Guest guest Posted June 18, 2002 Report Share Posted June 18, 2002 Barbara, Orthostatic hypotension is a known side effect of Mirapex, so Chuck's reaction is not too surprising. When you say he sleeps with his head raised, do you mean the whole bed (i.e. bricks under the head board) or just his head (i.e. pillows)? For the raised head to be effective it needs to be the bed, not just the head. The patient shouldn't " bend " in the middle or else you lose the benefit. According to Rob's doc, the timing of the florinef doesn't matter, since it is long acting and must build up in the blood stream to have an impact. In fact Rob takes his (3 X 0.1mg tablets) all at once at bedtime. Midodrine (aka proamatine) is short acting and you must use care in the timing of that one. You might want to check out my earlier post today which was a brain dump on hypotension. My suggestion is to talk to the doctor. As you know this is a huge balancing act, and if the Mirapex is helping the tremor the neurologist may want to add midodrine during the day to counteract the orthostatic hypotension and decrease the florinef to reduce the supine hypertension at night. It's a challenge, but with lots of effort they can probably get a better balance. Carol & Rob Lexington, MA Blood pressure Rise > Hello everyone, > > Norwegian Neurologist Bumbler has a question. > > My husband Chuck has been lucky in that his supine blood pressure has > been about normal, although of course upon standing it goes through the > basement. > > However, he has started taking Mirapex and, although the drug seems to > help the tremor, his blood pressure takes a much longer time to recover > on standing---in fact he MUST sit. Furthermore, at night, when he is > lying down I can see that his BP has gone up because his face gets red. > When measuring the BP, have found it to be like 180-90/105. > > My question to you who have dealt with this, is " How do you deal with > it? " Chuck does sleep with his head raised quite high, so can't get much > higher. Is there anything one can do besides lay there and cross your > fingers and toes? > > He takes 0.1 mg Florinef twice a day. Maybe he's taking the Florinef too > late in the PM. Have to check that. > > Barbara Woodford (Illinois) > > If you do not wish to belong to shydrager, you may > unsubscribe by sending a blank email to > > shydrager-unsubscribe > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 18, 2002 Report Share Posted June 18, 2002 woodford wrote: Hello everyone,Norwegian Neurologist Bumbler has a question.My husband Chuck has been lucky in that his supine blood pressure has been about normal, although of course upon standing it goes through the basement.However, he has started taking Mirapex and, although the drug seems to help the tremor, his blood pressure takes a much longer time to recover on standing---in fact he MUST sit. Furthermore, at night, when he is lying down I can see that his BP has gone up because his face gets red. When measuring the BP, have found it to be like 180-90/105.My question to you who have dealt with this, is "How do you deal with it?" Chuck does sleep with his head raised quite high, so can't get much higher. Is there anything one can do besides lay there and cross your fingers and toes?He takes 0.1 mg Florinef twice a day. Maybe he's taking the Florinef too late in the PM. Have to check that.Barbara Woodford (Illinois) Barbara, My mom has the same problem. She is in the hospital right now and the nurses and physical therapist say every time they try to get her out of bed her b/p drops so much so fast that she blacks out and gets stiff as a board. I am from South Roxana, Illinois across the river from St.Louis. What part of Illinois are you from? Pat If you do not wish to belong to shydrager, you may unsubscribe by sending a blank email to shydrager-unsubscribe Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 18, 2002 Report Share Posted June 18, 2002 Hello everyone, Norwegian Neurologist Bumbler has a question. My husband Chuck has been lucky in that his supine blood pressure has been about normal, although of course upon standing it goes through the basement. However, he has started taking Mirapex and, although the drug seems to help the tremor, his blood pressure takes a much longer time to recover on standing---in fact he MUST sit. Furthermore, at night, when he is lying down I can see that his BP has gone up because his face gets red. When measuring the BP, have found it to be like 180-90/105. My question to you who have dealt with this, is " How do you deal with it? " Chuck does sleep with his head raised quite high, so can't get much higher. Is there anything one can do besides lay there and cross your fingers and toes? He takes 0.1 mg Florinef twice a day. Maybe he's taking the Florinef too late in the PM. Have to check that. Barbara Woodford (Illinois) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 18, 2002 Report Share Posted June 18, 2002 Barbara, I wanted to second Carol's suggestion to check into adding Midodrine during the day. Like she said, it is a wonderful medication in that its effects only last a few hours, probably five tops. So, at the end of the day, you can tapper down and help prevent bp rise at night. Of course, this is all if you have not tried Midodrine. Midodrine can be increased when needed and acts up to its full potential within an hour. There are times when it does not get the job done, but it does quite a good job most of the time. Bear in mind, that all of this means that you must take it multiple times during the day. As for Florinef, Carol, I think, is right to say that it builds up in your body. I want to clarify how I see things: once it builds up, Florinef increments at night could cause a rise for that night or the day if taken in the AM. So, look at cutting the dosage at night. I cannot see how the time of the night would matter. (I lost myself here in who said what, but I hope my point is clear that my recommendation would be to cut it at night and not worry about the time at night. Of course, please check with your doctor.) I hope this helps. I cannot reiterate how many people have benefitted from Midodrine. I am aware of patients who cannot take it though. Best Wishes, Zac ______ > Hello everyone, > > Norwegian Neurologist Bumbler has a question. > > My husband Chuck has been lucky in that his supine blood pressure has > been about normal, although of course upon standing it goes through the > basement. > > However, he has started taking Mirapex and, although the drug seems to > help the tremor, his blood pressure takes a much longer time to recover > on standing---in fact he MUST sit. Furthermore, at night, when he is > lying down I can see that his BP has gone up because his face gets red. > When measuring the BP, have found it to be like 180-90/105. > > My question to you who have dealt with this, is " How do you deal with > it? " Chuck does sleep with his head raised quite high, so can't get much > higher. Is there anything one can do besides lay there and cross your > fingers and toes? > > He takes 0.1 mg Florinef twice a day. Maybe he's taking the Florinef too > late in the PM. Have to check that. > > Barbara Woodford (Illinois) Quote Link to comment Share on other sites More sharing options...
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