Re: Re: Actos and Norvasc

[Guest guest]

Bev Trice wrote:

<< I have gained 16 lbs (after my weight being stable for over 7 years),

Edema is a MAJOR problem, and I complained of irregular heartbeat and

strange pressure in my upper chest at my last doctors visit a couple of

weeks ago. Another thing.....since beginning Actos, I have had these weird

feelings in my head, kind of fuzzy like I might pass out. When the nurse

checked my blood pressure at the last visit, she was so taken

aback by my blood pressure that she exclaimed, " Man, your blood pressure has

REALLY come down!! " I assumed it was a mistake, and told my doctor that it

felt like my head was going to explode from

HIGH blood pressure. I have noticed that at times my pulse is extremely

low, like 48, and considering that I am taking medication for tachycardia,

that's rather interesting. >>

Bev, messed-up electrolytes can cause irregular heartbeat. You should find

out what your last test results were for electrolytes, and have it done

again. Since you're not taking any supplements, this is a real concern. I

keep rereading your post. I'm quite concerned that you are reporting what

are potentially serious health problems and your doctor seems to be waving

you off. Most of us suffer from hypertension, but hypotension can also be a

matter of concern. But more than that, what concerns me here is that your

pulse is absolutely *beating too slowly for safety*. When your pulse is too

slow, your blood is not pumping sufficiently, and pools. It is sort of like

mimicing congestive heart failure. I don't want you to go one more day with

those slow pulses without having someone address this. In the ER after the

horse wreck, I had lost a lot of blood, and when the doc saw that my pulse

was 48, he hospitalized me. And here you're walking around (barely) with

that scary-low of a pulse! Anytime my pulse gets below 60, in fact, I think

that's worrisome. A very real danger here is the risk of blood clots. I hope

group members with nursing or medical backgrounds will jump in here and help

you out. The symptoms you describe ... the " exploding chest, " as well as the

lower extremity edema, point to the need to alter your meds to get your

pulse back up.

<< Since I am already on Norvasc, a CCB, I theorize that I may be getting

overmedicated in this area, causing low blood pressure and a double whammy

on the edema. I haven't had any Norvasc since yesterday at lunch and I feel

fine, and my blood pressure is below normal, MUCH below what I have come to

expect. >>

Here's what RxList.com says about that Norvasc you've been taking:

Single oral doses of 40 mg/kg and 100 mg/kg in mice and rats, respectively,

caused deaths. A single oral dose of 4 mg/kg or higher in dogs caused a

marked peripheral vasodilation and hypotension.

Overdosage might be expected to cause excessive peripheral vasodilation with

marked hypotension and possibly a reflex tachycardia. In humans, experience

with intentional overdosage of amlodipine besylate is limited. Reports of

intentional overdosage include a patient who ingested 250 mg and was

asymptomatic and was not hospitalized; another (120 mg) was hospitalized,

underwent gastric lavage and remained normotensive; the third (105 mg) was

hospitalized and had hypotension (90/50 mmHg) which normalized following

plasma expansion. A patient who took 70 mg amlodipine and an unknown

quantity of benzodiazepine in a suicide attempt, developed shock which was

refractory to treatment and died the following day with abnormally high

benzodiazepine plasma concentration. A case of accidental drug overdose has

been documented in a 19 month old male who ingested 30 mg amlodipine (about

2 mg/kg). During the emergency room presentation, vital signs were stable

with no evidence of hypotension, but as heart rate of 180 bpm. Ipecac was

administered 3.5 hours after ingestion and on subsequent observation

(overnight) no sequelae were noted.

If massive overdose should occur, active cardiac and respiratory monitoring

should be instituted. Frequent blood pressure measurements are essential.

Should hypotension occur, cardiovascular support including elevation of the

extremities and the judicious administration of fluids should be initiated.

If hypotension remains unresponsive to these conservative measures,

administration of vasopressors (such as phenylephrine), should be considered

with attention to circulating volume and urine output. Intravenous calcium

gluconate may help to reverse the effects of calcium entry blockade. As

amlodipine besylate is highly protein bound, hemodialysis is not likely to

be of benefit.

Susie