Severe headaches and extremely high blood pressure

[OldGuysRule]

Seven months in on Lupron and Zytiga with typical SE and suddenly in the middle of the night, my head starts splitting with pain and blood pressure shoots to 222/122. I have never had high blood pressure so this a new event for me. I called my MO and his nurse said (after speaking with the Doc) to go to who ever manages my blood pressure, but I don’t have a Doc that does that because, I DON’T HAVE HIGH BLOOD PRESSURE!!!! They said it was not related to the meds. I looked it up and high blood pressure and headaches are listed as side effects. I ended in the ER. They only ran test and never did anything to lower it. It came down on its own. Any experiences similar out there?

[Fightinghard]

yes. I had several unexplained spikes while on xtandi. Not quite a high luckily mine hit 199. I do take bp meds daily so was able to immediately double dose for a day and it dropped right back down. No more xtandi now since it eventually failed and no more spikes so far

See if your dr will prescibe a couple days of bp meds for you to have ready if it spikes again

[OldGuysRule in reply to Fightinghard]

Thanks for your reply. I need go see an internist who gave me some BO meds.

[Spyder54]

I have been playing Pickleball 5x per week. Never a prob, until last Monday. I felt a bit fatigued and looked at my APPLE 8 watch, and it read 195 bpm. I was playing. Told my partner. We stopped play, and sat down in the shade on a bench. Stayed up there for 4 minutes. Took an EKG, with watch, and it said I was having aFib (1x only) which can lead to stroke. 220- your age (69)= 151bpm (should be my max bpm). After 4 min I webnt down to 105 bpm. Took another EKG= nothing. Did 4 more later thru day. All good.

Maybe you had an aFib situation? Mike

[OldGuysRule in reply to Spyder54]

it’s possible it started out that way. I have had three heart ablations, one for flutter, one for pvc’s and one for afib. I definitely know what it feels likes but I don’t as asleep when I all started. Thanks!

[lewicki in reply to OldGuysRule]

I think the oral medication for ADT has less side effects than Lupron. See if you can get it changed. There are other pluses to it over Lupron .

[tango65]

It may be related to the medication if the hypertension is persistent meanwhile you are on Zytiga.

Zytiga causes an increase in aldosterone which leads to water retention (edema), sodium retention, hypertension and low potassium (hypokalemia).

To avoid this problem (increased aldosterone), Zytiga is given with prednisone. Prednisone reduces the production of the ACTH which stimulates the adrenals and increases the production of aldosterone.

One way to try to control persistent hypertension when on Zytiga is to increase the dose of prednisone (to reduce even more the production of ACTH). If you are taking 5 mg of prednisone you could discuss taking 10 mg and see what happens.

If you are on 10 mg of prednisone and the hypertension continues, you should discuss adding eplerenone (Inspra) a specific aldosterone receptor blocker. You could start with 50 mg and if needed go up to 100 or more until control of the hypertension.

[OldGuysRule in reply to tango65]

Good information. I am on 5 mg if prednisone. I’ll ask my MO this Tuesday.

Thanks

[tango65 in reply to OldGuysRule]

If your BP continues to be elevated, it would be something to discuss with your doctor.

I prefer using eplerenone since prednisone has also mineralocorticosteroid activity.

I wish you the best of luck.,

[Fightinghard in reply to OldGuysRule]

i was on 5mg too. But dr changed to 10mg