Hi, I'm a boy of 25 years old, and because of high pressure (160/90) my doctor prescribed me Micardis to help control my BP.I have taken my Micardis dose (40mg) for the first time today at 2pm. I do realize now that taking it at that time is not a good idea, and I should switch to a 8am intake time. How do I proceed for the change:Do I simply start taking it a 8am right tomorrow?Do I skip one day in between to "start anew"?Do I clock it back, say I take it a 1:30 pm, then 1:00pm, etc until I get to 8am?Thank you in advance.JD
Person's Gender: Male
Person's Age: 25
Been reduced my sodium intake (approx 70% of DV) and started doing 2 hour of bike per day, but only since 5 days ago. Have only started taking med since today
Im a little stressed over this tho.
Considering I already took a dose today at 2pm, is it safe to take it immediatly tommorow at 8am?
or should I skip a day, or be more progreeive about this
I know its better to take it in the morning now
Thats why I want to change the time I take it
but every bit of information on micardis seem to heavily implie that constant time taking is crucial
and immediatly changing to 8am right tommorow might not be wuise since it would be ealry since last intake
how is that
Your situation is different, because you haven't been taking the med for too long.
In hospitals, they are very strict about times.
Daily = 9am by me. Bedtime = 2200.
All meds are given around those times. Period. Unless the MD wants a specific dose.
so there should be no "spike bucket" effect then?
However, if the patient comes in at let's say 9 pm , the MD may want a dose now, and then start the regular dosing at 9 am also.
Not so much. Especially since it is so close to 8 am. 2 pm isn't to far off.
By all means, if you feel more comfortable dosing 1:30PM, 1 PM, etc. That is fine.
However, from a clinical stand point, the drug isn't even at "steady state" in your body yet, so the quicker the better you change it.
You may even try to take it at 10 AM tomorrow, then 8 am the next day. It really is up to you. But I think whichever way you do decide to go, you will be fine. :)
As long as I'm constant about it, right?
Yes very constant.
Is it better to take it with food or not? been planning to take it before eating, but just to make sure
Sometimes people miss a dose, it happens. General instructions for those are NEVER double up on a dose, just take it as soon as you remember.
Do you take any other medication?
No, but I have tried to inform myself a bit avout this, and the ponly other med I take sometime is ibuprofen because im subject to headaches. As far as I can tell, I should not take motrin, but switch to tynelol if heacache arise. Is that true?
sorry for the typoes
I was disconnected sorry
You can take Micardis with or without food
If you do take thyroid medication, you shouldn't take this med with food
See how it feels before breakfast, it really doesn't have too much effect on the stomach. Everyone is different though.
It isn't like, for instance Naproxen, that is better to take with food
Are you still in the chat?
Just want to make sure I am not having problems
Ah ok good.
Also, how much salt intake are you consuming?
People generally say no more than 2.3 grams of sodium/day
But a little less I think is better. Sodium can raise BP significantly
That is usually the guidelines, 2.3grams a day.
before I could go over 250% DV a day. I now keep myself around 65-70%, just above minimum
minimum being 1.5 grams
Also it may take a little bit for you to see an effect.
I have been told 2 months.
Being a mathematician, I dont do lot of exercices, and not being able to cook led to more restaurant wic lead to massive salt intake. I have been changing thses two habits for the past week.
You want that BP to come down quite a bit. 160/90 = Stage 2 hypertension. The doctor may want add another drug in the future just in case it doesn't come down fully
It depends, sometimes a month is sufficient.
But my schedule is a bit crazy, so thats why I decided to start at 2pm, but now i have been thinking on changing it at 8am, as said before
Yes, I agree, the earlier the better, and always on time.
It isn't going to be terrible if you are off by an hour or two, it will be OK
but always try to remain on schedule.
Let me link you to some other steps you can do to lower your BP
more so for 40mg, or does that not matter at all?
Some non drug options
Not so much, the thing with Micardis is that it lasts 24 hours.
Some other blood pressure medication must be dosed twice a day, or three times a day.
See, the problem with those drugs, such as clonidine, is the risk of rebound hypertension
Those who have to be worried about that effect the most.
Clonidine is a very potent dilator. The route it works is different from other medication.
When the body doesn't have clonidine , or a dose is skipped, blood pressure spikes.
Therefore the medication has to be withdrawn very slowly.
Same with micardis?
Beta blockers, such as Coreg have this effect, and are usually dosed twice a day.
Most blood pressure medications- Yes, you have to decrease very slowly
But Micardis lasts 24 hours, therefore, a few hours of missing the medication will not be so detrimental
If a patient doesn't have clonidine for a few hours, his/her pressure may skyrockert, because it is so short acting.
I want to avoid taking any more med thou. Is there anything else appart from exercices and sodium I can do to lower bp?
I have some good hypertension information too, let me see if I can dig it up
Yup I am going to give you some information.
A BP 160/90 , however, needs to be treated promptly with medication.
Are you familiar with Adobe Acrobat reader? AKA PDF files?
Shame I have to worry about this at my age. But I had an ecg which pointed to possible infractus, which I din't have, so my doctor think I may have hearth malformation. But unless confirmation I am not relying on this, and i'm going to do whatever I can to lower this BP. I understand that med is needed for thr time being, but I donM't want the situation to get worse.
yes, I am.
I am sorry to here about that.
Trust me, I've had stress related BP issues myself , it really stinks. My BP is still high, I really need to make lifestyle changes myself.
Let me fetch this link, then we can discuss it a little bit, how does that sound?
This is the motherload for all blood pressure lowering guidelines
Go to page 26
Read that little chart, and let me know when you are done, so we can discuss
JNC 7 = The guidelines for hypertension
It is what clinicians use as a handbook.
I have a little extra information on those things in the chart I can explain
okay give me a sec.
So as you can see, it really isn't a myth that alcohol is good for you.
In moderation, it is actually part of the plan to lower BP.
Weight loss, in my opinion, is the most important thing here.
Are you overweight?
200 pounds. Never drank alcohol or coffe in my life too, since I dislike coffee semll, and there is too many alcoolics in my family, and I'm kind of a potoman, so I avoid alcohol as prevention.
overwight is more on restaurant and the fact that I do little exerccise
next to none, but changed that recently.
Good.. Yes you will see quite a change.
to 2hours bike ( to work actually) per day
If you drink soda, stop drinking it and replace it with water
In school, we were learning about studies being performed about people stopping soda intake.. and I remember one study, patients had lost on average 13 pounds.
well i drink a lot of water, like 4-5 liters a day ( thats why I said I'm a bit of a potomane)
Ok good, that's awesome.
Yes, insane right?
I used to be a cross country runner myself.. Then as soon I stopped running I gained so much weight.
I drank a LOT of soda in college
Up late.. Grab a red bull.. Or some Pepsi..
It all adds up. I stacked on the pounds nonetheless.
It really does help though. Just that alone is so vital .
never had energy drink either, and I don't like sugar or chocolate. It was more aboutch chips and french fries and burger honestly.
You saw the part about the DASH diet right? That is another key element. I know you hear it all the time on television, from doctors etc..
But it is true.. Diet and exercise is very important.
Just by doing those things alone, will drop your BP. If you get to a normal BMI (Body mass index ) you'll see your pressure will come down too. Sodium intake reduction helps a LOT too
I see. this pdf is really useful, I should read that tomorrow.
That is the motherload. I don't let my customers down. :)
Is there a general source for getting theses studies for the general public?
What about stress management? How are you with stress?
Yes, for the most part I can give you the names of major guidelines
The studies are a little tougher for the general public to find.
I read and researcha lot (kind of my job) and informations on nutrition and meds and such seem contradcitory or hard to get sometime
However, the actual "Gold"standards are easy to find
stress is usally high, but I menage it well, if it does make sense
ATP III is for cholesterol. GOLD guidelines is for asthma/COPD. JNC 7 ( JNC 8 is coming out this year) is for high BP
You have to manage stress. I can get stressed easily. I work two jobs, late hours. I have to really start putting an exercise plan in motion myself. It helps out a lot.
I've just been exhausted with family issues and work. But for now XBox makes me happy lol...
Also, I've taken on gardening.
Not only do you learn a lot about the plants, but also, the stuff you grow can be awesome health wise.
Well I do reasearch in mathematics, economics and cumputer science, teach to high school and do seminar at universities, so my schedule is kinda hectic lol
Last year I grew a lot of lettuce, peas, corn, brussel sprouts..
Again, these are all things you must enjoy .
They certainly help destress myself. Stress is very detrimental to the body.. So is lack of sleep.
I did some apps for a company 3 years ago. I learned C at 14 years old, I should keep myself good a t it, havent practiced since a long time
So you have to find a niche, something you really like. You'd be surprised how much it helps.
I always wanted to learn any time C based language, just never had time. My schedule has been easing up a bit, so I've been learning JS for now. I love it. Feels good to learn something.. The sense of accomplish certainly helps.
If you look at that chart ,on page 26, you can see just by lifestyle changes alone, for some people, can change a LOT
Thats what I'm going to do. Thank you for your time.
For a baseline pressure of 160/90, it may/may not be affected solely by lifestyle alone. I'd want to see you on Micardis to be honest until you have the pressure come down a bit
Micardis, and the class of medications, are great drugs.
Not too many side effects, lots of mortality/morbidity changing things that are associated with the drugs.
I know, I need to accept the fact that I'm taking the meds. I just hope this will settle down and I will be able to drop them in an year or so.
Preserve kidney function, great for Heart failure patients, etc.
And you very well may be able to.
Key things- Weight loss, Sodium reduction, stress reduction.
Work on those, and I promise you, you'll see a difference.
okay. Thank you very much.
I know, especially in the US it is hard to eat right. especially when you are on a busy schedule
But once it becomes routine, it is a lot easier.
well canada, not very different on that aspect.
Do you need help with anything else friend? Any other questions?
Oh for sure. fast food is an epidemic .
no I'm good.
Have I answered all the questions you had?
Great bud. Def read over the JNC-7 guidelines.
yes you did. and yes I shall read this.
It has a lot of useful information. In the future, if you need any studies pulled or any other guidelines, shoot me a line .
Great, am happy to help.
If you are satisfied click accept. If you have any last minute questions, be sure to click reply before accepting .
no im good. im just gonna copy all this for future references and click accpet thereafter.
I hope you have a great night. And like I said, don't worry too much about the Micardis. One day starting at 8 am tomorrow is fine. It will take about 5 days for that drug to build up completely in your body. So you are fine. :)
Steady state = 5 X Half life of drug ( in this case, micardis is ~ 24 hour duration ) = 5 days
okay. Im going to accept now. good night.
You too . I'll be here if you need anything else. Enjoy your night . :)
Hospital Pharmacist, with solid clinical knowledge.