There Are Better Options
Obviously, the goal is to optimize blood pressure, reduce risk of cardiovascular disease, minimize side effects, and save money. Many physicians and patients think that HCTZ fits the bill but, as youve already read, that simply isnt the case. So, if hydrochlorothiazide is so bad then what SHOULD we be using?
Angiotensin Converting Enzyme Inhibitors , Angiotensin Receptor Blockers , and Calcium Channel Blockers are great options. There are some diuretics that are beneficial as well as some beta blockers . Here are some of the studies validating these recommendations.
HCTZ vs Spironolactone
566 patients with uncontrolled hypertension were randomized to receive 4 weeks of either spironolactone or HCTZ. Carotid-Femoral pulse wave velocity was measured at baseline and again at 4 weeks to compare the effect of spironolactone vs HCTZ on the blood vessel. At baseline, there were no significant differences between the 2 groups. However, cf-PWV was markedly improved in the spironolactone group at 4 weeks . Patients with uncontrolled hypertension treated with spironolactone seem to have better control of their blood pressure and their arteries are less stiff.18
Evidence-Based Diuretic Therapy for Improving Cardiovascular Prognosis in Systemic Hypertension
They used Amlodipine/Perindopril vs Atenolol/Thiazide to evaluate this notion. It was stopped prematurely at 5.5 years with a total of 106,153 patient years of observation.
Is Your Medication Making You Lose Sleep
Certain medications can upset your normal sleep patterns. Switching medications or lowering doses under your doctor’s supervision can often fix the problem.
If you rely on medications for a chronic condition or even minor ailments, you may find yourself sleep-deprived or battling daytime drowsiness.
Certain heart, blood pressure, and asthma drugs, as well as over-the-counter medicines for colds, allergies, and headaches, can interrupt normal sleep patterns, says James Wellman, MD, medical director of the Sleep Disorders Center of Georgia in Augusta.
In fact, a number of common medications can prevent you from falling asleep or staying asleep others can make you groggy or sleepy during the day. Chemicals work differently on everyone, so a given medication may not affect you and your best friend the same way, but the following drugs could cause sleep problems for most people.
Asthma And Copd Medicines
Chronic obstructive pulmonary disease refers to a group of lung diseases that cause obstructed airflow from the lungs. Another chronic lung condition that causes breathing problems is asthma. Symptoms of both conditions are often treated with prescription medications.
Some of the medications used to treat COPD and asthma, such as albuterol and prednisone, can cause sleep problems, according toJohns Hopkins Medicine. Examples of COPD and asthma drugs include bronchodilators like albuterol, ipratropium, and levalbuterol, among others. Side effects from these medications include nervousness, insomnia, and a rapid heart rate.
If first-line treatments do not work, your doctor may recommend theophylline, a COPD and asthma medication that helps control inflammation in the lungs to ease symptoms. According to theNational Library of Medicine, theophylline has stimulating properties similar to caffeine, causing irritability, difficulty falling or staying asleep, and restlessness.
Talk with your provider if your asthma or COPD medications are causing insomnia. They may recommend changing the delivery method or reducing the dose to minimize side effects.
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Side Effects Requiring Immediate Medical Attention
Along with its needed effects, hydrochlorothiazide may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking hydrochlorothiazide:
Incidence not known
Hydrochlorothiazide May Interact With Other Medications
Hydrochlorothiazide oral tablet can interact with several other medications. Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.
Below is a list of medications that can interact with hydrochlorothiazide. This list does not contain all drugs that may interact with hydrochlorothiazide.
Before taking hydrochlorothiazide, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
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More Common Side Effects
The more common side effects that can occur with hydrochlorothiazide include:
- blood pressure thats lower than normal
- erectile dysfunction
- tingling in your hands, legs, and feet
- muscle spasms
These effects may go away within a few days or a couple of weeks. If theyre more severe or dont go away, talk with your doctor or pharmacist.
Does Losartan Cause Insomnia
Yes. Losartan may cause insomnia or sleeping difficulties. ARBs like losartan may elevate the levels of potassium in your blood. High blood potassium levels may lead to diarrhea, leg cramps, joint aches, muscle soreness, and bone pain. All these interfere with your ability to get a good nights sleep.
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Typical Dosing For Hydrochlorothiazide
- High blood pressure: Hydrochlorothiazide is typically started at 12.5 mg to 25 mg by mouth once daily for hypertension. It can be increased to 50 mg per day either as a single dose or split into two doses.
- Fluid retention: Typical dosing for hydrochlorothiazide is between 25 mg and 100 mg per day, and can be as high as 200 mg for edema. This can be taken as a single dose or divided doses throughout the day.
More About Hydrochlorothiazide / Quinapril
1. Cerner Multum, Inc. “UK Summary of Product Characteristics.” O 0
2. Lenz T, Schulte KL, Wagner B, Lilienthal J, Gotzen R “Quinapril, hydrochlorothiazide, and combination in patients with moderate to severe hypertension.” Eur Heart J 15 : 940-6
3. Romero R, Castellote E, Ocon J, Wagner B “Controlled multicenter study with quinapril, hydrochlorothiazide, and combination in patients with moderate to severe hypertension.” J Cardiovasc Pharmacol 26 : 114-8
4. “Product Information. Accuretic ” Parke-Davis, Morris Plains, NJ.
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Can You Drink Alcohol With Losartan Potassium
No. Consuming alcohol while taking losartan may cause and even aggravate undesirable side effects. Alcohol can have a sedative effect, manifesting as slowed reflexes, poor judgment, indecisiveness, and sleepiness. It can increase the blood-pressure-lowering mechanism of losartan. This can result in serious adverse effects like high potassium levels, allergic reactions, and kidney damage.
Warnings For People With Certain Health Problems
For people with diabetes: If you have diabetes and are taking aliskiren, you shouldnt take candesartan. It raises your risk of high blood potassium, worsened kidney function, and very low blood pressure.
For people with risk factors for low blood pressure: If you take a water pill, eat a low-salt diet, are on dialysis, or have diarrhea or vomiting, you shouldnt take candesartan. It may cause very low blood pressure.
For people with kidney problems: This drug can make your kidney problems worse. Your doctor will monitor your kidney function during treatment and change your dose as needed.
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Can Losartan Cause Weight Loss
Yes. Losartan causes weight fat loss by reducing blood cholesterol levels. More specifically, it lowers the amount of bad cholesterol and triglyceride circulating in the blood and fat deposits in the adipose tissue. ARBs also restrict the amount of angiotensin-converting enzymes in the body. A 2008 Australian study discovered that an ACE deficiency can spark fat loss and increase metabolism. Thus, ARBs like losartan can cause overall weight loss.
Cold And Allergy Drugs
Over-the-counter decongestants and allergy medications work wonders to help reduce the sniffles, sneezing, and a runny nose. But the main ingredients in some of these formulas can also cause jitteriness and insomnia. This includes phenylephrine and pseudoephedrine, according to the American Academy of Family Physicians.
Examples of cold and allergy treatments that might contain these medications include DayQuil, Sudafed, Claritin-D, and Allegra-D. If youre taking cold or allergy meds on a short-term basis, you can probably get by with a few restless nights. But if you take decongestants regularly, talk with your provider about a different medicine that may make it easier to sleep. If possible, avoid taking decongestants close to bedtime.
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Types Of Medications That Cause Insomnia
If you have difficulty going to sleep, staying asleep, or find that you wake up too early, you may have insomnia. Trying to figure out the cause of these sleepless nights can be tiresome , but sometimes, its as simple as reading the labels on your prescription medications.
Sleep deprivation can wreak havoc on your physical and mental well-being. Thats why its critical to understand how drug-induced insomnia impacts your health and what you can do to get a better nights sleep.
Pharmacist Tips For Hydrochlorothiazide
Hydrochlorothiazide starts working about 2 hours after you take it and can last up to 12 hours.
Hydrochlorothiazide is a water pill that makes you urinate more often. Taking it in the morning will make it less likely for you to wake up in the middle of the night to use the bathroom.
Hydrochlorothiazide can cause dizziness in the first few days since it lowers your blood pressure, but your body will adjust over time. Getting up slowly from your seat or bed can help with this.
A very small number of people with a sulfa allergy may also be allergic to hydrochlorothiazide . Let your doctor or pharmacist know if you have any drug allergies before taking this medication.
If you have diabetes, you may need to monitor your blood glucose more frequently and adjust your typical insulin dose when starting hydrochlorothiazide because it can affect your blood sugar.
Prices for hydrochlorothiazide start at just $2.10 with a GoodRx coupon. Theyâre fast, easy-to-use and free!
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Hyzaar Side Effects List For Healthcare Professionals
Clinical Trials Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed inthe clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug andmay not reflect the rates observed in practice.
Losartan potassium-hydrochlorothiazide has been evaluated for safety in 858 patients treated foressential hypertension and 3889 patients treated for hypertension and left ventricular hypertrophy. Mostadverse reactions have been mild and transient in nature and have not required discontinuation oftherapy.
In controlled clinical trials, discontinuation of therapy due to clinical adverse events was requiredin only 2.8% and 2.3% of patients treated with the combination and placebo, respectively.
In these double-blind controlled clinical trials, adverse reactions occurring in greater than 2% of subjectstreated with losartan-hydrochlorothiazide and at a greater rate than placebo were:
- Investigations:Liver function abnormalities.
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These studies demonstrate that the incidence of cough associated with losartan therapy, in a populationthat all had cough associated with ACE-inhibitor therapy, is similar to that associated withhydrochlorothiazide or placebo therapy.
Cases of cough, including positive re-challenges, have been reported with the use of losartan inpostmarketing experience.
What Are The Side Effects Of Hydrochlorothiazide
With any medication, there are risks and benefits. Even if the medication is working, you may experience some unwanted side effects.
The following side effects may get better over time as your body gets used to the medication. Let your doctor know immediately if you continue to experience these symptoms or if they worsen over time.
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Are Common Medications Interrupting Your Sleep
The reasons we might experience insomnia or sleep fragmentation are varied.
Emotional stress, pain, sleep disorders, medical conditions, and poor sleep hygiene are the most talked about root causes for sleeplessness.
But what about your prescriptions? Might they be contributing to poor sleep?
Yes. As a matter of fact, there are several common classes of drugs that can cause insomnia. Below, we discuss ten of them.
The Effect Of Metoprolol On Sleep
The CDC recommends that adults get between 7 and 9 hours of sleep per night. Unfortunately, 1 in 3 adults arent getting adequate sleep. A myriad of issues can interrupt sleep patterns and put you at risk of developing chronic insomnia. Stress, anxiety, and underlying health issues are some of the most common triggers. Certain medications can also reduce your sleep quality, leaving you fatigued and irritable.
One such medication is metoprolol. A common beta-blocker used to treat high blood pressure, heart attacks, and stroke, metoprolol can have adverse effects on sleep architecture. Here well take a closer look at how metoprolol and other beta-blockers work, how it can impact your sleep, and ways to combat these effects.
Dont Let Metoprolol Rob You of Your Sleep
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What Are The Uses Of Losartan
Losartan belongs to a group of drugs called angiotensin II receptor blockers or antagonists. It reduces blood pressure levels, prevents stroke, and protects kidneys from diabetic nephropathy.
Angiotensin is a biochemical that narrows blood vessels and makes it hard for patients with diabetes or heart problems to pump blood. Angiotensin II receptor antagonists inhibit the action of angiotensin and help relax the arteries and veins. This effect makes ARBs like losartan helpful for those with hypertension or diabetic nephropathy and those at risk of developing a stroke.
Consumer Information Use And Disclaimer
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How Is This Drug Best Taken
Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.
- This drug may cause you to pass urine more often. To keep from having sleep problems, try not to take too close to bedtime.
- Keep taking this drug as you have been told by your doctor or other health care provider, even if you feel well.
What Other Drugs Will Affect Hydrochlorothiazide And Propranolol
Tell your doctor about all medicines you use, and those you start or stop using during your treatment with propranolol, especially:
- insulin or oral diabetes medicine
- heart or blood pressure medicine –amlodipine, digoxin, diltiazem, nifedipine, verapamil, and others
- NSAIDs –aspirin, ibuprofen , naproxen , celecoxib, diclofenac, indomethacin, meloxicam, and others or
- steroid medicine –prednisone and others.
This list is not complete. Other drugs may interact with propranolol, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
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Angiotensin Ii Receptor Blockers
These drugs block the effects of angiotensin, a chemical that causes the arteries to become narrow. Angiotensin needs a receptor- like a chemical “slot” to fit into or bind with- in order to constrict the blood vessel. ARBs block the receptors so the angiotensin fails to constrict the blood vessel. This means blood vessels stay open and blood pressure is reduced.
Some noted possible side effects of Angiotensin II receptor blockers:
- May cause occasional dizziness.
- ARBs should not be used during pregnancy.Medications that act directly on the renin-angiotensin system can cause injury or even death to a developing fetus. When pregnancy is detected, consult your healthcare professional as soon as possible.
Dosage For High Blood Pressure
- Typical starting dosage: 25 mg taken by mouth once per day.
- Dosage increases: If your blood pressure stays high, your doctor may increase your dosage to 50 mg per day given as a single or two divided doses.
- Typical starting dosage: 25 mg taken by mouth once per day.
- Dosage increases: If your childs blood pressure stays high, their doctor may increase your childs dosage to 50 mg per day given as a single dose, or as two divided doses.
- Typical dosage: 0.5 to 1 mg per pound per day, taken in a single dose or two divided doses.
- Maximum daily dosage: 100 mg.
- Typical dosage: 0.5 to 1 mg per pound per day, taken in a single dose or two divided doses.
- Maximum daily dosage: 37.5 mg.
- Typical dosage: The usual dosage is up to 1.5 mg per pound per day, taken by mouth in two divided doses.
There are no specific recommendations for senior dosing. Older adults may process drugs more slowly. A normal adult dosage may cause levels of this drug to be higher than normal in your body. If youre a senior, you may need a lower dosage or a different dosing schedule.
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