• Medications for Treating Hypertension

     
     
     
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    9/09/2013

    Fortunately, there are many medications available to help control blood pressure.  Different types of medications work on different parts of the body to lower blood pressure. As a result, controlling your blood pressure may require taking more than one type of medication—usually two or three, but maybe up to five different medications. Over time, your doctor may also need to adjust the dose of your medications to ensure your blood pressure is well controlled.

    There are several classes of blood pressure medications, each with different actions in the body. Click each one for a table of more detailed medication information. This chart is provided to explain the actions of each of the classes of medications. Although the contraindications may warn against using certain medications in combination, or for certain groups of patients, your physician may still recommend them for you. That is because your cardiologist individualizes the treatment of your hypertension. Be sure to discuss these and all recommendations with your doctor.


    Type of Hypertension Medication Examples: Common Side Effects Contraindications: Call Your Doctor If:

    Diuretics (sometimes called a “water pill”)

    Action: Cause the body to rid itself of excess fluids and sodium through urination
    • Amiloride (Midamor)
    • Bumetanide (Bumex)
    • Chlorothiazide (Diuril)
    • Chlorthalidone (Hygroton)
    • Furosemide (Lasix)
    • Hydrochlorothiazide (Esidrix, Hydrodiuril)
    • Indapamide (Lozol)
    • Spironolactone (Aldactone)
    • Dizziness
    • Frequent urination
    • Headache
    • Feeling thirsty
    • Muscle cramps
    • Upset stomach

    People with kidney or liver problems, pregnant women, and the elderly should talk to their doctor before use.

    Tell your doctor if you are breastfeeding.
     

    ACE Inhibitors

    Action: Block a key enzyme responsible for high blood pressure, thereby reducing the heart’s workload.

    • Benazepril (Lotensin)
    • Captopril (Capoten)
    • Enalapril (Vasotec)
    • Fosinopril (Monopril)
    • Lisinopril (Prinivil, Zestril)
    • Moexipril (Univasc)
    • Perindopril (Aceon)
    • Quinapril (Accupril)
    • Ramipril (Altace)
    • Trandolapril (Mavik)
    • Cough
    • Dizziness
    • Feeling tired
    • Headache
    • Problems sleeping
    • Fast heart beat
     

    Do not use with a diuretic.

    Pregnant or nursing women and people who have kidney or liver problems, diabetes, or heart problems should talk to their doctor before use.
    Chest pain, Problems breathing or swallowing, Swelling in the face, eyes, lips, tongue, or legs

    Beta Blockers

    Action: Decrease the heart rate and force of blood pumped from the heart to lower blood pressure. Also used with therapy for cardiac arrhythmias and in treating chest pain.

    • Acebutolol (Sectral)
    • Atenolol (Tenormin)
    • Betaxolol (Kerlone)
    • Bisoprolol/hydrochloro-thiazide (Ziac)
    • Bisoprolol (Zebeta)
    • Carteolol (Cartrol)
    • Metoprolol (Lopressor, Toprol XL)
    • Nadolol (Corgard)
    • Propranolol (Inderal)
    • Sotalol (Betapace)
    • Timolol (Blocadren)
    • Feeling tired
    • Upset stomach
    • Headache
    • Dizziness
    • Constipation/ Diarrhea
    • Feeling lightheaded

    Do not use these drugs if you have slow heart rate, heart block or shock.

    Pregnant or nursing women, and elderly with kidney or liver problems, asthma, diabetes or overactive thyroid should talk to their doctor before use.
    Chest pain, Problems breathing, Slow or irregular heartbeat, Swelling in the hands, feet, or legs

    Calcium Channel Blockers

    Action: Block calcium from entering the muscle cells of the heart and arteries. (Calcium in the cells causes the heart to contract and arteries to narrow.) By blocking calcium, contraction of the heart is decreased and arteries are widened.
    • Nisoldipine (Sular)
    • Nifedipine (Adalat, Procardia)
    • Nicardipine (Cardene), 
    • Bepridil (Vascor)
    • Isradipine (Dynacirc) Nimodipine (Nimotop)
    • Felodipine (Plendil)
    • Amlodipine (Norvasc)
    • Diltiazem (Cardizem)
    • Verapamil (Calan, Isoptin)
    • Feeling drowsy
    • Headache
    • Upset stomach
    • Ankle swelling
    • Feeling flushed (warm)

    Do not use if you have a heart condition or if you are taking nitrates, quinidine, or fentanyl.

    Pregnant and nursing women and people with liver or kidney problems should talk to their doctor before use.
    Chest pain, Serious rashes, Swelling of the face, eyes, lips, tongue, arms, or legs, Fainting, Irregular heartbeat

    Peripherally Acting Alpha-Adrenergic Blockers

    Action: Lower blood pressure by relaxing the blood vessels.
    • Prazosin (Minipress,Vasoflex, Hypovase)
    • Indoramin (Baratol)
    • Doxazosin (Cardura and Carduran)
    • Dizziness
    • Feeling tired
    • Feeling lightheaded
    • Vision problems
    • Swelling of the hands, feet, ankles, or legs
    • Decreased sexual ability
     
    The elderly and people with liver problems should talk to their doctor before use.

    Chest pain, Irregular heartbeat, Painful erection in men

    Centrally-Acting Alpha Adrenergics

    Action: Lower blood pressure by blocking nerve impulses that cause small arteries to constrict or become narrow, thus easing blood flow. Usually prescribed when all other blood pressure medications have failed.
    • Clonidine hydrochloride (Catapres)
    • Clonidine hydrochloride and chlorthalidone (Clorpres, Combipres)
    • Guanabenz Acetate (Wytensin)
    • Guanfacine hydrochloride (Tenex)
    • Methyldopa (Aldomet)
    • Methyldopa and chlorothiazide (Aldochlor)
    • Methyldopa and hydrochlorothiazide (Aldoril)
    • Dizziness
    • Dry mouth
    • Upset stomach
    • Feeling drowsy or tired

    Drinking alcohol may make side effects worse.

    Pregnant or nursing women and people with heart disease, recent heart attack, or kidney disease should talk to their doctor before use.

    Fainting, Slow or irregular heartbeat, Fever, Swollen ankles or feet

    Angiotension II Antagonists (ARBs)

    Action: Produce effects similar to those of ACE Inhibitors. May be better tolerated: Produces less cough and other reactions.
    • Candesartan (Atacand)
    • Eprosartan (Teveten)
    • Irbesartan (Avapro)
    • Losartan (Cozaar)
    • Telmisartan (Micardis)
    • Valsartan (Diovan)
    • Sore throat
    • Sinus problems
    • Heartburn
    • Dizziness
    • Diarrhea
    • Back pain

    Do not take if you are pregnant or nursing.

    People taking diuretics and people who have kidney disease, liver disease, low blood volume, or low salt in their blood should talk to their doctor before use.

    Problems breathing, Fainting, Swelling of the face, throat, lips, eyes, hands, feet, ankles, or legs

    Vasodilators

    Action: Dilate (open) blood vessels to allow blood to flow through easier, lowering blood pressure.
    • hydralazine
    • minoxidil
    • Headache
    • Upset stomach
    • Dizziness
    • Growth in body hair
     

    Do not take with bisulfates.

    People taking diuretics (water pills), insulin, phenytoin, corticosteroids, estrogen, warfarin, or progesterone should talk to their doctor about their risks before use.

    Pregnant or nursing women, and people with diabetes, heart disease, or uremia (build up of waste in your blood) should talk to their doctor before use.

    Fever, Fast heartbeat, Fainting, Chest pain, Problems breathing, Sudden weight gain

    Direct Renin Inhibitors (DRI)  Aliskiren (Tekturna)  Diarrhea

    Tell your doctor if you are taking water pills (diuretics), high blood pressure medicines, heart medicines, or medicines to treat a fungus.

    People with kidney problems and pregnant women or women thinking about becoming pregnant should talk to their doctor before use.
    Low blood pressure, Swelling of the face, throat, lips, eyes or tongue

    Keep in mind that medications alone are insufficient for the treatment of high blood pressure. Lifestyle modifications are the cornerstone of treatment for hypertension. In some patients, lifestyle modifications and medications may not adequately treat everyone with hypertension. For these patients, the healthcare team may explore treating secondary causes of hypertension or offering renal denervation.