I Need Advice. I'm a bit freaked out by med-induced low BP

[PJmomrunner]

I started Altace 2.5mg yesterday a.m., took it again today in addition to the 100mg Toprol XL I take each night. My BP tonight is 98/61 with a HR of 52. The HR is my usual. My BP pre-Altace averaged about 120/80. Yikes! Be careful what you wish for, huh? Should I take my Toprol at bedtime as usual? Skip the dose? Halving the Toprol XL has caused dizziness in the past, presumably from expedited delivery, so that doesn't seem like such a good idea.... Any ideas?

 

[PJmomrunner]

I guess I'll skip tonight's Toprol XL dose...

 

[PJmomrunner]

C'mon Al...what do you think?

 

[Karlynn]

If you take Toprol for your BP and the Altace has already lowered it, sounds like mission accomplished for the BP.

I think your thought to skip the Toprol tonight is a good one. Then call doc tomorrow and discuss.

 

[PJmomrunner]

Karlynn, thank you thank you for posting! I have so little experience with medication or doctors!

 

[OldManEmu]

I am concerned

I am concerned

P.J. You shouldn't just stop taking Toprol XL or any Metoprolol suddenly as one of the potential side effects is heart attack! I have attached a link to the manufactures site. https://www.toprol-xl.com/about_toprol/how_to_take.aspx Metoprolol should always be titrated. I hope you are not going to skip any more doses before you see the doctor.

 

[aussigal]

PJ...

if you have these questions "after-hours"...as we mostly do ...

call the local hospital...

there is always someone there able to answer a question no matter how silly you think it is...

they have always been great when I have needed a quick answer to the above-type questions ...

Sounds like they have the BP meds doing their job to me...dont know what your TARGET BP is...but mine was approx 10 points lower than that when I came out of surgery for a day-procedure recently and the nurses were concerned til they remembered about my aneurysm...then they just smiled and let me be...

....and until recently my BP was hanging around the 110-115/60-65 mark with a h/r of 55ish...and I was a litle slower and tiny bit dizzy if i rushed about...and also more tired but I thought the tiredness was from the metoprolol...otherwise the only other thing I have noticed is less niggles or twinges in the chest...always a good thing.

For comparison I take 50mg metoprolol. twice a day and 1 coversyl-plus which is perindopril 4mg and indapamide 1.25mg., at the moment though I seem to be getting immune to their previous good Bp lowering effects unless of course I am stressed again and in denial ( which is a good possibility).

From what I have read the combination of beta-blocker and ACE inhibitor is the most common cocktail to sucessfully treat high BP in our cases...and there are lots of different ones to try so dont give up if this combo doesnt agree with you...

 

[PJmomrunner]

Thank you, Aussies, for the thoughtful input! I will not skip another Toprol, but I hadn't thought about the "don't stop abruptly" thing...glad you mentioned it, OldManEmu.

Aussigal, it helps to know you are on a similar regimen and your body has continued to adjust. I'll keep at this and I will call the doc. "After hours call the hospital"...fine idea! Gosh, why didn't I think of that??? Perhaps the brain power is a bit under-perfused???

Thanks again!

 

[Ross]

Or call your pharmacist!!!!

 

[PJmomrunner]

Yeah, Ross, that makes sense too!

 

[Debster]

Hey PJ! Hang in there...that is exactly what my mom's bp is each morning and it was never even remotely close to that before the Altace...check with your dr and keep us posted! Deb

 

[jeffp]

2.5mg of Altace is a very low dosage, I would not expect such a significant change in BP. Toprol can make these kinds of changes though. Will BP like that, many folks (I'm in this group) get kinda woozy.

 

[PJmomrunner]

I took the Altace on schedule yesterday and resumed the Toprol XL 100mg last night. My BP was 121/82 this morning so I went ahead and took the Altace. I have been told (ok, by some former mech valve salesman ) that one's body can take some time to adjust to Altace....

Jeff, my friend who is a retired nurse w/ 35 years experience in an internist's office says my Toprol may need to be adjusted, and it sounds like you might suspect along those lines too. Of course it would be nice to get word from the new cardio's office...I called and left a detailed message yesterday, talked to the nurse who called back (and thought Dr. would probably think 98/61 was fine and tell me to carry on) but said she would call me back with his instructions. She never did so I called at 4:50 and was told by the answering service that the nurses usually do their call-backs right after the office closes so if I didn't hear back within an hour I should call back. Of course life intervened with kid taxiing and dinner, etc. and my BP was okay at bedtime, so I forgot about it and never did get a callback.

So, I guess I'll just carry on and call if I get stumped again.

 

[Georgia]

My BP occasionally strays to that level and no one seems alarmed. Especially if I'm not running around and being busy.

 

[Marguerite53]

Hi PJ. sorry, my computer was down for awhile. I wonder if, instead of skipping a dose, could you halve the dose? Obviously I wouldn't suggest doing anything without your doctor's advice. I had just never thought of it, but with my breast biopsy coming up and my recent colonoscopy, coupled with my severe stenosis, my PCP told me to halve my dosage so that my blood pressure would be a little higher going into the procedures (as anesthetics lower BP, I guess). Just a mild safety measure. Presumably, while upping yours, a more gradual elevation might be achieved by going more slowly???? Just a thought. Again. I have NO medical training so please check with your doctor. It IS important, and all those questions need to be addressed by your doctor. How bad would you feel if you passed out while you were taxiing your kids around??? Take care of YOU!

Marguerite

 

[PJmomrunner]

Hi Marguerite!

Good thoughts, but when I halve my Toprol XL 100mg it seems to effect the release of the medication in to my bloodstream and I get dizzy. I do monitor my BP and can definitely feel when it's low ("woozy" like JeffP said). Anyway, I seem to fine now.

BTW, I hope all turns out okay with the breast biopsy

 

[aussigal]

YEP...
DEFINATELY

that anaesthesia for day-case surgeries and others I guess will lower your BP...