Secondary Drungs For Blood Pressure, Bloodpressure Uk

Information Sheet #06
Medicines for high blood pressure:

Non-standard
medicines
There are many different types of blood pressure medicine. Some are
used very often because they are effective and cause relatively few
side-effects. Then there are others that are not used so commonly.
These non-standard blood pressure medicines would only usually

be used in special circumstances for example if you are pregnant
or breastfeeding, if you are having difficult side-effects from other
medicines, or if your blood pressure is not being controlled enough
with other medicines. May 2009
Alpha-blockers Related information sheets

ACE inhibitors
Alpha-blockers block the effects of a hormone Angiotensin receptor inhibtors (ARBs)
called adrenaline. When adrenaline enters your
Calcium-channel blockers (CCBs)
blood stream it causes your blood vessels to
narrow. This gives your blood less space to move Diuretics
through, which will raise your blood pressure.
Alpha-blockers lower your blood pressure by
stopping adrenaline from having its full effect. This
Alpha-blockers used in the UK
allows your blood vessels to relax and widen,
Medicine name Brand names making it easier for blood to flow through.
Doxazosin Cardura, Cardura XL, Who might be given alpha-

Doxadura, Doxazosin
blockers?
Indoramin Baratol
You would rarely be given an alpha-blocker would
Prazosin Hypovase as a first choice of medicine for high blood
pressure. They would normally be used as a third
Terazosin Hytrin or fourth choice. Alpha-blockers may also be given
to men with an enlarged prostate or to people
For more information, please contact: The Blood Pressure Association is a Charity registered
The Blood Pressure Association
+ Address: 60 Cranmer Terrace, London SW17 0QS
( Info Line: 0845 241 0989 (11am - 3pm Mon to Fri)
: Website: www.bpassoc.org.uk
1 in England and Wales. Registered Charity No. 1058944
Company Limited by Guarantee registered in England and
Wales. Company No. 03251531.
Registered Office at: 60 Cranmer Terrace, London SW17 0QS
Non-standard medicines May 2009
Do they have side-effects?

Possible side-effects of alpha-
Some people taking an alpha-blocker will
blockers include: experience side-effects. There is no way to predict
sudden drops in blood pressure when if you will or not, until you start taking them.
sitting up or standing up Possible side-effects from alpha-blockers are
headaches or nausea shown in the box to the right.
swollen legs or ankles

tiredness, weakness or feeling lethargic Centrally-acting drugs
sleep disturbance (central alpha antagonists)
tremor
rash or itchiness of the skin
Centrally-acting drugs work directly on the part of
rarely, they may cause problems with the brain that controls blood pressure. They soften
erections in men the force of your heart beat and block nerve
signals that can narrow your smaller blood
who have a phaeochromocytoma (rare tumour of vessels. These actions make it easier for blood to
the adrenal gland which raises blood pressure). flow which helps lower your blood pressure.
Who would not be given alpha- Who might be given centrally-

blockers? acting drugs?
If you are pregnant, breastfeeding or planning a You would rarely be given a centrally-acting drug
pregnancy, you should not be given an alpha- as a first choice of medicine for high blood
blocker. pressure. They would normally be used as a third
or fourth choice. However, if you are pregnant or
Alpha-blockers are not normally given to women planning a pregnancy you may be given a
as they can cause stress incontinence and loss of medicine called methyldopa as it has been shown
bladder control. You will not be given an alpha- to be safe during pregnancy and breastfeeding.
blocker if you have a history of postural
hypotension (a sudden drop in blood pressure Who would not be given
when sitting up or standing up) or if you have ever centrally-acting drugs?
fainted after passing urine.
If you have heart disease, angina, kidney or liver
You may not be given an alpha-blocker if you have disease, Parkinsons disease or a history of
a history of heart failure, decreased liver or kidney depression you may need to be monitored closely
function, or have Parkinsons disease. while taking these medicines. Some centrally-
2
The Blood Pressure Association in England and Wales. Registered Charity No. 1058944
+ Address: 60 Cranmer Terrace, London SW17 0QS Company Limited by Guarantee registered in England and
( Info Line: 0845 241 0989 (11am - 3pm Mon to Fri) Wales. Company No. 03251531.
: Website: www.bpassoc.org.uk Registered Office at: 60 Cranmer Terrace, London SW17 0QS
trigger postural hypotension (a sudden drop in

Centrally-acting drugs used in UK blood pressure when sitting up or standing up) or
a slow heartbeat.
Medicine name Brand names
Clonidine Catapres, Dixarit
Methyldopa Aldomet, Methyldopa Direct-acting vasodilators
Moxonidine Moxonidine, Physiotens
Direct-acting vasodilators relax the muscles in your
blood vessel walls. This allows the blood vessels to
acting drugs may interfere with tests for widen and makes it easier for blood to flow. This
phaeochromocytoma. effect lowers your blood pressure.
Do they have side-effects? Who might be given direct-

Some people taking a centrally-acting drug will acting vasodilators?
experience side-effects. There is no way to predict
You would rarely be given a vasodilator as a first
if you will or not, until you start taking them.
choice of medicine for high blood pressure. They
Possible side-effects are shown in the box below.
would normally be used as a third or fourth. One
Less common side-effects may be depression, medicine called hydralazine may be given to
anxiety and problems with erections in men. people who have heart failure.
Methyldopa can sometimes cause liver problems. Who would not be given direct-
If you experience a fever after taking this medicine
acting vasodilators?
you should report it immediately. It may also
If you are pregnant, breastfeeding or planning a
pregnancy, you should not be given a vasodilator.
Possible side-effects of
centrally-acting drugs include:
feeling drowsy, tired, or dizzy
Direct-acting vasodilators
dry mouth used in the UK
upset stomach or nausea
Medicine name Brand names
swollen legs or feet
Hydralazine Apresoline, Hydralazine
headache
Minoxidil Loniten
sleep disturbance
3
Possible side-effects of direct- Aliskiren (Rasilez)

acting vasodilators include:
headaches Aliskiren (brand name Rasilez) is a new type of
a flushed appearance or skin rashes blood pressure medicine called a direct renin
inhibitor.
rapid or irregular heart beat
weight gain Aliskiren works by blocking the effects of a
chemical called renin. Renin is involved in
swelling of feet or lower legs producing a hormone called angiotensin, which
upset stomach raises your blood pressure. By blocking renin,
aliskiren reduces the amount of angiotensin in
excess body hair growth (with minoxidil)
your body.
Less commonly, you may experience chest
pain, shortness of breath or numbness. Who might be given aliskiren?
Aliskiren is not usually given as a first choice of
If you have heart disease, angina, diabetes or blood pressure medicine. You would only usually
uremia (build up of waste in your blood) you may be given it if you are not already taking an ACE
not be given a vasodilator, or will need to be inhibitor or an angiotensin receptor blocker (ARB).
closely monitored. Caution may also be required if
you have recently had a stroke or heart attack or if Who would not be given
you have kidney disease. If you have a phaeo- aliskiren?
chromocytoma you will not be given a vasodilator.
If you are pregnant, breastfeeding or planning a
pregnancy, you should not be given aliskiren.
Do they have side-effects?
Some people taking a vasodilator will experience You may not be given this kind of medicine if have
side-effects. There is no way to predict if you will or kidney problems, diabetes or hyperkalaemia (high
not, until you start taking them. Possible side- potassium levels in your blood). If you have heart
effects can include those listed above. failure, severe kidney impairment or a history of
dialysis then you may need to be monitored
closely.
Does it have side-effects?

Aliskiren is a relatively new medicine and not
much is yet known about its possible side-effects.
As with all medicines, there is no way to predict if
4
Check with your doctor or pharmacist before

Possible side-effects of taking any other medicines in combination with
aliskiren include: your non-standard medicine this includes over-
the-counter treatments. Your doctor will not give
The most common known side-effect of
you a non-standard medicine if they feel that it
aliskiren is diarrhoea. Other less common
could conflict with other conditions that you have
side-effects include:
or other medicines that you are taking.
headache
As with other blood pressure lowering medicines,
inflammation of the nasal passages once you start taking your medicine (whichever it
skin rash may be), be prepared to stay on it for the long
term. Some people stop taking their blood
swelling of the limbs. pressure medicines when they think their blood
pressure is under control, but doing this can put
you will experience side effects or not, until you your health at risk. If you have any concerns about
start taking the medicine. your medicine, speak to your doctor or pharmacist.
Other things to be aware of

about non-standard medicines About this information sheet
You may wish to ask your doctor for advice on This information sheet was produced by the
when and how to take your medicines. For Information & Support team at the Blood
example, it may be better to take an alpha-blocker Pressure Association. It is intended for people
before going to bed rather than in the morning. who have high blood pressure, or who are
This is because it can cause problems with interested in high blood pressure. For more
dizziness. Other medicines may affect your ability about how we make our information, go to
to drive or to use heavy machinery. Others can be www.bpassoc.org.uk/AboutUs
affected if you drink alcohol.
5

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Information Sheet #06

Medicines for high blood pressure:

These non-standard blood pressure medicines would only usually

Alpha-blockers Related information sheets

Doxazosin Cardura, Cardura XL, Who might be given alpha-

Do they have side-effects?

swollen legs or ankles

Who would not be given alpha- Who might be given centrally-

trigger postural hypotension (a sudden drop in

Do they have side-effects? Who might be given direct-

Possible side-effects of direct- Aliskiren (Rasilez)

Does it have side-effects?

Check with your doctor or pharmacist before

Other things to be aware of

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