicarbonate

      Msu

        SPOT URINE PROTEIN

        SPOT URINE CREATININE

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