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Has Nausea, headache, giddiness and weakness. Diabetes is under control. What to do?

hi, my wife 55yrs having diabetes for the last 22 yrs her diabetes is under control that is fasting 124 n p.p 167 her blood urea 55 n creatinine level is 1, now she is having morning nausea n headace giddiness weakness her b.p is rising 180 by 80 despite giving benatec h40, moxivas .3, n minipress xl 2.5.what to do. any suggestion.
Asked On : Fri, 15 Mar 2013
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General & Family Physician 's  Response
Long standing Diabetes leads to retinopathy, nephropathy, early atherosclerosis & other vascular complications.Your wife's Urea level is slightly higher. Minipress is Prazosin, a centrally acting drug used in the treatment of high BP. It produces vascular smooth muscle & reduces BP. But it may cause dizziness & fainting during the initial phases of treatment. This effect is called "First Dose Effect". This side effect wanes off after some time but may persist in the elderly. This can be minimised by starting a low dose (0.5mg) & should be given at bed time. The dose should be increased gradually. Prazosin is more suitable for diabetics as it improves carbohydrate metabolism. It can also result in headache, drowsiness, dry mouth, weakness & blurred vision. But it needs to be substituted with some other anti hypertensive drug if dizziness persists. Moxonidine(Moxovas) is also centrally acting antihypertensive drug. Also preferrable in Diabetes. Results in fatigue,dizziness, dry mouth & sleep disturbances.
Answered: Sat, 16 Mar 2013
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