Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Medication For Hypertension When Diagnosed With Kidney Failure
Question: my mother has renal kidney failure at 25% and also has high blood pressure. she is on several different bp meds and her blood pressure is still a little up and down which for her greatly effects her level of energy. I am looking for a blood pressure medicine that will better regulate her bp and not effect her kidneys. Do you have any suggestions. She is also a Diabetic
YYYY@YYYY
YYYY@YYYY
Brief Answer:
I would recommmend as follows:
Detailed Answer:
Hello!
Welcome on HCM!
I understand your concern and would explain that there are several treatment options in her clinical situation. I would recommend:
1- Calcium channel blockers like amlodipine, lercanidipine. They don't affect the renal function. Could I know what is her actual dose of amlodipine? An increase in the dose of amlodipine may be considered, to have a better control of her blood pressure.
2- Central antihypertensive drugs:
-Moxonidine. This drug has shown to be really effective in controlling blood pressure in diabetic patients with a low renal function. I would recommend starting with 0.4mg 1tb daily and gradually increase the dose, based on her tolerance.
-Methyldopa. This is another effective drugs in controlling high blood pressure, which does not affect the renal function. It can be started with 250mg daily and increase slowly the dose, based to her tolerance.
Regarding beta blockers, I would recommend switching from metoprolol to nebivolol, which is known for a better tolerance in renal dysfunction.
I would also recommend reducing the doses of lisinopril or even stop taking it. You should know that ACEI drugs like lisinopril, can lead to increased plasma levels of potassium (which is also common in impaired renal function). It is important to closely monitor the potassium plasma levels, while on lisinopril.
You should discuss with her attending physician all the above issues.
Hope to have been helpful!
Best wishes,
Dr. Iliri
I would recommmend as follows:
Detailed Answer:
Hello!
Welcome on HCM!
I understand your concern and would explain that there are several treatment options in her clinical situation. I would recommend:
1- Calcium channel blockers like amlodipine, lercanidipine. They don't affect the renal function. Could I know what is her actual dose of amlodipine? An increase in the dose of amlodipine may be considered, to have a better control of her blood pressure.
2- Central antihypertensive drugs:
-Moxonidine. This drug has shown to be really effective in controlling blood pressure in diabetic patients with a low renal function. I would recommend starting with 0.4mg 1tb daily and gradually increase the dose, based on her tolerance.
-Methyldopa. This is another effective drugs in controlling high blood pressure, which does not affect the renal function. It can be started with 250mg daily and increase slowly the dose, based to her tolerance.
Regarding beta blockers, I would recommend switching from metoprolol to nebivolol, which is known for a better tolerance in renal dysfunction.
I would also recommend reducing the doses of lisinopril or even stop taking it. You should know that ACEI drugs like lisinopril, can lead to increased plasma levels of potassium (which is also common in impaired renal function). It is important to closely monitor the potassium plasma levels, while on lisinopril.
You should discuss with her attending physician all the above issues.
Hope to have been helpful!
Best wishes,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for the information. In answer to you question about her dose of Amlodipine it is only 10mg once a day and I give it to her after dinner. Would it help better if I gave it to her in the morning?
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello again!
Thank you for the additional information!
This is a low dose of amlodipine. I would recommend increasing the dose to 10mg twice (morning and evening) or 20mg once a day in the evening. This drug has a long half-life, and it can also be taken once a day and act through 24 hours.
Hope you will find this answer helpful!
Kind regards,
Dr. Iliri
I would recommend as follows:
Detailed Answer:
Hello again!
Thank you for the additional information!
This is a low dose of amlodipine. I would recommend increasing the dose to 10mg twice (morning and evening) or 20mg once a day in the evening. This drug has a long half-life, and it can also be taken once a day and act through 24 hours.
Hope you will find this answer helpful!
Kind regards,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
