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What Causes Headache And Fatigue While On Atenolol?

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Posted on Mon, 3 Oct 2016
Question: I HAVE BEEN HAVING A PROBLEM GETTING REGULATED ON A BP MEDICATION. THEY EITHER DON'T CONTROL MY BP OR THEY MAKE IT TOO LOW. THE ONE I AM ON NOW HYDRALAZINE 10MG 3X A DAY IS MAKING ME EXTREMELY TIRED AND CONTROLS MY BP WHEN I AM SITTING OR DOING VERY LITTLE. AS SOON AS I EXERT MYSELF MY BP GOES HIGH. NO HAPPY MEDIUM. LOTS OF SIDE EFFECYS, HEADACHES, DIZZINESS, CONFUSION ETC. PLEASE HELP.
doctor
Answered by Dr. Ilir Sharka (6 hours later)
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

I carefully passed through your question and would explain that your blood pressure do not seem to be under control, and it is important on optimization of your current antihypertensive therapy.

Atenolol, may be responsible for the chronic fatigue, as betablockers are known to reduce the physical performance.

From the other hand, hydralazine can be responsible for some of your troubles. It has a short pharmacological half-life, which means that its effects last for up to 6 hours.

For this reason, I would recommend trying to stop hydralazine and switch to another antihypertensive agent, which has a more extended release and can also be taken once or twice daily.

ARB class (valsartan, irbesartan, etc.) or an ACEI (lisinopril, ramipril) could be helpful in this situation.

Another point to consider would be reducing the dose of atenolol as it has a weak antihypertensive effect and it can trigger the chronic fatigue which you are experiencing now.

Increase the dose of amlodipine. What is the current dose of amlodipine (norvasc)you are taking? Increasing the dose may help achieve a better control of blood pressure through the day.

I would also recommend performing some blood lab tests (complete blood count, thyroid hormone levels, blood electrolytes, fasting glucose, kidney and liver function tests) in order to exclude other possible secondary causes of uncontrolled high blood pressure.

You should discuss with your doctor on the above tests.

Hope you will find this answer helpful!

Kind regards,

Dr. Iliri


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (14 hours later)
I am no longer on the norvasc just the hydralazine and atenolol. My cardiologist has referred me to a nephrologist for better care, I think my cardiologist was stumped but he only tried the meds I mentiopned along with diazides which gave me horrifif headaches. Will let you know when I go to the nephrologist and what the treatment is. Thank you.
doctor
Answered by Dr. Ilir Sharka (45 minutes later)
Brief Answer:
My answer as follows:

Detailed Answer:
Hello again!

Thank you for the additional information!

If you suffer from chronic renal disease, I would not recommend taking ACEI or ARB as they are known to aggravate the kidney function.

Did you have troubles like headache or leg swelling with norvasc? This could be a good treatment option in your case.

Anyway, it is important performing the above mentioned tests in order to exclude other possible secondary causes of uncontrolled blood pressure and also find the proper treatment options based on possible comorbidities.

Reducing the dose of atenolol would help reduce the chronic fatigue.

A central antihypertensive drug like moxonidine or methyldopa could also be helpful.

Hope to have been helpful!

Best wishes,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (50 minutes later)
I have no hx of kidney disease. When on norvasc I only experienced headaches, no swelling of the hands, legs or feet. For 71 yo I am excellent physical condition as from the current problem with my bp. I have gained a few lbs. Which I know will help increase your bp. I will make an appt with the nephrologist within the next 2 weeks. Thank you.
One more question....I had an echocardiogram done which showed 1st stage diastolic dysfunction, should I be concerned with this diagnosis? My cardiologist said not to worry about it, it was insignificant, is thiis correct.
doctor
Answered by Dr. Ilir Sharka (11 hours later)
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello again!

It is true that norvasc can cause headache as a known adverse effect. So I would not recommend restarting it if you don't tolerate it well.

As you have no history of renal disease, I would recommend starting an ARB drug(valsartan, irbesartan, etc.) or ACEI ( lisinopril, ramipril,etc.).

Regarding mild diastolic dysfunction, it is not a concerning clinical situation.

A better control of blood pressure values would help in this regard too.


Hope to have been helpful!

Wishing good health,

Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9544 Questions

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What Causes Headache And Fatigue While On Atenolol?

Brief Answer: I would recommend as follows: Detailed Answer: Hello! Welcome and thank you for asking on HCM! I carefully passed through your question and would explain that your blood pressure do not seem to be under control, and it is important on optimization of your current antihypertensive therapy. Atenolol, may be responsible for the chronic fatigue, as betablockers are known to reduce the physical performance. From the other hand, hydralazine can be responsible for some of your troubles. It has a short pharmacological half-life, which means that its effects last for up to 6 hours. For this reason, I would recommend trying to stop hydralazine and switch to another antihypertensive agent, which has a more extended release and can also be taken once or twice daily. ARB class (valsartan, irbesartan, etc.) or an ACEI (lisinopril, ramipril) could be helpful in this situation. Another point to consider would be reducing the dose of atenolol as it has a weak antihypertensive effect and it can trigger the chronic fatigue which you are experiencing now. Increase the dose of amlodipine. What is the current dose of amlodipine (norvasc)you are taking? Increasing the dose may help achieve a better control of blood pressure through the day. I would also recommend performing some blood lab tests (complete blood count, thyroid hormone levels, blood electrolytes, fasting glucose, kidney and liver function tests) in order to exclude other possible secondary causes of uncontrolled high blood pressure. You should discuss with your doctor on the above tests. Hope you will find this answer helpful! Kind regards, Dr. Iliri