Surprising, because it’s been around since the ’90s… I’m lucky to have good insurance. CONCLUSION: The results demonstrate that, independently from the dosing time, the long-acting calcium antagonist amlodipine sufficiently reduced blood pressure in essential hypertensive patients without … I’m on it myself and I can’t wait until it goes generic and becomes less expensive for my patients. A quick search on Pubmed now pointed me to several abstracts: The main reason why you would want to switch to night time, or before bed dosing, is for side effect avoidance. This site needs JavaScript to work properly. When I switched to nebivolol, the very clear and almost immediate result was that these symptoms just vanished. I’m also taking 5mg Amlodipine in the AM and Metaprolol 25mg twice a day. What you eat and how much you exercise can help control blood pressure. How long does it take for Norvasc to work? Studies show that when simvastatin is taken at night, there’s a greater reduction in LDL cholesterol than when it’s taken in the morning. 2016 Apr 15;8(2):13. doi: 10.3390/pharmaceutics8020013. Indeed, the bedtime administration of nifedipine gastrointestinal therapeutic system was associated with a 93% reduction in oedema compared with morning dosing (1% vs 13%, p<0.001, respectively). We also don’t know it taking at bedtime (as was done in this study) is better than say after dinner. Q: I am currently taking the following medicines for treating hypertension: Amlodipine 10 mg and Atenolol 50 mg. Taking blood pressure pills at bedtime may prevent more heart attacks, strokes. Sorry — I meant TSC — The Skeptical Cardiologist. The following information includes only the average doses of this medicine. The best time to take statins depends on the specific drug. They all tend to have a peak BP lowering effect some time after ingestion and before 12 hours which corresponds to the peak levels in the blood. Would you like email updates of new search results? WEDNESDAY, Oct. 23, 2019 (HealthDay News) -- Taking blood pressure medications at bedtime rather than in the morning nearly halves the risk of dying from a heart attack, stroke or heart failure, … Would the diuretic cause the person to wake up and have to urinate in the middle of the night? Patients who don’t dip are at significantly higher risk stroke and MI than nondippers. Your doctor may occasionally change your dose to make sure you get the best results. Can I take both the medicines twice daily? This prospective chronotherapy trial will investigate the potential differing efficacy of ramipril in doses from 5 to 10 mg/day when administered, as a monotherapy either upon awakening from nighttime sleep or at bedtime, to diurnally active patients with grade 1 or 2 essential hypertension, who will be evaluated by 48-hour ABPM before and after pharmacologic intervention. However, the potential differing effects on BP of amlodipine given at different times of the day have only been addressed occasionally. I wonder how slope running compares with blood pressure medications over say a 5 year period. Amlodipine is usually taken once daily. In some cases, lifestyle changes can lower or eliminate the need for blood pressure medication. Are we worse off? More importantly, bedtime BP med ingestion in this randomized trial of over 19 thousand hypertensive … [Circadian rhythm of arterial pressure and use of amlodipine in primary hypertension]. The so-called Hygia Chronotherapy Trial was extremely well done and the results are powerful and should modify clinical practice immediately. ), More importantly, bedtime BP med ingestion in this randomized trial of over 19 thousand hypertensive Spaniards resulted in highly significant reductions in cardiovascular events including death, heart attack, heart failure and stroke over a 6 year median follow-up. For example, there is a long acting form of metoprolol. I’m inclined to recommend bedtime and adhere to how the drugs were administered in this very positive trial. OH! It is well known that blood pressure medications can cause dizziness, sedation or even orthostatic hypotension (a significant drop in blood pressure when you go from a lying position to a standing position). Beta brain fog is a common issue, and improvements with bedtime dosing are an added benefit. On atenolol my HR would hardly go over 105-115… If the benefit to bedtime prescribing is real, that may be why." 2015 Nov 5;13:7. doi: 10.5334/jcr.ah. Surprisingly easy, but not sure how I will go with the upcoming festive season. Weight is a big factor in high blood pressure. Curr Hypertens Rep. 2018 May 5;20(5):43. doi: 10.1007/s11906-018-0843-5. It’s best to consult with your provider and inquire why they have prescribed to take in the morning or before going to bed. . Research has shown that, in people who are … I think a likely mechanism is the (mentioned) enhancement of the dipping phenomena. What about someone who now takes metoprolol tartrate 100 mg twice daily, after rising in the morning and with after the evening meal? Thank you both for sharing your personal experiences with nevbivolol – will discuss this with cardiologist next visit. It is not associated with depression or anxiety, or “brain fog” as much as other ß-blockers. I tried this some time back and though I did not track my BP (it is fairly low to start with, so I don’t worry about it much), I did notice a reduction in my tendency toward palpitations (probably PVCs associated with a baseline slow pulse rate). 2003;19(3):226-37. doi: 10.1185/030079903125001677. Yes , except the metoprolol is likely the tartrate form that is taken twice daily. Knowing the best time to take such drugs … I have a post in the works on nebivolol (bystolic) and I may have mentioned it in a prior post on beta blockers and feeling logy. Thanks for that! I just really enjoy a little scotch in the evening, or 1-2 glasses of wine with supper. This was exactly my question too. The Role of Circadian Rhythms in the Hypertension of Diabetes Mellitus and the Metabolic Syndrome. Note that stroke rate was halved! (I switched because I wanted more cardiac adaptability to exercise/running…). Amlodipine, a calcium antagonist of the 1,4-dihydropyridine type, has been shown to be effective in reducing blood pressure (BP) throughout the day and night when given once daily. Since learning about this a month so ago, I have taken my once daily dose of beta blocker at bedtime. “To everything there is a season, and a time to every purpose under heaven.”. gordon, My take on the data has been that increased potassium goes along with eating more healthy things-vegetables and fruit so I encourage that as opposed to taking supplements. You should know that Caduet Generic Amlodipine besylate/Atorvastatine begins to work immediately you begin your treatment. Some statins work best in the evening while others work just as well in the morning. If you wish to try it at night to see if it changes your tired feeling, that should not hurt anything. Drug interactions are reported among people who take Amlodipine and Crestor. I take Amlodipine once daily and Atenolol twice daily. When should you take your once daily BP meds? The phase IV clinical study is created by eHealthMe based on reports of 6,009 people who take Amlodipine and Crestor from the FDA, and is updated regularly. One common side effect of amlodipine is fluid retention, commonly called swelling. 1 NIH Now a study published in European Heart Journal in October has demonstrated that routine ingestion of BP meds at bedtime as opposed to waking results in improved 24 hour BP control with enhanced decrease in asleep BP and increased sleep-time relative BP decline (known as BP dipping. That helped with beta blocker at night. Find everything you need to know about Norvasc (amlodipine), including what it is used for, warnings, reviews, side effects, and interactions. Amlodipine is used to treat chest pain (angina) and other conditions caused by coronary artery disease. Bystolic is not generic! Selfridge JM, Moyer K, Capelluto DG, Finkielstein CV. Blood pressure and heart rate were measured by use of ambulatory blood pressure monitoring after a wash-out period of 1 week and after treatment schedules with 5 mg amlodipine once a day either at 0800 h or at 2000 h for 3 weeks. ROSUVASTATIN, EZETIMIBE, METOPROLOL, HYDROCHLOROTHIAZIDE. Might that achieve some of the benefits mentioned above? The longer lasting ones have a very flat curve with minimal difference between peak and trough levels over a 24 hour period when taken consistently. Get the latest public health information from CDC:, Get the latest research information from NIH:, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: A. . I really really like that medication… As a mostly ß1-blocker (at doses lower than 10 mg/day), it does not slow down the heart as much, and works by enhancing peripheral vasodilation and cardiac output. Common interactions include dizziness among females and chronic kidney disease among males. Medication for high blood pressure is more effective when taken at bedtime than the following morning. I also had brain fog and symptoms of depression under atenolol. Are there differences in the effects of long-acting calcium antagonists on ambulatory blood pressure? I take amlodipine 2.5mg per day at night before going to sleep.  |  CONCLUSION: The results demonstrate that, independently from the dosing time, the long-acting calcium antagonist amlodipine sufficiently reduced blood pressure in essential hypertensive patients without increasing the nightly drop. Is it a reason why Indapamine is not prescribe in USA instead of HCTZ. Exactly. Blood Press Monit. I tried for a few more days, but it didn't improve at all. Thanks BP is 97/57 and RHR 55 BPM. Do you know of any studies that would support your assertion? Please enable it to take advantage of the complete set of features! In my case, there is a nearby mountain with just the right slope. But what about those of us who rarely are in this complete resting state. Relevance for chronopharmacology in practical medicine. Is there reliable information about a temporary upper systolic level during the day, or what the average should be throughout the day? So overall I feel the benefits of no alcohol are worthwhile. METHODS: Twelve mild-to-moderate essential hypertensives were investigated in this open, randomized cross-over study. However, due to baseline values being lower during night-time, a significant (P < 0.05) reduction was observed only in systolic, not in diastolic, blood pressure. Thanks to my cardiologist. New research suggests that taking your blood pressure medication at bedtime may more effectively reduce your risk of illness or death due to heart and blood vessel disease. Omega-3 Fatty Acids and Cardiovascular Disease Risk: Has the Story Ended or Only Just Begun? This is good to know,because my blood presión medication is a Thiazide. You can slope run using an incline treadmill with up to a 30% gradient. It’s definitely got the least side effects of the beta blockers. I wonder what TSC thinks of replacing essentially all added dietary table salt (sodium chloride) with powdered potassium chloride, such as in this product: I’ll go read that post now. Now a study published in European Heart Journa l in October has demonstrated that routine ingestion of BP meds at bedtime as opposed to waking results in improved 24 hour BP control with enhanced decrease in asleep BP and increased sleep-time relative BP decline (known as BP dipping.) I’d love to know the answer but pending having that information I’m going with shooting for lower BP goals when we are utilizing the SPRINT type #s in our measurement. I always find that for me personally slope running, that is running at least 5.5 mph at a 18% gradient reduces my BP for 1 or 2 days afterwards. J Circadian Rhythms. Curr Hypertens Rep. 2018 Sep 28;20(11):97. doi: 10.1007/s11906-018-0897-4. The morning administration of a valsartan/amlodipine combination showed noninferiority to the bedtime administration in the change of nocturnal brachial and central SBP in … Extended-release nisoldipine versus amlodipine as a model. Though both amlodipine treatments more effectively reduced daytime blood pressure levels, the circadian profile was not greatly affected. Although a 2006 Cochrane review concluded there was insufficient evidence to recommend potassium supplementation in the treatment of hypertension more recent meta-analyses suggest a modest effect (5 mm Hg drop in systolic). After about 7 days of taking the med once per day at the same hour, regardless of the time of day taken, the concentration in the bloodstream will be at steady state. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Patients are too often taking PPIs in the morning and not eating breakfast or taking their drug before bed on an empty stomach. Would the lipid-lowering meds be okay to take at bedtime? This study doesn’t answer that question. So I guess if you do have sleep apnea (as I do), treat it… but whatever: take your BP meds in the evening. Chief Medical Editor, Harvard Health Publishing. 4 Other reported side effects include dizziness, fatigue, headache, palpitations and nausea, although these are generally not bothersome enough to cause discontinuation of the drug. Instructions for home BP measurements give me a low point and my level is below 120/80 (taking bedtime telmisartan). Why take amlodipine at bedtime? Amlodipine works by relaxing the blood vessels (arteries) that carry blood away from the heart to the rest of the body, causing less resistance to blood flowing in your arteries. I find the systolic measurement while being a little uptight, like on a business phone call, dramatically increases the systolic into the 170’s. Lowering the amount of salt in your diet and eating plenty of fruits and vegetables, along with whole grains and low-fat dairy foods, can have a positive effect. Did the trial data separate between types of BP meds and their relative effect to dosing period? Sleeping very well, and waking BEABT (bright eyed and bushy tailed) meaning bright alert and enthusiastic for the coming day, with none of the beta brain fog that often happened when taking beta blocker in the morning. Amlodipine is also used to treat high blood pressure. Maximal blood pressure values were significantly (P