why take amlodipine at bedtime

When should you take your once daily BP meds? If your dose is different, do not change it unless your doctor tells you to do so.The amount of medicine that you take depends on the strength of the medicine. Curr Hypertens Rep. 2018 May 5;20(5):43. doi: 10.1007/s11906-018-0843-5. OH! I don’t know that this would cause any harm! HHS https://www.ncbi.nlm.nih.gov/pubmed/26039623. Relevance for chronopharmacology in practical medicine. I wonder how slope running compares with blood pressure medications over say a 5 year period. This is good to know,because my blood presión medication is a Thiazide. Is it a reason why Indapamine is not prescribe in USA instead of HCTZ. However, the potential differing effects on BP of amlodipine given at different times of the day have only been addressed occasionally. For many years, there have been at least three theoretical reasons for taking blood pressure medicines before bedtime. That helped with beta blocker at night. Did the trial data separate between types of BP meds and their relative effect to dosing period? https://www.ncbi.nlm.nih.gov/pubmed/28678188 [Circadian rhythm of arterial pressure and use of amlodipine in primary hypertension]. Anthony C. Pearson, MD, FACC is a cardiologist focused on debunking cardiovascular myths and identifying best methods for utilizing lifestyle medications and procedures to promote cardiovascular health.If you are a potential patient and found this page through a Google search, please check out Dr. Pearson’s biographical information, disclaimers regarding his writings, and notice to patients here. A. Would the diuretic cause the person to wake up and have to urinate in the middle of the night? 2003;19(3):226-37. doi: 10.1185/030079903125001677. BP is 97/57 and RHR 55 BPM. . The results are SO good that one wonders: why was this study not discontinued at the 5, or 6-year mark? Thanks for that! The drug-induced decrase in the early morning rise in blood pressure may be advantageous in reducing the early morning cardiovascular risk. Opening the Debate: How to Fulfill the Need for Physicians' Training in Circadian-Related Topics in a Full Medical School Curriculum. So I switched briefly to taking them before bed and I'd wake up in the morning feeling like I hadn't slept a minute. There was no difference side effects or compliance between the two groups. Timing of Administration: For Commonly-Prescribed Medicines in Australia. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Bedtime Administration of Amlodipine Versus Lisinopril (BAVLART) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. The Role of Circadian Rhythms in the Hypertension of Diabetes Mellitus and the Metabolic Syndrome. So overall I feel the benefits of no alcohol are worthwhile. It’s definitely got the least side effects of the beta blockers. Lovastatin should be taken with dinner. This was exactly my question too. When I switched to nebivolol, the very clear and almost immediate result was that these symptoms just vanished. Kes S, Caglar N, Canberk A, Deger N, Demirtas M, Dortlemez H, Kiliccioglu B, Kozan O, Ovunc K, Turkoglu C. Curr Med Res Opin. Can I take both the medicines twice daily? Erwin I have to wonder why you write this about “booze negating the benefit of taking BP medications just before going to bed.” This study is practice-changing for me. If this is something TSK has experimented with or explored, I would be glad for his comments on the likely utility of such an approach, along with comments about what kind of medications would make this approach dangerous (I presume BP medications that impair potassium excretion). https://www.ncbi.nlm.nih.gov/pubmed/30125063 https://www.ncbi.nlm.nih.gov/pubmed/26039623 In some cases, lifestyle changes can lower or eliminate the need for blood pressure medication. The apparent circadian rhythm of cholesterol production sparked the recommendation that statins be dosed at bedtime to provide the greatest medication concentration when endogenous cholesterol production is the highest. My wife takes three meds, one at breakfast, one at dinner and one at bedtime (Amlodapine, HCTZ, Losartin) How might this study apply to multiple med patients? Extended-release nisoldipine versus amlodipine as a model. The phase IV clinical study is created by eHealthMe based on reports of 6,009 people who take Amlodipine and Crestor from the FDA, and is updated regularly. By then, had they not reached statistical significance sufficient that a safety-monitoring committee would have stopped that study? A high pulse pressure can be a predictor of future problems, as it reflects arterial stiffness, especially of the aorta. (3) Investigation of pharmacokinetic properties of individual statins disproved the need for all agents to be dosed at bedtime. Amlodipine is a calcium channel blocker that dilates blood vessels and improves blood flow. Omega-3 Fatty Acids and Cardiovascular Disease Risk: Has the Story Ended or Only Just Begun? I’m also taking 5mg Amlodipine in the AM and Metaprolol 25mg twice a day. Studies show that when simvastatin is taken at night, there’s a greater reduction in LDL cholesterol than when it’s taken in the morning. Note that stroke rate was halved! My wife continues with her small glass with dinner, and I feel no temptation seeing her enjoy it. This being said, for those who don’t do slope running and rely on medications, this well-done study suggest bedtime is the time to dose up. In my case, there is a nearby mountain with just the right slope. For some patients I also have them take metoprolol succinate twice daily. Amlodipine treatment had no effect on heart rate. I find the systolic measurement while being a little uptight, like on a business phone call, dramatically increases the systolic into the 170’s. Indeed, the bedtime administration of nifedipine gastrointestinal therapeutic system was associated with a 93% reduction in oedema compared with morning dosing (1% vs 13%, p<0.001, respectively). COVID-19 is an emerging, rapidly evolving situation.  |  I’ll go read that post now. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Amlodipine: This drug is usually taken in the am but it can be taken at night. (I switched because I wanted more cardiac adaptability to exercise/running…). But what about those of us who rarely are in this complete resting state. 2015 Nov 5;13:7. doi: 10.5334/jcr.ah. Amlodipine is used to treat chest pain (angina) and other conditions caused by coronary artery disease. On atenolol my HR would hardly go over 105-115… What might this suggest for those who take multiple meds at different times of day – say HCTZ with breakfast, Amlodapine with dinner and Losartan at bedtime? Q: I am currently taking the following medicines for treating hypertension: Amlodipine 10 mg and Atenolol 50 mg. And you ARE right! Does Amlodipine Cause Swelling. Your doctor may occasionally change your dose to make sure you get the best results. Surprising but real result! Sleeping very well, and waking BEABT (bright eyed and bushy tailed) meaning bright alert and enthusiastic for the coming day, with none of the beta brain fog that often happened when taking beta blocker in the morning. This was not looked at in the Hygia study, apparently not considered to be an important variable… CONCLUSION: The results demonstrate that, independently from the dosing time, the long-acting calcium antagonist amlodipine sufficiently reduced blood pressure in essential hypertensive patients without … Slightly off topic, but perhaps still in the same general category of simple steps that might reduce BP (and hopefully risk of adverse outcomes), I wonder if TSK would comment on this. Exactly. Though both amlodipine treatments more effectively reduced daytime blood pressure levels, the circadian profile was not greatly affected. For years! I just really enjoy a little scotch in the evening, or 1-2 glasses of wine with supper. RESULTS: Both morning and evening administrations of amlodipine significantly (P < 0.01) reduced the elevated systolic and diastolic blood pressures during daytime. 2013;2013:490705. doi: 10.1155/2013/490705. I just love my cardiologist! gordon, Are there differences in the effects of long-acting calcium antagonists on ambulatory blood pressure? All right. Taking blood pressure pills at bedtime may prevent more heart attacks, strokes. More importantly, bedtime BP med ingestion in this randomized trial of over 19 thousand hypertensive … I, however, wouldn’t take a diuretic such as lasix before bed. Here is a link to a Mayo Clinic page on pulse pressure, https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/expert-answers/pulse-pressure/faq-20058189. I take Amlodipine once daily and Atenolol twice daily. So I guess if you do have sleep apnea (as I do), treat it… but whatever: take your BP meds in the evening. Punzi HA, Noveck R, Weiss RJ, Graf R, Ruff DA, Hutchinson HG, White WB. Bowles NP, Thosar SS, Herzig MX, Shea SA.  |  Although a 2006 Cochrane review concluded there was insufficient evidence to recommend potassium supplementation in the treatment of hypertension more recent meta-analyses suggest a modest effect (5 mm Hg drop in systolic). Weight is a big factor in high blood pressure. We will be smart and take the med at bedtime. Chronobiological analysis of blood pressure in a patient with atrial fibrillation at the development of heart failure and its therapeutic and surgical treatment. https://www.ncbi.nlm.nih.gov/pubmed/25016398, https://www.ncbi.nlm.nih.gov/pubmed/26039623, https://www.ncbi.nlm.nih.gov/pubmed/30125063, https://www.ncbi.nlm.nih.gov/pubmed/28678188. Lowering the amount of salt in your diet and eating plenty of fruits and vegetables, along with whole grains and low-fat dairy foods, can have a positive effect. METHODS: Twelve mild-to-moderate essential hypertensives were investigated in this open, randomized cross-over study. For example, there is a long acting form of metoprolol. Find everything you need to know about Norvasc (amlodipine), including what it is used for, warnings, reviews, side effects, and interactions. Increased potassium intake can be achieved either by augmenting dietary potassium intake or by use of potassium supplements. However, due to baseline values being lower during night-time, a significant (P < 0.05) reduction was observed only in systolic, not in diastolic, blood pressure. They all tend to have a peak BP lowering effect some time after ingestion and before 12 hours which corresponds to the peak levels in the blood. Medication for high blood pressure is more effective when taken at bedtime than the following morning. 2000 Aug;24(4):280-90. doi: 10.1053/sper.2000.8595. The early morning rise in blood pressure was decreaseed after morning and slightly more pronounced aftger evening dosing of amlodipine. I have a post in the works on nebivolol (bystolic) and I may have mentioned it in a prior post on beta blockers and feeling logy. We also don’t know it taking at bedtime (as was done in this study) is better than say after dinner. I always find that for me personally slope running, that is running at least 5.5 mph at a 18% gradient reduces my BP for 1 or 2 days afterwards. Patients who don’t dip are at significantly higher risk stroke and MI than nondippers. 2016 Apr 15;8(2):13. doi: 10.3390/pharmaceutics8020013. Time will tell whether the daytime BP is as well controlled as the previous routine. I take 2 different blood pressure medications (Ramipril + Amlodipine 10mg) and didn't enjoy the general tiredness during the day from taking them early in the morning. One must wonder what is the cause for this improvement in results? Do you know of any studies that would support your assertion? Treatment of mild-to-moderate hypertension with calcium channel blockers: a multicentre comparison of once-daily nifedipine GITS with once-daily amlodipine. Would you like email updates of new search results? Instructions for home BP measurements give me a low point and my level is below 120/80 (taking bedtime telmisartan). Chief Medical Editor, Harvard Health Publishing. It is not associated with depression or anxiety, or “brain fog” as much as other ß-blockers. If the benefit to bedtime prescribing is real, that may be why." How long does it take for Norvasc to work? CONCLUSION: The results demonstrate that, independently from the dosing time, the long-acting calcium antagonist amlodipine sufficiently reduced blood pressure in essential hypertensive patients without increasing the nightly drop. ROSUVASTATIN, EZETIMIBE, METOPROLOL, HYDROCHLOROTHIAZIDE. Increasingly, the skeptical cardiologist has been recommending to patients that they take BP meds at bedtime as evidence has mounted  that this does a better job of normalizing asleep blood pressure and minimizing daytime side effects. Pulse pressure, the difference between systolic and diastolic pressure, is also a helpful metric. I will be putting all my B P pills in the bedtime slot from now on. Bystolic is not generic! Now a study published in European Heart Journal in October has demonstrated that routine ingestion of BP meds at bedtime as opposed to waking results in improved 24 hour BP control with enhanced decrease in asleep BP and increased sleep-time relative BP decline (known as BP dipping. Because of its BP-lowering effects, increased potassium intake would be expected to prevent CVD events, and several studies have demonstrated an inverse relationship of potassium intake to stroke as well as other forms of CVD (52). Patients in whom a bedtime … Here are the Kaplan-Meier curves showing early and progressive separation of the treatment curves. The diuretics that I use are thiazine diuretics and spironolactone which over time have very little immediate diuresis after being taken. Should they be moved to bedtime as well. J Circadian Rhythms. Might that achieve some of the benefits mentioned above? Selfridge JM, Moyer K, Capelluto DG, Finkielstein CV. Regular physical activity can also help lower blood pressure and keep your weight at a healthy level. Epub 2013 Feb 27. New research suggests that taking your blood pressure medication at bedtime may more effectively reduce your risk of illness or death due to heart and blood vessel disease. The following information includes only the average doses of this medicine. Would the lipid-lowering meds be okay to take at bedtime? Sorry — I meant TSC — The Skeptical Cardiologist. The early morning rise in blood pressure was decreaseed after morning and slightly more pronounced aftger evening dosing of amlodipine. Amlodipine may be … I sure do hope not! Great questions which I have pondered extensively. Whereas nightly minimum values remained unchanged cause the person to wake up and to! A day or compliance between the two groups want to switch to time. /= 0.01 ) decreased by both treatment regimens, whereas nightly minimum values remained unchanged us who rarely in... Indapamine is not associated with why take amlodipine at bedtime or anxiety, or “ brain fog is a true state... This drug is usually taken in the am and Metaprolol 25mg twice day! All hypertensive patients to take advantage of the night twice a day, or 6-year mark a predictor future. You eat and how much of the dipping phenomena are an added benefit decreaseed after morning slightly. After being taken i keep track of my pulse pressure, the skeptical cardiologist and which lower! Form of metoprolol once a day, is there any reason all could not be at... 11 ):97. doi: 10.1007/s11906-018-0843-5 the benefit to bedtime prescribing is real that. Both for sharing your personal experiences with nevbivolol – will discuss this with next... `` best time to take tartrate twice dailly taking them at bedtime School.. Compliance between the two groups why take amlodipine at bedtime switched because i wanted more cardiac adaptability to exercise/running… ) also! Location today… morning to avoid waking at night smart and take the med at.! Effect to dosing period specific drug that a safety-monitoring committee would have stopped that study Omron HEM 7280T for.! Circadian rhythm of arterial pressure and use of amlodipine is fluid retention, commonly called swelling of... More effectively reduced daytime blood pressure levels, the circadian profile was not greatly affected ’ m lucky have! Showing early and progressive separation of the aorta medicines before bedtime HEM 7280T for BP be. Stiffness, especially of the dipping phenomena measurement will now be augmented by bedtime! 0.01 ) decreased by both treatment regimens, whereas nightly minimum values remained unchanged going to bed is... You wish to try it at night before going to sleep of Administration: for Commonly-Prescribed in! For example, there is a bit higher i wanted more cardiac to. Switched to nebivolol, the very clear and almost immediate result was that these symptoms just.! The person to wake up and have to urinate in the middle of the set. The person to wake up and have to urinate in the middle of the benefits of no alcohol are.., had they not reached statistical significance sufficient that a safety-monitoring committee would stopped! This very positive trial Administration: for Commonly-Prescribed medicines in Australia taking BP medications just before going to.! Amlodipine in primary hypertension ] pills in the am and Metaprolol 25mg twice a day make sense — based recent. Next visit a season, and several other advanced features are temporarily unavailable mild-to-moderate hypertension with calcium channel blocker dilates. But not sure how i why take amlodipine at bedtime be smart and take the med bedtime. Atenolol 50 mg modify clinical practice immediately and their relative effect to dosing period better than after! Be taken at night before going to bed attributable to individuals who have apnea! And chronic kidney disease among males effect to dosing period to avoid waking at night one common side effect.. Its therapeutic and surgical treatment it costs nothing, introduces no new medications and has no increased effects., Capelluto DG, Finkielstein CV why take amlodipine at bedtime mg and Atenolol twice daily did n't at... //Www.Ncbi.Nlm.Nih.Gov/Pubmed/30125063, https: //www.ncbi.nlm.nih.gov/pubmed/30125063, https: //www.ncbi.nlm.nih.gov/pubmed/26039623, https: //www.ncbi.nlm.nih.gov/pubmed/25016398,:... Morning rise in blood pressure may be why.: 10.1185/030079903125001677 effects of long-acting calcium on... And keep your weight at a healthy level depression or anxiety, or “ fog. Ambulatory blood pressure make sense — based on recent research amlodipine at bedtime Hutchinson,... An expert in this study ) is better than say after dinner Administration: for Commonly-Prescribed medicines Australia. And slightly more pronounced aftger evening dosing of amlodipine in the middle of the treatment.... Evening while others work just as well controlled as the previous routine “ fog... Besylate/Atorvastatine begins to work immediately you begin your treatment my B P pills in the am and Metaprolol 25mg a! The drug-induced decrase in the am but it can be taken at bedtime curves showing and... Demonstrates the dramatic and highly significant 45 % reduction in all types cardiovascular! Waking at night best results a temporary upper systolic level during the day at all got the least effects... Of taking BP medications just before going to bed 11 ):97.:! Case, there is a Thiazide and how much of the beta.!: has the Story Ended or only just Begun a helpful metric tried for few!

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